Food and Nutrition in the context of HIVAIDS

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Food and Nutrition in the context of HIV/AIDS
Uganda Partnership Forum, 29-30 November
2004 WFP-AVSI NGO Collaboration
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• Structure of the presentation
• HIV/AIDS and the importance of food security
• Role of Food in HIV/AIDS
• WFP food support to HIV/AIDS Activities in Uganda
• The AVSI field experience
• Challenges and issues to be addressed

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• HIV/AIDS and the importance of food security (1)
• AIDSs greatest impact has been in developing
  countries where agriculture is the predominant
  sector, and where majority of the population live
  in rural areas

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HIV/AIDS and the importance of food security (2)

• Up to 80 per cent of the population in HIV/AIDS
  affected developing countries depend on
  subsistence agriculture crops, livestock and
  other natural resources as the mainstay of
  economy and export earnings and agriculture,
  forestry and fisheries traditionally provide
  vital safety nets for rural communities.
• Chronic malnutrition in these countries is up to
  38 due to underdevelopment and social amenities
• Good nutrition is often the only means for
  people to slow progression from HIV to AIDS.

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HIV/AIDS and the importance of food security (3)

• HIV/AIDS is increasingly being recognised as a
  cause of hunger and continued food insecurity,
  particularly in the African context
• Food-insecurity often triggers response
  mechanisms which undermine the viability of
  livelihood strategies and may place individuals
  at greater risk of HIV infection.
• However, the loss of productive members of
  society to AIDS, leaving the orphans, youth and
  the elderly as the main breadwinners, severely
  affects household capacity to sustain
  livelihoods.
• Improved nutrition enhances effective AIDS drug
  utilization

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Poverty and inequality
Care/ Treatmt Complemented with Nutrition
support
Rapid progression increased morbidity
Food insecurity
Vicious Circle of HIV and malnutrition
Prevention Mitigation Food supplements to
vulnerable adults children FFA/vocational
skills/ education
Care and treatment Nutrition support complemented
with IGA/ Vocational skills/ education
HIV infection
Risky survival strategies
Prevention Mitigation Nutrition support
complemented with IGA/ Vocational
skills/education
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Role of Food in HIV/AIDS

• Treatment Improvement of nutritional status and
  promotion of drug adherence
• Care Supporta) Supplementary food to HIV/AIDS
  infected affected food insecureb) Therapeutic
  for severely malnourished HIV/AIDS infected
  individuals
• Prevention MitigationSupplementary food to
  mitigate negative coping strategies, for food
  insecure, vulnerable adults and children

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Opportunities

• Integrated multi-sectoral approach is an entry
  point in both the prevention and mitigation of
  the impacts of HIV/AIDS.
• There is urgent need for action, identifying and
  promoting ways to raise awareness and prevent the
  transmission of HIV amongst communities,
• Natural resources exist in our environment
  (communities, agriculture, fisheries and
  forestry) should be tapped to provide care and
  mitigating strategies.

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Priority areas

• Mainstreaming HIV/AIDS considerations into the
  policy environment, project design, emergencies
  and early warning systems and advocacy,
• Institutional and Community capacity building
  for enhanced response
• Improving household and community access to farm
  inputs improving food and nutrition security
  and strengthening resilience through labour and
  time saving practices, and livelihood
  diversification

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WFP food support to HIV/AIDS Activities in Uganda
In collaboration with Government, WFP complements
the multi-sectoral programs of NGOs and CBOs,
with food support to 75,000 food insecure people,
infected and affected by HIV/AIDS, in 18
districts.
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Care and Support to Persons and Families Living
with HIV/AIDS

• AVSIs INTEGRATED APPROACH
• Every programme
• Is integrated in the social, political, economic
  and health contexts of the region
• Is related not only to the needs of the
  individual, but also to the needs of their
  families and communities
• Is implemented in partnership with national and
  local authorities
• Pursues the public-private partnership for
  development
• Works together with other AVSI programmes in the
  region.

