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

["Jean Tshiula" <jtshiula@aed.org.za>]

Dear Dr Mwadime,

Thank you for facilitating this discussion on integration of nutrition and 
HIV interventions. I am confident that I will learn a lot from this forum.

One of my main concerns is the tanslation of nutrients requirements as 
stated in our guidelines into food consumption. What does one RDA of each 
micronutrients means for PLHA in the African context? On the other hand, and if we can provide micronutrients supplementation, do we know any multiple micronutrients supplement found on the market that contains one RDA of those micronutrients we are talking about? How do we address this? We also say that asymptomatic people living with the virus need 10% more energy, what does it mean practically in terms of specific message(s) to be given to an HIV-infected client with all these problems around food intake? 

This may look obvious for some of the colleagues nutritionists or dieticians but can be very challenging for some of us in the field. Is high density food by  prescription THE solution? Kindly share information on what countries have done to overcome these challenges.

Jean T. Tshiula (MD, M.Ped)
Senior Technical Advisor
Academy for Educational Development
Capable Partners South Africa
Tel: +27 12 423 8600
jtshiula@aed.org.za



-----  "Dr. Robert Mwadime"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 
> developed "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.
>
>
>