Nutrition knowledge and practices of trained home based care volunteers for people living with HIV/AIDS in Kakamega, district Kenya.

Abstract

Home-based care includes the care given to the sick and affected in their homes and care extended from the hospitals or health facilities to their homes through family participation and community involvement. One of the components of home-based care is nutritional care and support. In Kakamega district, home-based care volunteers have been trained from 2000 to date. The main trainers were Pathfinder trains for three weeks, Grass Root Organization Operating in Sisterhood trains for two days and Joy three days. This cross sectional study was conducted to assess the nutritional knowledge and practices of the trained volunteers in Kakamega district. The study population comprised of 200 trained volunteers. A questionnaire, focus group guide and observations were used. In the study, 146 volunteers were interviewed and 27 people living with HIV IAIDS participated in focus group discussions. Observations were made on the condition of people living with HIV/AIDS, time spent on nutrition education and content in three refresher trainings. Supplies given to volunteers were observed and recorded. Various attributes of knowledge were sought. These included knowledge on spread, symptoms of AIDS that affect the nutrition of people living with HIV/AIDS and nutrition knowledge needed to take care of the symptoms. Data were analysis using SPSS computer software. The percentage score was put into quartiles and used as cut off points to categorise the knowledge of the v olunteers into adequate (upper quartile), moderate (third quartiles) and inadequate (second and lower quartile). Their practice was determined by finding out how many clients they saw per month, how they decided the visits, the interval they took before seeing clients and the services they offered. The volunteers ranked challenges encountered in the course of their work. Coping strategies used by the volunteers in their work were documented. The associations among the variables was determined. The results from the study showed that only 3.4% of the volunteers had adequate nutrition knowledge. The education level of the volunteers was positively related to their nutrition knowledge. The volunteers who had been trained for three weeks had better nutrition knowledge than those trained for two days and one week. More than half (59%) of volunteers were committed to their work, they visited clients weekly. The services offered by most volunteers were environmental and personal hygiene, training 0 f care givers in the homes, nutrition education and counseling. The three most important challenges to volunteers in their work were high expectations from clients and the community, poverty and uncooperative patients. Among the various coping strategies that were available to volunteers, giving what they had, involving the community and counseling families and PLWHA were the ones most applied. In conclusion, the hypothesis that most home-based care volunteers have adequate nutrition knowledge was not supported by the results of the study. The second hypothesis that nutrition knowledge does not depend on training time or the trainer was not supported by the results. The results also showed that nutrition knowledge was associated with the training time and trainer. Those trained by Pathfinder (3 weeks) and Joy ( 3 days) had better knowledge than those trained by GROaTS (2 days). Volunteers trained for three weeks had better knowledge than those trained for two days. The last hypothesis that nutrition knowledge does not affect the practice of volunteers was supported by the results of the study. There was no association in services given, number seen and interval before seeing a client between those with adequate knowledge and those with inadequate knowledge. It is recommended that for the volunteers to have adequate nutrition knowledge the agencies who train volunteers ought to consider the education level of volunteers, give adequate content and time to nutrition during trainings and carry out refresher trainings. The practice would improve if the volunteers get supportive supervision and some of the challenges like lack of supplies attended to.