Re: [pronut-hiv] Topic 1: Promising Approaches in Nutrition -HIV Integration

["Tadayo Hanna" <ctungo@yahoo.com>]

   Dear Robert,

   Thanks for the discussion below. Actually from my experience some of
   the pertinent issues that have come up through the use if the
   guidelines in Kenya is that service providers trained using the
   guidelines will always raise the following concerns:

   1. That their patients do not have access to the nutritional
   supplements ( i.e others understand it to mean that the training goes
   hand in hand with provididing Nutritional supplements to their health
   facilities for distribution to all their PLHIV patients/clients
   regardless of the eligibility criteria)

   2. That they have no uniform way of capturing their data and reporting
   as well as lack of  the data collection tools

   3. That they lack  uniform basic anthropometric equipment/supplies to
   assess their patients( MUAC tapes, weighing scales etc) hence minimal
   reporting rates

   4. That the information relating to management of infants and young
   children in the context of HIV is limited in the guidelines and should
   be strengthened to support service providers who provide services in
   the Comprehensive Care Clinics for both adults and children


   Recommendations.

   1. Advocate for Provision of uniform/standard basic
   anthropometic supplies  to all HIV clinics( MUAC tapes, weighing
   scales and height/length boards)

   2. Advocate for printing and provision of data collection
   documentation and registers on Nutrition-HIV to all HIV clinics along
   side other patient forms for uniform data collection and reporting

   3. Advocate for intergration/strengthening of IYCF component in the
   context of HIV into the guidelines


   All in all strengthening the M&E component through training and
   provision of basic data collection supplies and uniform reporting
   tools will go along way in providing the  desired results.



   I look forward to your input.

   HANNA C. TADAYO
   NUTRITION AND HIV/AIDS SPECIALIST
   INTRAHEALTH/CAPACITY PROJECT
   C/O NASCOP(KNH GROUNDS)
   TEL: 0722 278 582/ 0726 457990
   NAIROBI

   ---  Dr. Robert Mwadime <rmwadime@rcqhc.org> wrote:

     Now let's discuss our experience and feelings, suggestions etc. on
integration of (or is it "link"?) nutrition and HIV interventions. To
help facilitate the process of integration, a number of countries have develope
d
"guidelines on nutrition and HIV/AIDS" (some countries were shy so
they called it nutrition and "chronic diseases").  

I propose that we start by giving our experiences on the (development and) use
of guidelines on nutrition and HIV/AIDS. Are they used in the integration
process? Are there concerns on the guidelines we have? What are the promising
issues in use of national/international guidelines on nutrition and HIV?

Please let us keep to discussions on use of guidelines (or policies) and the
experiences we have. 

We shall move to other integration issues soon.
  

Robert Mwadime (Ph.D, MPH)
Regional Senior Nutrition 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

NB/

We look at integration from two main lenses. 
One, that nutrition services are provided as part of care and treatment
interventions for PLHIV. Initially this was not heard off and many clinicians
(including funders of programs) were resistant to this. Whenever they heard of
nutrition, man, they interpreted it to imply "food assistance for the food
insecure". And when nutritionists sat on the same table with HIV/AIDS
experts they had little to share, other than the 4/6 food groups and cookery
demonstrations. We have come from far as relates this definition. 

The second lens is that of protection of means of livelihood/production (or
restoration of resource assets) that are the means of food security for the
household. We have had to improvise new (or old??) production techniques (and
social networks) and sometimes provide food assistance to reach households
affected (or infected) by HIV in order to mitigate against the effects/impact
of the disease. A lot of resources have been invested in this definition but we
have a long way to go still.