Nutrition & HIV/AIDS Programming: Success Factors for Integration
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1 Nutrition & HIV/AIDS Programming: Success Factors for Integration Tim Quick Senior Nutrition Advisor, USAID/OHA Co-Chair, PEPFAR Food & Nutrition TWG Informing Feed the Future: Integration Successes Global Health Council December 12, 2011
2 Early Integration of Nutrition within HIV/AIDS Programming 2005: WHO Consultation on Nutrition & HIV/AIDS in Durban, South Africa calls for the integration of nutrition into the essential package of care, treatment and support for people living with HIV/AIDS and efforts to prevent infection. 2005: Congress mandates PEPFAR to develop and implement a strategy to address the nutritional requirements of those on antiretroviral therapy. 2006: The World Health Assembly passes a resolution calling on Member States to develop evidence-based policies and programs on HIV/AIDS and nutrition. 2006: Kenya implements Food by Prescription as national program for nutrition assessment, counseling & support (NACS) for PLHIV in clinical care & treatment services. Malawi initiates similar program.
3 NACS: Integrating Nutrition Assessment, Counseling & Support within Clinical Services Entry Points: ANC/PMTCT Clinical referral Community Referral Assessment: Anthropometric Biochemical Clinical Dietary Food Security Clinical Mgmt & PMTCT Services: ART Opportunistic Infections MAM Chronic disease management Counseling: Adherence Diet WASH Infant/child feeding Referral to Community Services Clinic Support: Food by Prescription: therapeutic & supplementary feeding MN supplements Livelihood & food security referrals
4 NACS: Integrating Nutrition Assessment, Counseling & Support within Community Services Community Services: Nutrition surveillance & referrals to clinical care Nutrition counseling & support CMAM MCH/CHWs Family Planning Economic strengthening, livelihood & food security support
5 Integration between Clinic & Community NACS Assessment: Anthropometric Biochemical Clinical Dietary Food Security Clinical Mgmt & PMTCT Services: ART Opportunistic Infections Chronic disease management Counseling: Adherence Diet WASH Infant/child feeding Referral to Community Services Support: Food by Prescription: therapeutic & supplementary feeding MN supplements Livelihood & food security referrals Community Services: Nutrition surveillance & referrals to clinic services Nutrition counseling & support CMAM MCH/CHWs Family Planning Economic strengthening, livelihood & food security support Entry Points: ANC/PMTCT Clinical referral Community Referral Clinic Community
6 The NACS Continuum Care Across the Life Cycle NACS Care & Support ANC/PMTCT ANC ART/PNC/Infant Feeding Support Birth Infancy ES/Livelihoods /FS Clinical Nutrition Care & Referral to Community Services Adulthood Adult C&T Pediatric and OVC C&T Adolescence Childhood Clinical & Community Growth Monitoring & Support
7 Strategies, Policies & Guidelines Training/Quality Improvement Inventory Control/Supply Chain Management Monitoring & Evaluation/Surveillance/information Systems Research NACS Integration, Implementation & Sustainability Public-Private Partnerships Health System Strengthening Nutrition Care Resources Program Funding/Financing Human Resources/Staffing/Retention Commodity Procurement Economic Antenatal Care/PMTCT Strengthening/Livelihood/Food Security Program Linkages/Continuum of Care Global Health Initiative Feed the Future Scaling Up Nutrition/1000 Days
8 Phased Implementation of NACS Early Planning/Implementation South Africa, Mozambique, Nigeria, Vietnam Program Expansion Côte d Ivoire, Ghana, Ethiopia, Uganda, Tanzania, Namibia, Zambia, Haiti Implemented at National Scale Malawi and Kenya
9 NACS: Integrating Nutrition Care within Health Services through Quality Improvement Human Resources Training Quality Improvement Roles & Responsibilities Performance Standards Team CQI Supportive Supervision Job Aids Records/Tracking M&E
10 The United States President s Emergency Plan for AIDS Relief Thank You!
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