Integration of HIV/AIDS activities with food and nutrition support in ...

Emphasis on participatory and community-led approaches. The cultural beliefs and practices
of refugees may affect how they perceive issues such as HIV testing, condom use and care
for HIV-infected patients. Collaboration among clinic-based and traditional health care providers
requires mutual respect. Each must recognize the other’s areas of expertise and potential
contributions to community health.
Logistics of implementation. Facility-based and traditional health care providers should meet,
possibly under the umbrella of an HIV/AIDS committee, to identify the relative strengths and
weaknesses of the two types of service in HIV/AIDS diagnosis, treatment and long-term management.
Together they should identify areas in which additional training and capacity-building
are needed, and draw up a training action plan. A formal referral system may be established to
ensure that patients receive appropriate care in a timely manner, drawing on the strengths of
both types of service.
How would this integrated programme strategy be monitored?
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Programme-level indicators Population-level indicators
Input/process Output Outcome Impact
• No. of formal and traditional
health care providers receiving
HIV/AIDS and nutrition training
(by type of caregiver) (and %
of planned)
• No. of training sessions
conducted (and % of planned)
• Amount of materials
distributed (and % of planned)
• % of targeted formal
and traditional
health care providers
adequately trained in
HIV/AIDS and nutrition
(by type of caregiver)
(and % of planned)
• Reduction
in high-risk
practices by care
providers (by type
of practice)
• Referral practices
among providers
• Caretaking
practices for
PLWHA within
the home
• HIV prevalence
• Crude mortality
rate (with
age-related
distribution if
possible)
Experiences from the field…
Kala and Mwange Camps, Zambia. The NGOs, Aktion Afrika Hilfe (AAH) and the Red
Cross (ZRCS/ IFRC), took dramatically different approaches to working with traditional healers
in Kala and Mwange Camps, respectively. Both are the types of health care provider training
programmes that could be supported by use of food resources where appropriate.
In Kala, AAH participated in the Kala HIV/AIDS Task Force (chaired by the Zambian NGO,
HODI), and successfully distributed large numbers of condoms at the health clinic. AAH also
conducted training sessions for traditional healers on the risk of HIV transmission associated
with traditional health practices, such as cutting and scarification. When interviewed, however,
some of the traditional healers felt that their health care skills were not recognized by AAH, and
that their relationship with AAH was competitive or non-cooperative rather than collaborative.
As a result, some traditional healers were unwilling to refer clients to Kala Clinic, and were
treating suspected HIV/AIDS cases with traditional treatments, involving in some cases several
months of vomiting, diarrhoea and spiritual cleansing.