Counseling Tools and Training Manuals

ACTIVITY UNCHANGED FROM FY2008

This is a continuing activity from COP08. In 2008, FANTA finalized the development of nutrition guidelines,

counseling tools and training manuals to facilitate integration of nutrition into HIV/AIDS care and support

services at the facility and community levels. The request to fund FANTA is to extend technical assistance

to regional health departments, health centers and hospitals to strengthen nutrition training and mentoring

for service providers. There is no change in budget from COP08.

COP 08 ACTIVITY NARRATIVE:

Related Activities

In response to the pressing need to address the nutritional needs of HIV-infected individuals and OVC in

PEPFAR programs in Ethiopia, PEPFAR activities began introducing nutrition assessment and counseling

into HIV clinical services in FY07 . Technical assistance from the Food and Nutrition Technical Assistance

(FANTA) Project is supporting the government and PEPFAR implementing partners in preparing a national

strategy on nutrition and HIV, developing training materials on nutrition and HIV, producing materials to

support service providers in carrying out nutrition assessment and counseling, and integrating nutrition

counseling and assessment into PEPFAR-supported HIV care and treatment services. PEPFAR Ethiopia is

also starting a food program on a pilot basis to provide therapeutic and supplementary food to severely

malnourished PLWHA and to HIV-infected women during pregnancy and lactation. Based on assessed

need and the results of the FY07 activities, FANTA activities will expand through FY08 to reach more

beneficiaries, include new activities and establish broader and more permanent capacity for nutritional care

among HIV service providers in Ethiopia.

Food and nutrition interventions are an important component of comprehensive care and support for people

living with HIV (PLHIV). Building on Ethiopia's recent National Guidelines on HIV/AIDS and Nutrition,

FANTA will work with the Government of the Federal Democratic Republic of Ethiopia (GFDRE), the U.S.

President's Emergency Plan for AIDS Relief (PEPFAR) partners, and their implementing partners to

strengthen the integration of food and nutrition into Ethiopia's national response to HIV. After the FANTA

visit in July 2007, a strong need was identified for nutrition technical assistance and support to PEPFAR, its

implementing partners and the Ministry of Health (MOH)/HIV/AIDS Prevention and Control Office (HAPCO).

With the current interest in food and nutrition programming it is critical that PEPFAR, the HAPCO and

implementing partners receive appropriate technical support to coordinate, implement and sustain effective

food and nutrition activities. The increase in the FANTA budget will:

1) Expand training in nutritional care for PLWHA through regional trainings to cover service providers from

45, in the previous year, to at least 150 hospitals and health centers that provide ART and other HIV

services;

2) Integrate key indicators of nutritional care for PLWHA into the national health management information

system to ensure outcomes of nutritional care activities are monitored and used to inform the national HIV

response and PEPFAR Ethiopia approaches;

3) Support PEPFAR Ethiopia and its partners to establish quality assurance and quality improvement

systems for nutrition services at hospitals and health centers, in particular nutrition assessment, nutrition

counseling, and therapeutic and supplementary feeding services where available;

4) Provide training and support materials to community-level health workers such as Health Extension

Workers and community/home-based care workers in nutrition and HIV, and strengthen linkages between

facility-based and community support for food and nutritional care for PLWHA;

5) Assess the progress, challenges, initial results, and gaps in the Food by Prescription program that began

in FY07 and identify refinements to the program as needed;

6) Support the secondment of a nutritionist in HAPCO at the central level to serve as the focal point for

nutrition and HIV activities nationally, and support nutrition focal points at regional levels to coordinate

regional implementation;

7) Integrate nutrition and HIV into pre-service training curricula for Master of Science (Nutrition), Master of

Public Health, nursing school, and medical school students to strengthen long-term capacity in addressing

nutritional aspects of HIV care and treatment;

8) Establish a national-level technical working group (TWG) on food, nutrition, and HIV and support for

development of a national strategy on nutrition and HIV

9) Develop, produce and disseminate guidelines and training materials on clinical nutritional care of

PLWHA;

10) Develop, produce and disseminate program implementation materials and tools to support nutrition

assessment and counseling of PLHIV;

11) Provide technical support to PEPFAR implementing partners for the introduction, strengthening, and

monitoring of nutrition assessment and counseling at HIV care and treatment sites;

12) Provide technical support to the design and monitoring of a food and nutrition program targeting

clinically malnourished PLHIV and orphans and vulnerable children (OVC); and

13) Facilitate of a regional meeting for PEPFAR and Title II implementing partners to strengthen

coordination and integration of food aid and HIV programs.

To help support food and nutrition activities effectively in Ethiopia, FANTA has dramatically scaled-up their

activities for FY2008. The increased budget will allow FANTA to increase technical assistance and support,

in the above areas, to PEPFAR, implementing partners and the Ministry of Health to help build capacity to

address food and nutrition issues in Ethiopia.

Together these activity components will increase the number of PLWHA reached with nutritional care and

support and improve the quality and outcomes of HIV care and treatment services that PEPFAR is

supporting. Approximately 200 service providers at 150 service outlets will be capacitated to provide

Activity Narrative: nutritional care and support to PLWHA.

By ensuring that nutritional aspects of care and treatment are addressed with high quality support, this

activity will strengthen the care and support, ART, and other services that PEPFAR Ethiopia is supporting

through the Care and Support Program and the ART Scale-Up activities listed above. The technical

assistance partner will work closely with implementing partners to ensure coordination and integration of

nutrition into clinical services. The partner will also coordinate with UNICEF, the World Food Program,

Clinton Foundation HIV/AIDS Initiative, and other partners providing nutritional support to HIV-affected

populations to ensure coordinated coverage and help standardize approaches and protocols for nutritional

care of malnourished PLWHA. The nutrition counseling and assessment and capacity strengthening of

Government HIV services complements the food services provided through the Food by Prescription

activity.

PLWHA including HIV-infected pregnant women will be reached with nutrition assessment, counseling, and

food support services that the activity will introduce and support through technical assistance to HAPCO,

hospitals, health centers, and community programs. HIV-infected children and their caregivers will also be

reached with nutrition assessment and counseling. Service providers will be targeted with training, support

materials and capacity strengthening activities.

The activity will incorporate nutrition and HIV content into pre-service and in-service training for doctors,

nurses, counselors, and other health care providers. A key approach used in this activity is to strengthen

HAPCO's capacity to support, provide, and coordinate food and nutrition activities targeting PLWHA. By

supporting human capacity and providing technical input to the national technical working group on nutrition

and HIV, the activity will strengthen HAPCO at the national and regional levels.

Incorporation of nutrition indicators into the existing M&E system used for HIV facilities will improve the

national M&E system and provide information that will enhance both service provision and program

management. The focus of services introduced through this activity at the clinical level is on nutritional care,

but referrals and linkages will also be established to available services that support livelihoods and address

household access to food.

New/Continuing Activity: Continuing Activity

Continuing Activity: 18693

Continued Associated Activity Information

Activity Activity ID USG Agency Prime Partner Mechanism Mechanism ID Mechanism Planned Funds

System ID System ID

18693 18693.08 U.S. Agency for Academy for 12032 12032.08 $750,000

International Educational

Development Development

Emphasis Areas

Gender

* Increasing gender equity in HIV/AIDS programs

Human Capacity Development

Estimated amount of funding that is planned for Human Capacity Development $550,000

Public Health Evaluation

Food and Nutrition: Policy, Tools, and Service Delivery

Estimated amount of funding that is planned for Food and Nutrition: Policy, Tools $200,000

and Service Delivery

Food and Nutrition: Commodities

Economic Strengthening

Education

Water

Table 3.3.08: