[pronut-hiv] Supplementation for moderatelymalnourished HIV-infected children - Share your experience)

["cener" <cener@wananchi.com>]

Dear Pronut Forum,
I completely agree with Dr. Mwadime. Experience is the best teacher. So lets share these experiences and stop recommending all those Costly Abbot  products and the likes because even you cannot sustain consumption of them. But we are talking about the low income person, is more affected than the middle and high income group. Let's be realistic. There are so many relief work going on with WFP and other organizations, if they belong to this forum, can they please share their experiences. I am personally  benefiting from this discussion.

I do a lot of radio and television education, for Kenya and BBC world service. What will I tell that mother who is listening and is living a in remote region where there is no relief food or some kind people to distribute the plumpy nut and the like. How about the mother whose child is not HIV and does not meet the criteria for food by prescription?. 99% of the time, we need to be very practical realistic and make recommendations that are cheap and sustainable.

Thanks you, I am reading on.


Alice Ojwang-Ndong
MNutr (Stellenbosch), Nutrition and Dietetic Consultant
Center for Nutrition, Education and Research
P.O.Box 8105 - 00200 Nairobi
Kenya
===============================
Tel: +254-2-2711447 (direct) 
Cell: +254-721939067
Email: Cener@wananchi.com/xenihealth@wananchi.com
Website: www.xenihealth.com
" Healthier choices, longer lives"
 

-- Dr. Robert Mwadime wrote: 
  
  Friends,

  I think this forum will benefit more from field examples and experiences,
  rather than "theories and wishful thinking". Lets share experiences that
  have worked or not worked. For example Lungi could share with us where they
  are using the "positive deviance model" to address moderate malnutrition and
  it has worked effectively in the context of HIV. Or examples of where RUTF
  was used to treat severe malnutrition and it was not sustainable. George
  could tell us where Plumpynut has been used among PLHIV and it resulted in
  increased diarrhea or oral thrush among people living with HIV; and what
  they did about. Otherwise we shall not move-forward to solving the
  nutritional problems in Africa/Asia. 


  Robert Mwadime (PHD)
  Regional Senior Nutrion and HIV/AIDS Advisor
  Academy for Education Development (AED)
  Food and Nutrition Technical Assistance (FANTA) Project
  c/o Regional Centre for Quality of Health Care,
  P. O. Box 29140 Kampala, Uganda
  Tel: +256-772-517438, 752-587635, 414-530888
  www.fantaproject/www.aed.org

  -----Lungi Lumumba Okoko wrote:

  Dear all,

  Why not not use local food and knowledge to rehabilitate moderately
  malnourished children, instead of using food aid (in the form of PlumpyNut
  and others)?

  What happens when PlumpyNut or whey protein is no longer available to the
  community? How will they rehabilitate malnourished children if they have
  been taught to think that external food is the cure?

  In my opinion, using behavior change approaches, such as the positive
  deviance/hearth approach would be more sustainable. Even with HIV infected
  children, some mothers (or caregivers) engage in behaviors and practices
  that result in good nutritional outcome for child succeed. Why not use the
  positively deviant caregivers as models to teach mothers of moderately
  malnourished children new locally acceptable and affordable practices in
  terms of feeding, care, and hygiene?

  For more on positive deviance visit: http://www.positivedeviance.org/

  -Lungi


  ------ George Carter  wrote:
  >
  > Geoffrey - wow!! The dreadful thing to many outside Africa is the
  > notion that Plumpynut sounds like the better than abject starvation
  > so many face--but you are absolutely correct. And a high fat
  > intervention for people with HIV can be problematic with all the
  > attendant gut problems (let alone high sugar feeding candida).
  >
  > Which brings me back to the notion of a fortified whey protein (or
  > some such protein source). What I think we know is needed is high
  > protein and micronutrient repletion. At least from a nutritional
  > standpoint - let alone the need for things like gardens, fresh
  > vegetables, reinvigoration of older farming techniques that use
  > forests and don't burn them for corn for diesel.
  >
  > We need a lot in this world but we're not going to ever get it in
  > Africa. What do African kids want? What do their (still living)
  > parents and guardians need?
  >
  > I think Plumpynut does remain a bit better than nothing. Hey--in the West
  > you can make garbage like that and sell it for an outrageous price--you
  > don't get  shot. You get rewarded!
  >
  > George M. Carter
  >
  >