FACTORS INFLUENCING THE NUTRITIONAL OUTCOME OF HIV POSITIVE CHILDREN 6-59MONTHS ON FOOD BY PRESCRIPTION IN DANDORA, NAIROBI KENYA

EDWINA MAKOKHAA90/0307/2008SUPERVISOR 1:Prof.S.K.MbuguaSUPERVISOR 2: Mrs. A.A. Andago

INTRODUCTION FBP is a nutrient based intervention that

provides fortified blended food and nutritional care at HIV care and treatment facilities in Kenya.

The programme’s objective is to provide energy and nutrient-dense food products along with nutrition assessment, counselling and clean, safe water to PLHIV who are malnourished or at risk of malnutrition

Study was conducted in Dandora at Lea Toto program -provides support to most of the households of children infected with HIV through provision of medication, nutrition support and social support

RESEARCH PROBLEM

Despite the efforts by the government and various NGOs to offer nutrition and food to PLHIA to improve well-being and treatment outcomes, support treatment adherence and protect household integrity and to encourage a productive recovery and sustained adherence through various interventions ,there are various factors that interfere with the effectiveness and positive outcomes of such food based interventions.

These factors are both external and internal.

JUSTIFICATION Food by prescription aims at improving

nutritional status of children living with HIV/AIDS.

This is quite a challenge because of various factors e. g socio-economic factors, demographic factors, household food security and morbidity experience that negatively impact on the improvement of nutritional status.

This research will assist bring out the real issues beyond the service delivery which when addressed will improve the nutritional outcome and thus nutritional status of the HIV positive children.

AIM

To contribute towards improving the nutritional status of HIV positive children who are below five years of age in Kenya

PURPOSE

To identify factors affecting the effectiveness of feeding programme related to HIV/AIDS for children to ensure improvement of service delivery aimed at enhancing their nutritional status and their overall health

MAIN OBJECTIVE

To assess factors influencing the nutritional outcome of HIV positive children 6-59months on Food by Prescription in Dandora

SPECIFIC OBJECTIVE

To determine the socio-economic and demographic factors that affect children who are on FBP

To determine adherence to prescribed treatment and feeding regimes

To determine the nutritional status of the children at their enrollement to the programme and subsequent visits to the clinic

To determine the morbidity experience of the study children.

METHODOLOGY AND TOOLSSTUDY SETTING

Study was based in Dandora at the Lea Toto program.

Dandora is a high density slum with high poverty, unemployment and crime rates and high prevalence of disease especially HIV/AIDS.

STUDY DESIGN

The study encompassed a cross-sectional design with a descriptive and analytical component undertaken at Lea Toto program in Dandora

Both qualitative and quantitative data was collected

The study tools used; semi structured questionnaire and Dietary diversity score

SAMPLE SIZE DETERMINATION

Exhaustive sampling was done that generating a population size of 37 clients which met the rule of a minimum size of 30 for valid statistical analysis.

This is because only 37 clients were enrolled into the programme at the time of the study.

DISTRIBUTION BY AGE AND SEX

Boys Girls Total Ratio

AGE (mo) no. % no. % no. % Boy:girl

6-17 8 66.7 4 33.3 12 32.4 2.0

18-29 8 44.4 10 55.6 18 48.6 0.8

30-41 1 100.0 0 0.0 1 2.7

42-53 1 50.0 1 50.0 2 5.4 1.0

54-59 1 25.0 3 75.0 4 10.8 0.3

Total 19 51.4 18 48.6 37 100.0 1.1

EDUCATION LEVEL ATTAINED

AVERAGE FAMILY SIZE

PROPORTION OF CLIENTS COLLECTING FBP/MEDICINES AS SCHEDULED

PERCENT DISTRIBUTION OF CLIENTS WHO FINISHED THE FEED GIVEN

NUMBER OF FOOD GROUPS CONSUMED

MORBIDITY EXPERIENCE

CD4 COUNT VS DISEASE FREQUENCY

There is a relationship between CD4 count and frequency of disease but the influence is small

(r=-0.291)

MUAC

MUAC BEFORE MUAC AFTER

WEIGHT FOR HEIGHT Z SCORES

Baseline WHZ Intervention WHZ

CONCLUSION

From the study it was evident that majority of the clients were complying to the specifications of the programme, but a few who did not, was as a result of external and internal factors that influenced their intake of the food supplement given and thus their nutritional status

This factors negatively influence the effectiveness of such food based intervention programs.

RECOMMENDATIONS

The program should introduce an aspect of economic empowerment into it objectives so as to address the problem of poor economic status at the household level which affects the household food security.

The Lea Toto management should stress the appropriate usage of FBP in terms of adherence to FBP guidelines to ensure maximum benefits from the program.

REFERENCES

UNAIDS/WHO/UNICEF,2009/2010 .Global HIV/AIDS Statistics vol. 6, pg 2

Kenya Demographic Health Survey 2008-2009, pg213-214

Child survival and Development Strategy Ministry of Health and Sanitation 2008-2015, pg 1-24

Kenya National Guidelines on Nutrition and HIV/AIDS, 2007, pg 54-64

CONT.

UNAIDS, Report on the global AIDS epidemic, Geneva, 2010.

FANTA 2/USAID, “A Review of Kenya’s Food by prescription Program” 2009

THANK YOU!