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November 2006-April 2007 |
Introduction
"Malnutrition and food insecurity heighten susceptibility to HIV exposure and infection, while HIV/AIDS in turn exacerbates hunger and malnutrition" (International Food Policy and Research Institute).
Good nutrition is of immense importance to HIV positive sufferers. A weakened immune system, opportunistic infections, and severe muscle waste are all manifestations of the virus. This combined with a common loss of appetite and rapid weight loss, accelerates the deterioration of the individual's health. Regaining weight is often difficult to achieve, but can result in an overall improvement in the health of the individual.
In this project, six individuals (four of which were children), suffering from HIV and malnutrition, were selected to receive nutritional support from CINI over a six-month period to help them become more healthy and resilient. The total cost of this project was £179.
Rationale
CINI implements a number of interventions to help people living with HIV/AIDS and their families. CINI understands the importance of bespoke treatment for HIV sufferers (especially children) and their family, through home-based care and support programmes. The aim of the project was to demonstrate how low cost nutritional support and treatment of infections can make a profound difference in the overall health of those receiving assistance.
Identifying beneficiaries
Four HIV positive children aged between 5-8 years, with different levels of malnutrition and also suffering from various ailments (such as fever and diarrhoea), were chosen to receive case-based interventions. The children were selected from households receiving an income of less than £11 a month (based on an average of five family members). Three had contracted HIV through their mothers at birth, whilst one child contracted the virus through contaminated blood.
| In addition, two adults requiring emergency nutritional support and treatment of infections were also selected. The adults were selected as a result of the poor physical condition they were in at the time. One was female, aged 40, and the other was male, aged 25. Both had contracted HIV through sexual contact. The female suffered from oral thrush, and the male was diagnosed with tuberculosis and scabies. Sadly, the male died of AIDS during the project period in December 2006. Home visits and clinical check-ups were carried out, but the deterioration in his health was too rapid and severe. |
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Project activities
After identifying cases to support, CINI health workers discussed the rationale of the project and the planned interventions with the selected individuals and their families and caregivers to help them understand HIV, and how malnutrition can exacerbate the condition.
Follow-up meetings enabled staff to formulate individual diet plans, and discuss the food preferences of the selected beneficiaries. The families received non-perishable food from CINI during the duration of the project (such as grains and pulses), whilst the families provided perishable food. The families were advised how to select the non-perishable items, and how to keep costs to a minimum.
In order to monitor the progress of each beneficiary, regular check-ups were made at home and in the clinic. The weight and height of each individual was recorded, and a monthly home visit was carried out. All the data was analysed regularly to ensure that each individual was making progress, and that the necessary alterations to diet plans were being made.
Results of the interventions*
Each beneficiary has experienced considerable weight gain during the six month period of the project (November 2006-April 2007). The first four results are that of the children, and the fifth result is that of the female adult. This clearly demonstrates that tackling malnutrition in HIV sufferers with secondary infections is achievable, and should be considered as an important means of supporting HIV sufferers.
* The results do not include those of the male adult, who died in December 2006 |
Table 1: Weight increase in project beneficiaries |
Problems encountered and lessons learnt
Project workers observed that some of the families involved were unable to buy perishable goods as initially agreed, due to a lack of purchasing power. Therefore, to help maintain such interventions, CINI linked these families to existing care and support programmes run by CINI, which help poor families access nutritional food and teaches them how to retain nutrients during the cooking process.
Due to a lack of safe drinking water in some areas, families receiving support were often unable to follow hygienic practices when washing their fruit and vegetables. This was difficult to resolve, so CINI project workers continued to emphasised the importance of personal hygiene whilst preparing food.
Case study: Moumita
Moumita is seven years old. After the death of her father, she and her mother were tested at CINI's community based testing centre for HIV. They were both found to be HIV positive.
In November 2006, despite being on anti-retroviral drugs, Moumita's health was very poor. She weighed just 15kg and was suffering from recurrent infections. Furthermore, she had high fevers which were potentially life-threatening. Her family was given advice on how to buy the protective nutrients she needed from cheap, locally produced food to help compensate for the lack of immunity bought on by HIV. The non perishable food for her diet was provided on a monthly basis by CINI for a period of 6 months, to give her family time to get back on its feet after the stress caused by her condition and the medical costs that were incurred.
A CINI health worker and counsellor made regular home visits to monitor Moumita's progress and to not only provide support for her family, but also educate them about her condition. CINI has also helped her family get connected to government services which provide economic support to those living below the poverty line.
By April 2007, with CINI's support, Moumita's health had improved substantially. She was fit and active, had grown taller, and her weight had increased to 21kg. Her prognosis is now good and she is living a normal life and goes to school.
(The name of the child in this case study has been changed to protect her identity)
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