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Availability of nutritional support services in HIV care and treatment sites in Sub-Saharan African countries

Publication year: 
Author (s): 
Anema, Aranka [et al.]
Publication details: 
s.l., Public Health Nutrition, 2011
Publication in: 
Public Health Nutrition: 15(5), 2011, pp. 938–947

A cross-sectional survey of sites providing antiretroviral therapy (ART) in nine sub-Saharan African countries was conducted. Outcomes included availability of: (i) nutritional counselling; (ii) micronutrient supplementation; (iii) treatment for severe malnutrition; and (iv) food rations. Associations with health system indicators were explored using bivariate and multivariate methods. Setting: President’s Emergency Plan for AIDS Relief-supported HIV treatment and care sites across nine sub-Saharan African countries. Subjects: A total of 336 HIV care and treatment sites, serving 467 175 enrolled patients. Results: Of the sites under study, 303 (90%) offered some form of nutritional support service. Nutritional counselling, micronutrient supplementation, treatment for severe acute malnutrition and food rations were available at 98%, 64%, 36% and 31% of sites, respectively. In multivariate analysis, secondary or tertiary care sites were more likely to offer nutritional counselling (adjusted OR (AOR): 2?2, 95% CI 1?1,4?5). Rural sites (AOR: 2?3, 95% CI 1?4, 3?8) had increased odds of micronutrient supplementation availability. Sites providing ART for .2 years had higher odds of availability of treatment for severe malnutrition (AOR: 2?4, 95% CI 1?4, 4?1). Sites providing ART for .2 years (AOR: 1?6, 95% CI 1?3, 1?9) and rural sites (AOR: 2?4,95% CI 1?4, 4?4) had greater odds of food ration availability. Conclusions: Availability of nutritional support services was high in this large sample of HIV care and treatment sites in sub-Saharan Africa. Further efforts are needed to determine the uptake, quality and effectiveness of these services and their impact onpatient and programme outcomes.