Assessment of Nutrition Support Services for Persons Living with HIV at Selected Art Sites in Ghana
Date
2013-07
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Publisher
University of Ghana
Abstract
According to the 2012 HIV sentinel Survey Report, it is estimated that 235,982 people are living with HIV in Ghana. There have been several interventions all making attempts to address challenges PLHIV face. One of such interventions is the Nutrition Assessment Counselling and Support programme (NACS) which aims at providing a comprehensive nutrition services for PLHIV.
The study hopes to bring to the fore the capacity of health workers to deliver NACS services in Ghana, the availability and use of NACS related educational materials and equipments, the adequacy of nutrition counselling as part of NACS services and also to assess the nutrition knowledge of the PLHIV’s receiving NACS services at the selected ART sites.
This is a cross-sectional study. Persons Living with HIV (PLHIV) and Health workers were conveniently selected from eight (8) active ART sites implementing NACS. Participants were interviewed with the use of structured questionnaire. A standardized observation checklist was also used to collect information on the quality of nutrition counselling and the availability and use of NACS related equipment and materials.
Nutrition knowledge of PLHIV was determined based on knowledge of two or more critical times to wash hands properly, three basic ways to increase energy intake, two or more advantages of eating a nutritionally adequate diet, and eating three or more times a day. Adequacy of nutrition counselling was determined using a standardised checklist from FANTA on nutrition counselling quality. Scoring 75% or more means nutrition counselling was of good quality. The capacity of the health workers delivering nutrition services to PLHIV was also assessed by way of looking at their background training as nurses/nutritionist or dietician or Counsellors and if they have ever received an MOH approved training in nutrition and HIV. The availability on use of NACS related educational material and equipment was also assessed.
Data from 261 PLHIV’s 13 health workers and eight ART sites were included in the analysis. For the PLHIV, there were 197 females (75.5%) and 64 females (24.5%), Less than 30.0% have never had any form of education, 81% of them are employed. For the health personnel, four were Nurses, two Dieticians, two Models of Hope Personnel, a Statistician, two Health educators and two Psychologists. Routine individual nutrition counselling was not observed in any of the facilities except for those visibly wasted who needed to be put on therapeutic food. Seven of such sessions were observed using a nutrition quality checklist. All counselling sessions were of good quality as the average scores ranged from 75% to 90%. Almost all (89%) of PLHIV had adequate knowledge on the need to eat three or more times a day. However, less than 20% of them knew three basic ways to increase energy intake. Most health workers have the requisite training to provide NACS services to PLHIV’s. Almost all ART sites are not adequately equipped to deliver NACS services to PLHIV’s.
In conclusion, routine nutrition counselling for PLHIV has been found to be inadequate even though most health personnel delivering nutrition services have been trained. There is the need for regular refresher training for health workers and to replace health worker who have gone on transfer or retirement with those with the requisite skills and appropriate training to provide comprehensive nutrition services for PLHIV. Most PLHIV’s were found to have quite an adequate nutrition knowledge but there the need to help improve the availability with the use of BCC/IEC materials like posters that communicates nutrition and HIV messages in languages that are easy to comprehend
Description
Thesis (MPH) - University of Ghana, 2013