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THE GOOD FOOD TOOLKIT (Participant Manual)

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PARTICIPANT MANUAL

THE GOOD FOOD TOOLKIT

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This participant manual was first created in 2014.

Reviewed in 2017.

FOREWORD

FOREWORD (TRANSLATION)

The integration of HIV and nutrition activities in the health sector in Cambodia has been identified as a priority area in both the National Nutrition Strategy 2009-2015 and the National Strategic Plan for Comprehensive and Multi-sectoral Response to HIV/AIDS III (2011-2015). This is in keeping with global recognition that optimal nutrition plays a critical role in the health and wellness of all individuals, particularly people living with HIV (PLHIV).

HIV and nutrition are inextricably linked. HIV impacts the nutritional status of PLHIV, including children living with HIV (CLHIV) and orphans and vulnerable children (OVC). HIV compromises a person’s nutritional status by undermining their immune system, as well as their ability to assimilate nutrients. Malnutrition in turn further weakens the immune system increasing vulnerability to opportunistic infection and disease. HIV combined with pre-existing under nutrition makes it difficult for PLHIV to remain healthy and economically productive as well as support and provide for family members, particularly children.

Nutrition support is a critical component of comprehensive prevention, care and treatment for individuals with HIV. The provision of nutrition assessments, education, counselling and support can help to improve a person’s nutritional status, ensure adequate food intake, improve the effectiveness, tolerance and adherence to antiretroviral therapy, and enhance quality of life.

Recognizing the critical role that nutrition plays in the comprehensive care of PLHIV, the Good Food Toolkit has been developed for service providers together with an accompanying manual for trainers. This Toolkit is intended for use by professional staff working in health facilities and non-government organizations, home-based care team members, self-help groups who provide nutrition education and support for adults, children, and communities living and affected by HIV. It will also help facilitate nutritional assessments, counselling, education and support to address nutrition issues faced by PLHIV.

The Ministry of Health endorses this toolkit for training on HIV nutrition as an important tool to build the capacity of counsellors to provide effective nutrition counselling, care and support for PLHIV in Cambodia.

Phnom Penh 04 December 2014

(Signed and sealed)

Professor Eng Huot
Secretary of State
Ministry of Health

ACKNOWLEDGMENTS

The second edition of the Good Food Toolkit and Training Manual is a collaborative effort of numerous partners involved in HIV and nutrition work in Cambodia. Its printing marks the culmination of the considerable effort that has gone into updating and broadening this important manual to bring it in line with the latest HIV policies and thinking on HIV and nutrition. Coordination for this process has been led by the National Maternal and Child Health Center (NMCHC) in collaboration with the Core Group on HIV Nutrition, under the leadership of Dr. Prak Sophonneary and Dr. Lan Van Seng of the National Centre for HIV/AIDS, Dermatology and Sexually Transmitted Infections (NCHADS). Technical support was provided by the United Nations World Food Programme (WFP) Cambodia, specifically Dessa Shuckerow and Seanglay Din, with support from World Food Programme Regional Bureau for Asia. This update would also not have been possible without the generous funding support from UNAIDS.

The first edition of the Toolkit and Training Manual was published in 2009. The 2014 revision reflects lessons learned from the implementation of the Toolkit, advances in evidence-based literature on HIV nutrition, and changes to HIV policy at national level. The content has also been expanded to include additional populations, including pregnant and lactating women living with HIV, HIV exposed infants, children with HIV (paediatric HIV) and orphans and children made vulnerable by HIV/AIDS.

Members of the Core Group on HIV Nutrition who contributed to the development of this second edition also include: National Nutrition Programme (NNP), Prevention of Mother to Child Transmission (PMTCT) Programme, Cambodian HIV/AIDS Education and Care (CHEC), Khmer HIV/AIDS NGO Alliance (KHANA), Caritas, Catholic Relief Service (CRS), Family Health International (FHI) 360, Clinton Health Access Initiative (CHAI), World Health Organisation (WHO), United Nations Children’s Fund (UNICEF) and the Joint United Nations Programme on HIV/AIDS (UNAIDS).

Particular acknowledgement is also extended to Lia Purnomo, Amanda Justice, Katherine Coote and Charmaine Turton of The Albion Centre in Australia, who provided their technical expertise in the revision of this second edition; and Chamroen Chim for the photographs, illustrations and design.

Special thanks are also expressed to numerous service providers, home-based care teams, self-help group members, and people living with HIV whose experiences and inputs formed the basis of the development of this second edition. Finally, sincere thanks are again extended to all those previously acknowledged for the development of the first edition of the Good Food Toolkit and Training Manual.

ACRONYMS AND ABBREVIATIONS

AIDSAcquired Immune Deficiency Syndrome
AHEADAction for Health and Development
ARTAntiretroviral Therapy
ARVAntiretroviral
BCGBacillus Calmette–Guérin
BFCIBaby Friendly Community Initiative
BDFBuddhism for Development
BMIBody Mass Index
CHAIClinton Health Access Initiative
CHCCommunity Health Cambodia
CHECCambodian HIV/AIDS Education and Care
CRSCatholic Relief Services
DNADeoxyribonucleic Acid
H/AHeight-for-Age
HCHealth Centre
HCWHealth Care Workers
HIVHuman Immunodeficiency Virus
HKIHelen Keller International
FANTAFood and Nutrition Technical Assistance
FAOFood and Agricultural Organization
FHI 360Family Health International 360
KHANAKhmer HIV/AIDS NGO Alliance
LBWLow Birth Weight
MoHMinistry of Health
MSGMother Support Group
MUACMid-Upper Arm Circumference
NCHADSNational Centre for HIV/AIDS, Dermatology and Sexually Transmitted Infections
NGONon-Governmental Organization
NAANational AIDS Authority
NMCHCNational Maternal and Child Health Centre
NNPNational Nutrition Program
OI/ARTOpportunistic Infection/Antiretroviral Therapy Clinic
OIOpportunistic Infection
ORSOral Rehydration Solution
OVCOrphans and Children Made Vulnerable by HIV/AIDS
PCPartners in Compassion, Cambodia
PCRPolymerase Chain Reaction
PLHIVPeople Living with HIV
PMTCTPrevention of Mother to Child Transmission
SCCSalvation Centre Cambodia
SHGSelf-Help Group
SITSave Incapacity Teenagers
TOTTraining of Trainers
WAOWest Area Office
W/AWeight-for-Age
W/HWeight-for-Height
WFPWorld Food Programme
WHOWorld Health Organization

TRAINING SCHEDULE

DAY 1

Time

Duration (minutes)

Topic

8.00 – 8.40

40

Opening Session (formal opening, overview, ice breaker)

8.40 – 9.00

20

Pre-test

9.00 – 9.30

30

Lesson 1: Introduction to the Good Food Toolkit – Purpose of the Toolkit

9.30 – 9.45

15

Break

9.45 – 10.00

15

Lesson 1: Introduction to the Good Food Toolkit – Target groups & primary target for nutrition counseling

10.00 – 10.15

15

Lesson 1: Introduction to the Good Food Toolkit – Contents of the Toolkit

10.15 – 10.30

15

Lesson 2: Nutrition Basics – Basic nutrition terms

10.30 – 11.30

60

Lesson 2: Nutrition Basics – Three food groups

11.30 – 13.30

120

Lunch Break

13.30 – 14.00

30

Lesson 2: Nutrition Basics – Energy requirements

14.00 – 15.00

60

Lesson 2: Nutrition Basics – Nutrition throughout the lifecycle

15.00 – 15.15

15

Break

15.15 – 16.00

45

Lesson 2: Nutrition Basics – Nutrition throughout the lifecycle

16.00 – 16.30

30

Lesson 3: Nutrition and HIV – Relationship between HIV and nutrition

16.30 – 17.00

30

Conclusion of the day and daily training evaluation

17.00

End

DAY 2

Time

Duration (minutes)

Topic

8.00 – 8.15

15

Recap Day 1

8.15 – 8.45

30

Lesson 3: Nutrition and HIV – Energy requirements and percentage increase for PLHIV

8.45 – 9.30

45

Lesson 3: Nutrition and HIV – Cycle of HIV, poor nutrition and infection

9.30 – 9.45

15

Break

9.45 – 10.30

45

Lesson 3: Nutrition and HIV – Some common misinformation about nutrition for PLHIV

10.30 – 11.30

60

Lesson 4: Anthropometry – Assessment for malnutrition in adults

11.30 – 13.30

120

Lunch Break

13.30 – 15.00

90

Lesson 4: Anthropometry – Assessment for malnutrition in children

15.00 – 15.15

15

Break

15.15 – 16.30

75

Lesson 4: Anthropometry – Assessment for malnutrition in children

16.30 – 17.00

30

Conclusion of the day and daily training evaluation

17.00

End

DAY 3

Time

Duration (minutes)

Topic

8.00 – 8.15

15

Recap Day 2

8.15 – 9.30

75

Lesson 5: How to use the Good Food Toolkit – Five steps for nutrition counseling

9.30 – 9.45

15

Break

9.45 – 11.00

75

Lesson 5: How to use the Good Food Toolkit – Using small food cards

11.00 – 11.30

30

Lesson 5: How to use the Good Food Toolkit – Using large food cards

11.30 – 13.30

120

Lunch Break

13.30 – 13.40

10

Energizer

13.40 – 15.00

80

Lesson 5: How to use the Good Food Toolkit – Filling out monitoring forms

15.00 – 15.15

15

Break

15.15 – 16.30

75

Lesson 5: How to use the Good Food Toolkit – Filling out monitoring forms

16.30 – 17.00

30

Conclusion of the day and daily training evaluation

17.00

End

DAY 4

Time

Duration (minutes)

Topic

08.00 – 08.15

15

Recap Day 3

08.15 – 9.30

75

Lesson 6: Positive Living for PLHIV – Positive Living Cards

9.30 – 9.45

15

Break

9.45 – 11.30

105

Lesson 6: Positive Living for PLHIV – Positive Living Cards

11.30 – 13.30

120

Lunch Break

13.30 – 13.40

10

Energizer

13.40 – 15.00

80

Lesson 6: Positive Living for PLHIV – Introduction to communication skills

15.00 – 15.15

15

Break

15.15 – 16.15

60

Supervised Field Practice preparation

16.15 – 16.35

20

Post-test

16.35 – 17.00

25

Conclusion of the day

17.00

End

DAY 5

Time

Duration (minutes)

Topic

08.00 – 11.30

210

Supervised Field Practice

11.30 – 13.30

120

Lunch Break

13.30 – 14.30

60

Debriefing

14.30 – 15.00

30

Final Training and Field Practice Evaluation

15.00 – 15.15

15

Break

15.15 – 16.00

45

Certificate Ceremony

16.00 – 17.00

60

Conclusion and closing

17.00

End

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