National Nutrition and HIV/AIDS Guidelines for Service Providers of ...

4.3.3 Clinical
The key in clinical assessment is to identity physical manifestation of nutrient deficiencies or excesses.
This requires a lot of skill and experience. Careful examination of eyes, hands, fingers, hair, mouth,
gums and skin, tummy and body shape can provide valuable information for nutrition assessment.
4.3.4 Dietary
Dietary assessment evaluates the adequacy of the food and the nutrients consumed. This involves
assessment of eating patterns, frequency of meals and the factors influencing the choice of food
procured. The underlining objective is to establish the client's ability to consume enough amounts and
variety of food to meet his/her needs. A variety of methods are available for use. Some of these are
food records, dietary history, 24-hr recalls and food frequency. The choice of the method should match
the characteristic of the clients. It is best to use a combination of methods that will adequately reflect
the clients' usual intake, current intake, dietary preferences and practices, food intolerances and any
dietary changes that may undermine dietary intake. Dietary assessment should also capture
information regarding the use of food supplements or substances used as such.
4.3.5 Environmental status
The physical, psycho-social and economic environment in which PLWA live may also influence their
nutritional status. These environments may negatively affect food security, balance and variety in
diet, frequency of meals and methods of food preparation. For example, PLWHA who are temporarily
debilitated by illnesses may find it difficult to purchase, prepare, and eat food, while poverty, lack of
refrigeration or lack of appropriate cooking facilities, may restrict the choice of food. Some PLWHA
may also find it difficult to access social safety net programs or fail to collect their food supply if
already enrolled in safety net programs. The amount of food consumed at each sitting may also be
restricted by factors such substance / alcohol abuse, depression or senile dementia. All these factors
have a bearing on the overall nutritional status of PLWHA and should receive prompt attention as do the
ABCDs of nutritional assessment.
Proper utilization of nutritional assessments methods enables providers to
° Establish the correct nutritional status of PLWHA
° Confirm the adequacy of recommended interventions and prompt providers to review
the interventions.
° Confirm the absence of illnesses that aggravate nutritional wastage and provide
treatment for illnesses that reduce food intake.
° To adjust meals and meal plans for other chronic illnesses associated with HIV.
° To facilitate provision of therapeutic nutritional care and support PLWHA
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