WFP’s Urban HIV/AIDS

Nutritional Support Program in

EthiopiaA joint program of USAID/Ethiopia – FFP, PEPFAR, and WFP

Michelle Jennings

USAID/Ethiopia

Overview• Problem

• Background

• WFP/USAID Urban HIV/AIDS Nutritional Support Program

• Opportunities

• Challenges

• Broader Issues

• Future vision

The Context

• Staggering

malnutrition country-wide

• 47% of children under

five are stunted

• 8-10 million (avg.) food

insecure in rural areas

The Numbers

• National HIV/AIDS prevalence is 2.03 which means over 1.5 million people in Ethiopia are living with HIV/AIDS

• Equally troubling is the high prevalence in URBAN areas, esp. among girls and women (1 and 8 in Addis are infected)

• We think that almost half of PLWHAs come from the RURAL setting although are infected in Urban areas

The Problem

“ART without food is meaningless” ARV Clinic M.D., Nazareth, Ethiopia

• HIV and malnutrition exacerbate one another and have profound consequences for clinical outcomes for PLWHA

• Effectiveness of drug response in patients under treatment for HIV/AIDS is strongly dependant upon their nutritional status

History

• WFP had supported an urban food security program in Addis Ababa in 2000

• Refocused program to address nutritional support for Urban HIV/AIDS affected households in Addis Ababa in 2003

• WFP scaled-up further to the current 14 large towns in Ethiopia

• $350,000 USD from PEPFAR

• 13,800 MT of Title II food ($8.2 million)

Total program cost: $19.2 2006/2007 (2 yr.)– Outstanding needs for 2007 are $5 million

in food resources

ObjectivesBy providing nutritional support WFP contributes to the national response to

HIV/AIDS by

• Increasing nutrition, health and overall well being of PLWHAs (including complementary support to Home Based Care Services)

• Supporting enrollment and adherence to anti retroviral treatment (ART) and prevention of mother to child transition (PMTCT) programs

• Supporting school attendance of orphans and vulnerable children (OVCs)

Urban HIV/AIDS Project

• The project targets urban food insecure/poverty stricken, HIV/AIDS infected or affected households

• The Food Basket provided consists of Wheat, Corn Soya Blend (CSB), Oil and Pulses

• There are currently more than 111,000 beneficiaries

Food and Nutritional SupportEntry Exit

Orphans andVulnerable Children

IndividualRation

VCT/PMTCT(HIV +)

NutritionalCounselingand Support

HH ration

Pre-ARTor ART

Provision ofBasic CarePackage &HH ration

SeverelyMalnourished

Pre-ART or ART

RUTF(if eligible BMI/MUAC)HH ration

Linkages

Nutritional Support for affected HHs is linked to a collection of other referral services

• Care • Treatment • Prevention

Capacity Building

• PEPFAR funding provides training in HIV/AIDS & Nutrition for Partners and Home Based Care Volunteers

• Training in preparation of Corn Soya Blend (CSB) provided to beneficiaries through HBC volunteers

• Training in Logistics and M&E for partners

• Capacity Building for implementing partners through provision of IT equipment

Promising Results• 98% of patients receiving ART and

nutritional support were able to adhere to their treatment

• Over 90% of PLWHAs receiving nutritional support reported that their health condition was improving or stable

• 90% of OVCs receiving nutritional support were able to attend school regularly

OpportunitiesNutritional support provides entry points to increase nutrition awareness and linkages to

other HIV/AIDS services for beneficiaries

• Strong and committed partnerships between Government, donors and WFP to collaborate on nutritional support

• Presence of strong implementing partners, including government and NGOs

• Complementary activities, including Home Based Care and OVCs programmes

Challenges

Increased demand as VCT and ARV services expand

Lack of longer term food security programs with which to link in the Urban areas

Exit strategy and linking to income generating activities (IGA)

Unpredictable food resource

Broader Issues

Inadequate food and food security resources link to PEPFAR programs

Imbalance in USAID resources (Title II and PEPFAR)

Are there alternative mechanisms to provide food to PLWHAs?

Can PEPFAR cover transportation and operational costs to allow for more food to be purchased?

Capitalize on geographic overlap (mainstreaming)

Future Vision Establish a long term solution to HIV/A nutritional

support that is predictable and reliable

Ensure nutritional support to acutely malnourished PLWHAs is linked to complementary household ration

Title II and community therapeutic center (CTC) experience is applied and informs HIV/AIDS programming for nutrition

Harmonize policy and implementation guidelines

THANK YOU !

Questions? mjennings@usaid.gov