The “Good Food Toolkit” it is an education, counseling, problem solving and behavior change tool that will support counselors to help people living with HIV (PLHIV) in addressing and finding practical solutions to the health and dietary challenges that PLHIV face every day.
PURPOSE OF THE TOOLKIT
The purpose of the “Good Food Toolkit” is to help PLHIV plan nutritious meals with the food and drinks they have available, so that they can keep a healthy body weight and fight infection. The Toolkit will also help PLHIV learn how to manage symptoms of illness with appropriate food and drink and to maintain a healthy lifestyle.
PLHIV who are pregnant and breastfeeding, as well as exposed and infected children, are at increased risk of nutritional problems and have additional nutrition requirements. The Toolkit will also help HIV-positive pregnant and breastfeeding women and their children to make the best nutrition (food and drink) choices for their situation.
PRIMARY TARGET FOR NUTRITION COUNSELING
The Toolkit has three key target groups. The first one is adult PLHIV who are relatively healthy and leading normal lives – it is designed to help these people stay healthy and continue to live well with their families in their communities. Good nutrition is important for the well being of PLHIV, even if the PLHIV is not ill, because good nutrition keeps the body strong. The body can better resist infection and delay progression to AIDS. Good nutrition is particularly important in the early stages of HIV infection. Early nutrition counseling and education gives the person a chance to build up healthy eating habits, to take action to improve access to food, and to adopt healthy practices.
The second target group is HIV-positive pregnant and breastfeeding women. Good nutrition before conception and during pregnancy and breastfeeding (lactation) is important for the health of both mother and baby. Well nourished mothers have healthier babies of adequate weight, and are at much lower risk of poor maternal health outcomes, including the transmission of HIV from mother to child. As each pregnancy places considerable nutritional demands on a mother, women who are HIV infected are likely to become malnourished during pregnancy if insufficient energy and nutrients are not consumed. Increased energy needs during breastfeeding also may accelerate weight loss in breastfeeding women with HIV. The increased energy needs as well as the common HIV-related infections increase the nutrition risk of pregnant and breastfeeding women with HIV.
The third target group is HIV-exposed infants, young and older children with HIV (pediatric HIV) and orphans and children made vulnerable by HIV/AIDS (OVC). Infants and children are growing, or trying to grow at all times. Good growth is critical to the development of the brain, which continues to develop into adulthood. Good growth as an infant and child will enable an adolescent to reach their maximum height potential, and maximum bone strength. All children need adequate nutrition for growth and development, but it is particularly important for HIV exposed infants, children with HIV and OVC. They are vulnerable to childhood illnesses, malnutrition and poor growth. Like adults, children with HIV may have difficulties eating due to poor appetite or other symptoms such as nausea, vomiting or mouth sores and thrush. Because of these factors that may reduce food intake in young children with HIV, mothers or carers will need guidance and support for appropriate feeding practices and to ensure improved food intake of their children during illness and recovery.
Adults and children who are very sick with advanced AIDS and are bed-ridden are not included in this Toolkit. These target groups require specific advice on nutrition and HIV that are not covered in this Toolkit.
CONTENTS OF THE TOOLKIT
- “Small food cards” with photos of many different foods – help you and the PLHIV decide what food is available, practical and affordable for the PLHIV, so that you can plan good meals realistically (and which the PLHIV will be able to prepare).
- “Large food cards” showing pictures of plates and bowls of food such as rice, soup, and desserts – the large cards can help you show the PLHIV about the amount of food they should be eating.
- “Positive Living” counselling cards – these illustrations, along with the questions and information on the back of the cards, will help you and PLHIV have a two-way conversation and make feasible plans about different ways to stay healthy and manage symptoms of illness with the right kinds of food.
- “Drinking Cups” – pictures of three different size drinking cups to help estimate the amount of water and other fluids the PLHIV normally drinks each day and how much he or she should drink each day.
- Assessment tools:
- Body Mass Index (BMI) table for adults (both gender and over 6 months post-partum women) – a tool to help estimate BMI in a simple way without having to compute using the formula.
- World Health Organization (WHO) BMI-for-age chart for children (boys and girls) – a tool to assess nutritional status of children aged 5-19 years of age.
- Food and Nutrition Technical Assistance (FANTA) BMI-for-age look up tables for children and adolescents 5-18 years – these tables are a quick reference to work out a child or adolescent BMI (weight-for-height) without having to compute using the formula.
- Mid-upper arm circumference (MUAC) child and adult tapes – a tool to measure nutritional status in children (6-59 months of age), pregnant and post-partum within 6 months after delivery.
- Nutrition Counselling Monitoring Forms – for counsellors to keep a record of the PLHIV’s status, and key suggestions provided during nutrition counselling. This will help you follow up on the improved behaviour with the PLHIV from one visit to the next. There are three different monitoring forms to record nutritional related changes for:
- Adults (both gender) and over 6 months post-partum women
- Adults pregnant and post-partum within 6 months after delivery
- Children aged 0-19 years
- Cooking Demonstration for People Living with HIV: A Manual – This guide is designed to assist those who provide cooking demonstration activity for PLHIV. It contains information, advice, and resources including recipes for planning and conducting an effective cooking demonstration.