Nutrition and HIV/AIDS: A Training Manual - Linkages Project

Africa, however, showed no increase in morbidity or mortality among breastfeedingwomen (Coutsoudis et al 2001). WHO issued a statement on June 7, 2001, that thereis insufficient evidence on the issue and additional research is needed.Interventions to prevent MTCTCase studies from relevant countries should be included as examples whenfacilitating this section. For this module, the Ndola Demonstration Project in Zambiais used to illustrate various aspects of community PMTCT programming. Include box1 as a handout, or develop another example.Box 1 Ndola Demonstration Project, Zambia (slide 23)In 1997 the LINKAGES Project began a demonstration project with the Ndola DistrictHealth Management Team and the National Food and Nutrition Commission inZambia to introduce voluntary counseling and testing (VCT) and improved infantfeeding counseling into antenatal care and community services. Other partnersincluded Hope Humana and the Horizons project. This pilot project included thefollowing interventions:• Formative research• Policy and advocacy (for the Baby-Friendly Hospital Initiative, International Codeof Marketing of Breast-milk Substitutes, and national policies and guidelines)• Training of health workers• VCT for pregnant women and their partners, including prevention• Infant feeding counseling and support• Improved care and nutrition during pregnancy and delivery• Community support• Antiretroviral prophylaxis (Nevirapine)LINKAGES offered three training courses to strengthen the knowledge and skills ofhealth workers. All health professionals attended a 12-day basic course on HIV,PMTCT, and infant feeding. Some participants then participated in an 8-weekcounseling course developed at national level with significant input from the Ndolaprogram on the infant feeding and HIV component. Health staff who completed bothcourses were trained in a 2-week training of trainers course so they could facilitatetraining of other health workers in the 12-day course. Both the 12-day and 8-weekcourses were adapted and offered to community health volunteers and traditionalbirth attendants. In 2002 the program expanded to other sites in Ndola District andto the districts of Kabwe, Kapriri-Mposhi, Livingstone, and Lusaka.194