Example Programming for people living with
HIV/AIDS
HEALTH CARE Medical Assistance
HOME-BASED CARE Psychosocial needs and health
care
PHA and Family
PREVENTIVE Education,Vocational skills for
OVC PMTCT Programme
NUTRITIONAL EDUCATION SUPPORT
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Care and Support to Persons and Families Living
with HIV/AIDS

• WFP/AVSI PARTNERSHIP FOR IMPROVED CARE OF PLWHAs
• Activities
• WFP Provision of food and funds
• AVSI Coordination, logistics and monitoring,
  Prevention, Education, IGA, Health Care, and
  Nutritional Support
• Local partners Identifying the beneficiaries,
  implementing distribution, HBC community
  mobilization
• Strategic direction To support the network of
  existing actors that provide assistance to PHA
• They are a social resource that can be
  strengthened through capacity building.
• These actors are very familiar with the
  challenges and context in which they operate.
• PHA are often members/promoters of these
  community-based partner organizations.

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Care and Support to Persons and Families Living
with HIV/AIDS

• AVSI is present in Uganda since 1984 and is
  familiar with different Ugandan environments and
  geographical areas
• Urban areas (Kampala)
• Rural areas (Hoima)
• Conflict-affected areas (Kitgum, Gulu, Pader,
  Lira, Apac)
• AVSI programmes are designed and implemented with
  families, community-based organizations and local
  NGOs in order to strengthen the civil society.
• The programmes positive results depend also on
  the partnership AVSI creates with social groups,
  local administration and national and
  international bodies.
• AVSI collaborates with UN agencies, other
  bilateral donors, USAID, the EU and the Italian
  Cooperation.

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Care and Support to Persons and Families Living
with HIV/AIDS
KAMPALA DISTRICT Implemented by AVSI in
partnership with 8 local organizations Number of
PLWHAs/households involved 1,867 (20 males 80
females) Number of beneficiaries 10,916 (4,688
males or 43 6,228 females or 57)
HOIMA DISTRICT Implemented by AVSI in
partnership with Meeting Point Hoima Number of
PLWHAs/households involved 749 (93 males and 407
females) Number of beneficiaries 4,475 (1,932
males or 43.1 and 2,543 females or 56.9 - all
beneficiaries are members of local CBOs, about
half of the CBO Meeting Point Hoima)
Total number of PLWHA/households involved 2,616
Total number of
beneficiaries18,007
KITGUM DISTRICT Implemented by AVSI up to
December 2003 in partnership with Meeting Point
Kitgum and St. Josephs Hospital Number of
PLWHAs/households involved 1,209 (573 hhs from
Meeting Point and 636 hhs from St. Josephs
Hospital) Now the project continues with direct
partnership between WFP and CBOs and NGOs
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RESULTS

• Significant increase of body weight
• From 1 meal/day to three meals a day
• Generally no worsening of clinical stage
• Reduced incidence of O.I.
• Great incentive to participate in preventive
  programs (i.e. PMTCT and ART)
• Extraordinary participation by CSOs

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CHALLENGES

• HIV/AIDS is not only a health problem, but also a
  social, economic and political concern.
• Access to scattered affected Households
• Funding of integrated activities in AIDS response
• Co-ordination of holistic programmes
• Identification targeting the most vulnerable
• Documenting role of nutrition other support in
  reducing the HIV/AIDS impact.
• Integrated programmes in responding to the
  different needs of PHA (nutritional support,
  income-generating activities, PMTCT, Home Based
  Care Services, prevention, and anti-retroviral
  therapy).

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Flora is a person living with HIV/AIDS in Hoima
District, western Uganda. In 2001, Flora enrolled
in an AVSI-supported programme to prevent
mother-to-child transmission of HIV. Nine months
later, she gave birth to a baby girl, Mary
Gloria. Mary Gloria was the first baby born
through Hoima's prevention programme. When she
was 18 months old she was tested, and was found
to be HIV-free. Still, life is a constant
challenge for Flora, who struggles to meet the
needs of her 3 children, send them all to school
and fight her own sickness. But in her connection
to Meeting Point, Flora has found both support
and friendship. Today she receives regular
distributions of food from WFP to help feed her
family, and regular visits from Meeting Point
volunteers. "I feel that they care for me," she
says.