|
Prevalence and correlates of nutrition support services in PEPFAR-supported programs from 9 Sub-Saharan African countries
A. Anema1,2, S.D. Weiser3, R.S. Hogg1,4, W. Zhang1, J.S.G. Montaner1,2, B. Elul5, S. Kelbert6, W. El Sadr5, D. Nash5
1British Columbia Centre for Excellence in HIV/AIDS, Vancouver, Canada, 2University of British Columbia, Vancouver, Canada, 3University of California, San Francisco, San Francisco, United States, 4Simon Fraser University, Burnaby, Canada, 5International Center for AIDS Care and Treatment Programs (ICAP), Columbia University Mailman School of Public Health, New York, Canada, 6International Center for AIDS Care and Treatment Programs (ICAP), Maputo, Mozambique
Background: International guidelines recommend provision of nutritional support to HIV-infected individuals, including those receiving antiretroviral therapy (ART). Little is known about the availability of nutritional support services at HIV clinics in sub-Saharan Africa.
Methods: During January-July 2008, a structured site assessment was conducted at PEPFAR-supported HIV care and treatment sites in 9 countries (Kenya, Tanzania, Ethiopia, Rwanda, Mozambique, South Africa, Nigeria, Lesotho and Cote d'lvoire). We describe the availability and characteristics of nutritional support services at these sites.
Results: The 338 sites enrolled 118,527 individuals on ART, including 10,105 children. Of the 338 sites, 303 (90%) reported offering any nutritional support service, including nutritional counseling 298/303 (98%) [289/298 (97%) to adults and 277/298 (93%) to mothers with infants] and weight for height evaluation [292/303 (93%)]; 21/303 (7%) reported having a nutritionist on site. Micronutrient supplementation was available at 194/303 sites (64%), and included provision of Vitamin A (157/194, 81%), Iron (141/194, 73%), and multivitamin/minerals (75/194, 39%). Treatment for severe malnutrition (as defined nationally or by WHO) was available at 109/303 sites (36%), including for adults at 71/109 sites (65%) and for children at 100/109 sites (92%). Food rations were available at 95/303 sites (28%), including for adults at 62/95 sites (65%) and for children at 88/95 sites (93%). Among sites with any nutrition services, 136/303 (45%) were rural and 139/303 (46%) were primary care clinics; Secondary/tertiary care sites were more likely to offer nutritional counseling (p=0.029); Rural sites were more likely to offer micronutrient supplementation (p< 0.001); Older programs were more likely to offer treatment for severe malnutrition (p< 0.01); Older and rural programs were more likely to distribute food rations (p=0.001,p< 0.001).
Conclusions: Nutritional support services are available at most sites, but the specific services vary by level of the health care facility, geographic context, and time since site initiated HIV services.
Download the e-Poster
|