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

["Godwin Ndossi" <gndossi2@yahoo.co.uk>]

Dear Colleagues,

Let me also provide a short account of our experience in Tanzania regarding development of guidelines on nutrition and HIV/AIDS. Our first experience was in the mid 1990s when nutrition professionals at the Tanzania Food and Nutrition Centre (TFNC)developed draft guidelines on nutrition and HIV/AIDS. These set of guidelines were not widely circulated but were quite useful locally at the time. To our knowledge only Zimbabwe had developed a Nutrition Guide for People Living with HIV/AIDS by that time. HIV/AIDS and Nutrition by Piwoz & Preble-AED came out later in 2000. In early 2001 a team from TFNC developed another draft guiedelines that were presented at a stakeholder workshop for comments and inputs. The improved draft was subsequenly shared among a wider spectrum of in-country stakeholders for further input. The list of stakeholders included:

-	National AIDS Control Programme (NACP) 
-	World Health Organization (WHO) 
-	United Nations Children Fund (UNICEF), Service 
-	Health and Development for People Living With HIV/AIDS (SHDEPHA+) 
-	Tanga AIDS Working Group (TAWG)
-	Centre for Counseling on Nutrition and Health Care (COUNSENUTH)
-	Sokoine University of Agriculture (SUA)
-	African Medical Research Foundation (AMREF)
-	Pastoral Activities and Services for People with AIDS Archdiocese of Dar es Salaam (PASADA)
-	Alcohol and Drug Information Centre/Tanzania Assistance Strategy (ADIC/TAS)
-	Family Planning association of Tanzania (UMATI)
-	Tanzania Home Economics Association (TAHEA) and 
-	Ministry of Community Development Gender and Children. 

So the process was very participatory and at the end of it (2003) we produced a National Guide on Nutrition Care and Support for People Living with HIV/AIDS. This Guide was a useful reference material for differnt groups and individuals providing nutrition care and support for PLHA. It was also translated into the national language "Kiswahili".

Concurrently we developed Guidelines on Healthy Eating for PLHA in Kiswahili. Also various brochures addressing specific issues on nutrition of PLHA. Out of a felt need we have also developed a draft Training Manual for Home Based Care Providers. This draft is in use as we continue to refine it.

I hope that this account will provide additional experience from yet another country in the sub saharan region. We have noted with appreciation all of the good comments and issues raised by colleagues on the forum and hope to learn more from the rich experience of all.  
 

Godwin D. Ndossi, PhD
Managing Director
Tanzania Food and Nutrition Centre
22 Ocean Road
P.O. Box 977
Dar es Salaam, TANZANIA.
Tel:(255-22)211 8137/8/9
Fax:(255-22)211 6713


--- 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).