Performance Of The Nutrition Care, Support And Treatment Programme For Malnourished People With Hiv On Antiretroviral Therapy

Abstract

In spite of financial, human and material resources investment in Nutrition Care, Support and Treatment programme for close to five years by the Government of Malawi and its collaborating partners, the programme had never been evaluated to gauge whether it had been implemented according to originally set objectives and targets. This evaluative study was conducted from July 2010 to October 2010 in Dowa and Ntchisi districts in Malawi where the Nutrition Care, Support and Treatment had been implemented. The main objective of the study was to evaluate the performance of the programme in the two districts. A total of six health facilities were purposively sampled because they had implemented the programme. A total of 187 clients receiving antiretroviral therapy and nutrition care, support and treatment were randomly sampled from the six facilities using probability proportion to size approach. The data collection tools used included a pre-tested semi-structured questionnaire, Key Informant Interview guide, Strengths, Weaknesses, Opportunities and Threats guide, Focus Group Discussion guide and a secondary data template. Analysis for quantitative data was done using Statistical Package for Social Scientist version 17, Microsoft Office EXCEL 2003 and EPI6 while qualitative data were thematically analysed. Statistical tests employed included chi-square, paired t- test, and F-test and significance in the outcomes was tested at p<0.05. Two thirds (66.8%) of the clients in the study sample were females. Most (44.9%) of the clients were in monogamous marriages and had some formal education. The mean age of the clients in the study was 38.2±9.1 while the mean household size and dependency ratio were 5.02±2.2 and 1.07 respectively. The vast majority of the clients (94.1%) indicated that they usually finished consuming the entire daily prescribed ration of ready to use therapeutic food and almost all (99.5%) of the clients never missed their anti-retroviral pills. The programme therefore achieved its set target of 95% on adherence to drug protocols. On nutrition knowledge, majority of the study clients (98.9%) scored less than 50%, the expected programme target for nutrition knowledge.