Kenya Nutrition and HIV Program (NHP)
CURRENT PROJECT
Funded by the United States Agency for International Development (USAID), the Kenya Nutrition and HIV Program (NHP) is USAID's flagship nutrition program in Kenya to strengthen nutritional therapy to those malnourished from HIV/TB, both in and out of hospital settings. The project is a five-year cooperative agreement managed by FHI 360 in collaboration with a Kenyan-owned company, Insta Products EZP Ltd., as its private sector food partner.
Importance of Nutrition Services in HIV Care and Treatment
- Severely malnourished people living with HIV (PLHIV) are four times more likely to die of complications than those who are not severely malnourished. Preventing malnutrition is a key objective in HIV and TB control programs
- Compliance and adherence to antiretroviral (ARV) therapy is dependent upon the availability of food. Clients are more likely to take and tolerate ARV drugs taken orally if they are food secure
- Adequately nourished patients also have a higher quality of life, are more productive, and better able to provide for their families. Restoration of nutrition and health of PLHIV helps reduce stigma, lower the burden of orphans, and reduce the socioeconomic impact of the pandemic
Project Vision
The program is designed to increase access to nutritional therapy in and out of hospital settings. NHP strengthens HIV care and treatment by improving the nutritional status of ARV therapy clients, pre-ART clients, orphans and vulnerable children (OVCs), and HIV-infected pregnant and postpartum women.
NHP ensures the integration of food by prescription in HIV care and treatment, along with nutrition education and counseling, at all 461 public and mission hospitals and their satellite sites, surpassing the project goal of 250 sites. In addition, these sites are encouraged to establish linkages with community and faith-based organizations supporting community nutrition and food security services so as to increase access to NHP supported services.
Strategy
The project's three-pronged strategy of introducing effective nutritional products, building a robust supply chain, and improving health facility commitment and performance, strengthens the capacity of health providers to deliver nutrition services as an adjunct in the care and treatment of HIV and AIDS. It also catalyses local capacity development to produce supplemental and therapeutic foods and supports the creation of supply chains.
Public-Private Partnership
NHP strives to forge and nurture public-private partnerships in Kenya. To this end, NHP collaborates closely with its private sector food partner, Insta Products EZP Ltd., to ensure local production of food products. Insta manufactures energy-dense fortified blended foods and a new ready-to-use therapeutic food (RUTF) product, developed in partnership with a charitable international organization, Valid Nutrition. NHP also supports capacity building within Kenya's Ministries of Medical Services and Public Health and Sanitation as well as among community service organizations through training, advocacy, monitoring and evaluation, procurement, and technical assistance activities.
Supply-Chain Development
NHP is strengthening the private sector supply chain system for nutritional commodities and stimulating the government's existing supply structures by boosting institutional capacity, encouraging growth, and promoting standardized nutritional care services.
Integration of Nutritional Care and Treatment in Health Facilities
NHP conducts in-service health worker training for all new scale-up sites to help begin integration. To improve the long-term sustainability of the program, the project collaborates with Kenya National AIDS/STD Control Program (NASCOP) to include nutrition management in national health worker training curricula and develops educational materials for clinic staff and patients.
Treatment Regimens
NHP supports the development of protocols to ensure that eligible HIV+ patients at hospitals and health centers receive a bottle of WaterGuard® as well as a prescription for one of the following food products.
- First Food® designed for OVC aged six months to nine years
- Foundation Plus® for older orphans ages 10 to 17 years and adults
- Advantage® for pregnant and postpartum women
- RUTF, which is used alone to treat severe acute malnutrition in children 6 to 59 months old and in combination with the above-named food products for older children and adults
The RUTF rations dispensed target 100 percent of energy requirements for children 6 to 59 months old and at least 75 percent of energy requirements for older children, adult PLHIV, and pregnant or postpartum women
Community-Based Approach
NHP fosters community involvement and tests best practices by:
- Incorporating nutritional services at all levels of HIV/AIDS care and treatment
- Integrating nutrition and safe water interventions into community and home-based care approaches
- Strengthening linkages between health facilities and community-based organizations providing nutrition support to OVCs
News, Publications, and Results
News
- Executive Director of GHI Lois Quam Visits Nairobi Hospital (March 2011)
- Dr. Rajiv Shah Visits AED-Implemented Nutrition and HIV Program (June 2010)
Presentations
- Food by Prescription: Impact of food supplements on nutritional recovery of malnourished HIV infected clients (PDF, 348kb)
- Approaches and Lessons from Rapidly Scaling-Up Nutrition Assessment, Counseling and Support (NACS) Services (PDF, 733kb)
Results
- NHP is supporting 155 primary sites that facilitate support to 261 satellite sites. By June 2010, the program reached a total of 171, 281 clients, 46% of which were malnourished adults, 11% were pregnant or post partum women, and 43% were OVCs.
- To date, the project has exceeded USAID goals by 3.4 times for clients served and 2.8 times for sites covered.
- On average, the project supplies about 100 metric tons of FBF and four metric tons of RUTF per month to health facilities. Prescribing and dispensing of food is carried out by more than 541 healthcare providers and 200 community health volunteers who have received training in FBP services along with other nutrition and HIV services.
- NHP is leading USAID's efforts to demonstrate the efficacy of FBP programs by preparing scientific papers and professional presentations, including three papers in 2010.
Contacts
| Christian
Winger Project Director 1825 Connecticut Avenue NW Washington, DC 20009 +1 (202) 884-8779 cwinger@fhi360.org |
|
Dr. David Mwaniki Chief of Party ABC Place, Waiyaki Way Westlands, Nairobi, Kenya dmwaniki@fhi360.org |