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

["Dr. Robert Mwadime" <rmwadime@rcqhc.org>]

Thanks Hana..........Very detailed BUT informative. Thanks.

Robert 



-----Tadayo Hanna wrote:

Dear colleagues and friends,

In kenya, NASCOP( National AIDS and STI Control program) is one of the
departments of the Ministry of health Kenya that handles HIV related
issues(prevention,care, treatment and support).NASCOP provides support to
the Government through the Ministry of health by participating in policy and
guidelines development, resource mobilization and coordination of activities
relating to HIV.

With funding from different sources that include PEPFAR, Global Fund
and various Donors, the key personel;in the different units within NASCOP
(PMTCT, ART, TB, Nutrition, HBC etc)  formed linkages with various
partners to develop Technical working groups and subcommmittes to chart the
way forward for their units.


Nutrition being part of the core component in NASCOP plays a role that cuts
across other units and this lead to the formation of a Nutrition Technical
Working group with representation from all sectors.
the TWG has representation from FANTA/AED, UNICEF, WHO, WFP;Institutions of
higher learning(Universities), National Aids Control council, CDC; National
Referal Hospitals, Research Institutions as well as other HIV Care and
Treatment Implementors.


The TWG holds Quarterly meetings and plays the think -tank role for new
initiatives based on identified gaps as well as borrowing from best
practices. 

The representatives are Nutrition point persons;from the various
organizations/institutions.(Multi sectoral approach)
The need to standardize messages on Nutrition and HIV across; the country
lead to the development of National Nutrition guidelines on HIV and other
materials. Various organizations took the initiative by funding the process
or giving technical support to develop the materials. The roll out strategy
is done through training of National TOTs followed by Training of frontline
service providers who implement HIV services in health facilities (Doctors,
nurses, clinical officers, pharmacists etc.) To speed up the process, a
decentralized approach has been adopted so that the trained Trainers can
carry out trainings regionally at provincial level and this cascades
downwards to the districts and health facilities.

The National office plays a coordination role to mobilize resources and
ensures availability of materials to be diseminated  and provision of
serialised certificates. This provides a database of all those trained hence
forms a referal system for others to utilize the resources available. The
materials that have been developed and adopted include ( National
guidelines on Nutrition HIV,Nutrition HIV curriculum, wallcharts, Toolkit,
Trainers manual, flipcharts); These materials are used at HIV Care service
points (Comprehensive Care Clinics)
 
The new initiative with Support from FANTA/AED is to carry out a mapping
process at community level ( Linkage from facility- community) so as to
develop simpler IEC materials for use at the community as well as other
services at community level.

A national Nutrition HIV strategy has been developed and will be available
for use soon. It supports the intergration of Nutrition and HIV into other
sectors- (Education, Agriculture, etc)

The TWG meets quarterly and there are subcommittes that have been initiated
to look at various components including M&E, training and food and
nutrition supplements/ commodities .

Through NASCOP and the Ministry of Health, alot has been achieved with
support from various people and organisations/institutions.
This initiatives require a lot of commitment and resources ( Time, money,
and people).

I wish to thank you all for role you have played in supporting the Nutrition
and HIV agenda.

I hope all of you will continue steering the process forward for the benefit
of all HIV patients/ clients who need our support.

HANNA C. TADAYO


--- Dr. Robert Mwadime wrote:

Colleagues and friends

Already good discussions. I am getting excited!!! LETS KEEP IT MOVING.

A number of us have asked questions. That is great, and I will be providing
some clues and summarizing some key issues. BUT, meanwhile we should also
provide responses and offer discussions to some of the issues raised.

For instance Madam Hana Tadayo of NASCOP could easily explain to us
(specifically to Stella) the process that the Kenyan Technical Working Group
used to develop the Nutrition Guidelines for PLHIV in Kenya. Others from
other countries (e.g. Beatrice from Zambia, + Marjorie in Namibia, TFNC
friends from Tanzania, Hana in Ethiopia, Samalie in Uganda, + Rwanda, + RSA,
+ Zimbabwe, ++++++) can also tell us how they did it.....But more important
whether you consider the process as adequate/participatory to produce a
quality and acceptable product. 

Please let us also offer suggestions to the other questions/issues.......it
is OUR discussion. Here are some of the issues that have coming out so far:

Guidelines by themselves are not enough, service providers need training.
How do we operationalize technical recommendations (RDA, 10% additional
energy, etc)
What are the indicators to monitor progress in implementation of guidelines?

How do we have uniformity among different partners/programs?
How do we involve community-based programs in nutrition and HIV efforts in
the guidelines?
Guidelines have little on integration of the general nutrition aspects, e.g.
ENA.

LET US HAVE YOUR QUESTIONS/ISSUES BUT ALSO GIVE COMMENTS....

On Friday I will try to summarize some of the issues; then we shall move to
another aspect of the integration.

Robert Mwadime (Ph.D).