Number/percent of HIV care and treatment sites providing individual nutrition counseling services
The number or percent of HIV care and treatment sites that provide one-on-one nutrition counseling services to people living with HIV (PLHIV).
As part of the recommended nutrition assessment, education and counseling (NAEC) services provided to PLHIV (FANTA, 2008), nutrition counseling services are defined as an individual, one-on-one counseling session during which a service provider discusses the client’s situation with her or him and provides information on topics related to diet and nutritional status. Group education and counseling on nutrition and HIV topics do not meet the criteria for this indicator.
This indicator is calculated as:
(Number of HIV care and treatment sites that provide individual nutrition counseling services for PLHIV/ Total number of HIV care and treatment sites in a country or specified area) x 100
Surveys or reports from program sites provided by supervisors or evaluators on whether individual nutrition counseling services are provided. It is recommended that data are collected using a census-based approach (i.e., from all program sites in the target area). For validation purposes, the data collector may choose to conduct brief follow-up interviews with a subset of clients. Where the data are available, the indicator can be disaggregated by province and district, urban/rural location, type of facility (public, private, community-based), and client characteristics (age group, sex, most-at-risk populations).
Surveys, reports, and interviews from program sites, staff, and clients.
WHO recommends that any comprehensive program for HIV/AIDS include nutritional support (WHO, 2003) and the provision of individual nutrition counseling is a key component of NAEC services provided to PLHIV (Fanta 2008). Adequate nutrition helps maintain the immune system, sustain physical activity, and is essential for improving treatment outcomes with antiretroviral drugs. Women of reproductive age with HIV are a critical population for health and nutrition interventions. According to UNAIDS data from 2009, women account for over 50 percent of global HIV infections and over 19.2 million women live with HIV. The nutritional status of HIV-infected women before or during pregnancy and during lactation influences both the women’s health and the health and survival of their infants. An overview of the recommended nutrient requirements for people living with HIV (PLHIV) and specifically for pregnant and lactating women can be found at FANTA (2007).
Given the growing recognition of the important role nutrition plays in the care and support of PLHIV and the scaling up NEAC services into HIV care and support programs, harmonized approaches to monitoring and evaluation (M&E) specific for nutrition and HIV are essential. This indicator can provide information on reach and coverage of nutrition counseling across program sites, help inform program design, resource allocation decisions, identify workload constraints (especially with scaling up of programs) and can be used for reporting to donors and stakeholders on key site-level outputs. Additional background on NEAC, a conceptual framework, process for developing an M&E system, and related indicators can be found in FANTA (2008). For additional background and technical guidance on interventions and indicators for nutrition and HIV care and support and prevention of mother-to-child transmission of HIV, see WHO/UNICEF (2003); WHO (2004); UNAIDS (2010); and WHO/UNICEF/UNAIDS (2011) .
This indicator does not provide information about the quality of counseling services and cannot be used to measure the relative success of nutrition and HIV care and support interventions. The FANTA (2008) resource has an indicator specific for measuring quality of counseling.
access, nutrition, HIV/AIDS, integration
FANTA (Food and Nutrition Technical Assistance) Project. 2007. Recommendation for the Nutrient Requirements for People Living with HIV/AIDS, Washington, DC: USAID/Academy for Educational Development. https://www.unscn.org/web/archives_resources/files/Nutrient_Requirements_HIV_Feb07.pdf
FANTA (Food and Nutrition Technical Assistance) Project. 2008. A Guide To Monitoring and Evaluation of Nutrition Assessment, Education and Counseling of People Living with HIV. Washington, D.C.: USAID/Academy for Educational Development. http://www.hivpolicy.org/Library/HPP001508.pdf
UNAIDS, 2010, Prevention of Mother-To-Child Transmission of HIV (PMTCT): Technical Guidance Note for Global Fund HIV Proposals, Geneva: UNAIDS. http://www.who.int/hiv/pub/toolkits/PMTCT_Technical_guidance_GlobalFundR10_May2010.pdf
WHO, 2003, Nutrient requirements for people living with HIV/AIDS: Report of a technical consultation, May 13-15, Geneva: WHO. http://www.who.int/nutrition/publications/Content_nutrient_requirements.pdf
WHO, 2004, Nutrition Counseling, Care and Support for HIV-infected Women, Geneva, Switzerland: World Health Organization. http://www.who.int/hiv/pub/prev_care/en/nutri_eng.pdf
WHO/UNICEF, 2003, Global Strategy for Infant and Young Child Feeding, Geneva: WHO. http://whqlibdoc.who.int/publications/2003/9241562218.pdf
WHO/UNICEF, 2007, Planning Guide for national implementation of the Global Strategy for Infant and Young Child Feeding, Geneva: WHO. http://whqlibdoc.who.int/publications/2007/9789241595193_eng.pdf
WHO/UNICEF/UNAIDS, 2011, A Guide on Indicators for Monitoring and Reporting on the Health Sector Response to HIV/AIDS. Geneva: WHO. http://www.who.int/hiv/data/UA2011_indicator_guide_en.pdf