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Namibia[2005-Present] Recognizing the importance of nutrition in effective HIV programming, USAID/Namibia requested FANTA’s technical assistance to strengthen nutrition capacity in the context of HIV. Continuing FANTA’s efforts, FANTA-2 helps to integrate food and nutrition into HIV care and treatment programs for malnourished people living with HIV (PLHIV) and orphans and vulnerable children (OVC) and to strengthen capacity in nutrition assessment, counseling and support (NACS) among health care providers at HIV care and treatment sites. Advocacy for Integrating Nutrition Into Health Services: FANTA-2 is a member of the National Alliance for Improved Nutrition (NAFIN) under the Office of the Prime Minister. NAFIN’s objectives are to improve maternal, infant and child nutrition; prevent micronutrient deficiencies; advocate for appropriate food fortification; and raise awareness of the importance of good nutrition. FANTA-2 has worked with UNICEF and the Ministry of Health and Social Services (MOHSS) to harmonize guidelines for integrated management of acute malnutrition with Food by Prescription (FBP) guidelines for acutely malnourished PLHIV, provided advocacy points on intersectoral collaboration for implementing the National Nutrition Strategy and contributed nutrition content to the training curricula on Integrated Management of Adult and Adolescent Illness and Integrated Management of Childhood Illness. Assessment of Food and Nutrition Needs of PLHIV: In 2008 FANTA and the MOHSS assessed the food and nutrition needs of PLHIV, the support that service providers need to provide quality nutrition care and gaps and opportunities in integrating nutrition into HIV treatment and support. The assessment was the first step toward improving nutrition care and support for PLHIV in Namibia and informed programming for food and nutrition assistance funded by the President’s Emergency Plan for AIDS Relief (PEPFAR). Operational Guidelines for a National Nutrition Program for PLHIV: Based on the assessment’s findings, FANTA helped the MOHSS develop a strategy and operational plan on nutrition and HIV that defines the components of and resource needs for a PEPFAR-funded FBP program for PLHIV. The Nutrition Assessment, Counselling and Support for PLHIV Operational Guidelines, completed under FANTA-2, serve as the framework for planning, resource mobilization and monitoring of nutrition care and support implementation. Nutrition and HIV Counseling Materials and Job Aids: Also based on the assessment’s findings and at the request of the MOHSS, FANTA-2 worked with Government of Namibia partners to develop counseling materials and job aids to support nutrition care and support for PLHIV. The materials include job aids for nurses and physicians, a monitoring checklist for supervising and mentoring trained health care providers and client education materials on nutrition management of HIV-related symptoms and on food and water safety and hygiene. These materials will be distributed to initial FBP sites. FBP Program: The MOHSS will initiate the Namibia FBP program in nine clinics where the national Integrated Management of Acute Malnutrition (IMAM) program has been launched. FANTA-2 helped the MOHSS estimate needs for and plan procurement of specialized food products for clinically malnourished PLHIV and worked with UNICEF/Namibia to harmonize the cutoffs and treatment guidelines for children with severe acute malnutrition with the national IMAM guidelines to ensure consistent protocols. FANTA-2 also helped develop an FBP training manual and co-facilitated training of seven regional health managers with the MOHSS and the International Training and Education Center on HIV/AIDS (I-TECH).
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