Nutrition and Access to Food

This section looks at issues which affect the nutrition of orphans and other vulnerable children and their access to food. Other sections cover general issues of health and nutrition and details of access to health care.

Key points about nutrition are:

1. Good nutrition is essential for the physical growth and development of children. It is also necessary for full development of their immune system, which defends the body against infections.

2. Certain groups of children are particularly vulnerable to nutrition problems. These include young children and children living with HIV/AIDS.

3. Children's need for good nutrition starts before they are born. Children and young people of different ages have different nutritional needs.

4. HIV is known to be transmitted from mother to child through breastfeeding. However, children are more at risk of other infections if they do not breast feed. Things to consider when a woman decides how to feed her baby include whether or not she knows her HIV status and whether or not she is able to safely feed her baby in another way.

Good nutrition is essential for the physical growth and development of children. It is also necessary for full development of their immune system.

Certain groups of children are particularly vulnerable to nutrition problems. These include young children, orphaned children and children living with HIV/AIDS. Although some studies have shown no nutritional problems among orphans compared with non-orphaned children in the same community, many studies have shown that orphans are more likely to suffer stunting, wasting and reduced weight.

Children's need for good nutrition starts before they are born. Children and young people of different ages have different nutritional needs. Young children are particularly at risk of problems with nutrition. For this reason, many of the documents focus on the nutrition of children under the age of five years. These children can also be broken down into groups, 0-6 months, 6-11 months, 12-23 months and 24 months to 5 years.

Issues to consider in the nutrition of children under the age of 5 include:

The role of breastfeeding. It is well-known that breastfeeding is very good for children. It protects them against many diseases and greatly increases their chances of survival. However, breast milk can transmit HIV. Deciding on how to feed an infant can be very difficult for women because of HIV. This choice will depend on whether the woman knows if she is HIV positive and whether or not she can safely feed her baby in another way. Policy principles on infant feeding were agreed by leading UN agencies in 2002. Approaches to infant feeding form an important part of measures to prevent mother to child transmission (PMTCT) of HIV. However, there are other important ways to prevent mother to child transmission, including preventing HIV infection in women, preventing unintended pregnancy and providing long-term support to women.
Other foods. Breast milk provides all the energy and nutrients a child needs for the first few months of life. Children need other foods apart from breast milk from the age of 3-6 months. There is some evidence that exclusive breastfeeding before that time reduces the risk of transmission of HIV from an HIV positive mother. UNICEF recommends that women who are known not to be HIV positive and those who do not know their HIV status should exclusively breastfeed for six months.
Feeding practices can affect whether or not a child is well-nourished. A child should be provided with food they can digest on their own plate. Good hygiene is very important when preparing food for children. Particular care is needed to ensure that a child continues to receive nutrients when they are ill. Children need a range of nutrients including those which provide energy and a range of micronutrients. Important micronutrients include vitamin A, iron and vitamin C.
Access to food. Many documents which talk about nutrition of children overlook a key problem. Many families do not have enough food throughout the year. They do not always have the right kinds of food. Ensuring children and families have enough food is important to ensure that orphans and other vulnerable children are well-nourished. Community grain banks are one way in which communities can provide 'safety nets' for vulnerable children.

Resources

HIV/AIDS: A Guide for Nutrition, Care and Support (Eng) (Module 5 only)

This guide was developed for PVOs and community organizations and field-tested in Malawi and Uganda. The guide is intended to help program managers make recommendations on food management and nutritional issues for HIV/AIDS-affected households.
FANTA, 2001, PDF, 56 pages, 35 kb.

Guiding Principles for Feeding Non-Breastfed Children 6-24 Months of Age (Eng)

This document presents guidelines for feeding non-breastfed children after the first 6 months of life. These principles are intended to guide policy and programmatic action at global, national and community levels.
WHO2005,PDF, 42 Pages

HIV and Infant Feeding (Eng)

This UNICEF fact sheet focuses on the issue of infant feeding in a context of HIV/AIDS.
UNICEF, 2002, PDF, 2 pages, 195 kb.

Community Grain Banks (Eng)

This article appeared in Tearfund's magazine Footsteps, edition 32. It describes the experience of grain banks for improving food security in Burkina Faso through the detailed description of two examples.
Yameogo, P.S., Tearfund, 1997, PDF, 2 pages, 185 kb.

HIV/AIDS: A Guide for Nutrition, Care and Support (Eng) (Full version)

Breastfeeding and Replacement Feeding Practices in the Context of Mother-to-Child Transmission of HIV: An Assessment Tool for Research (Eng)

This document aims to guide research into the links between infant feeding practices and the transmission of HIV.
Piwoz, E., World Health Organisation (WHO), Word, 33 pages, 347 kb.

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Counselling Mothers on Infant Feeding for the Prevention of Mother to Child Transmission of HIV (Eng)

This is a detailed and very practical guide aimed at primary health care workers who need to be able to counsel women regarding infant feeding.
Regional Centre for Quality of Health Care/USAID, PDF, 21 pages, 637 kb.

Prevention of Mother to Child Transmission: Baseline Assessment Tools (Eng)

This document aims to provide a way of assessing the ability of health services to contribute effectively to the prevention of mother to child transmission (PMTCT) of HIV.
Family Health International, 2003, 85 pages.

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South Africa: Children Living with HIV/AIDS in South Africa (Eng)

This Save the Children publication describes the situation of children affected by HIV/AIDS in South Africa and some of the responses to the situations they face.
Smart, R., Save the Children UK, 2001, PDF, 97 pages, 1000 kb.

HIV/AIDS Mitigation: Using What We Already Know (Eng)

This technical note for program staff and the overall development community emphasizes the importance of using what is already known by the development community about food security in the context of HIV/AIDS mitigation.
Bonnard, P., USAID/AED/FANTA (Food and Nutrition Technical Assistance), 2002, PDF, 8 pages, 56 kb.

Potential Uses of Food Aid to Support HIV/AIDS Mitigation Activities in Sub-Saharan Africa: Supporting Intergrated Food Security and Nutrition Programs to Improve Health and Well-Being of Women and Children (Eng)

This paper examines whether and how food programs fit in to overall HIV/AIDS-related development efforts in Sub-Saharan Africa.
USAID/AED/FANTA (Food and Nutrition Technical Assistance), 2000, PDF, 12 pages, 1117 kb.

Nutrition and HIV/AIDS: A Training Manual (Eng)

This training manual is a comprehensive source of information about nutrition and HIV/AIDS which provides trainers with a range of materials for planning and facilitating courses and lectures.
USAID/AED/FANTA (Food and Nutrition Technical Assistance)/LINKAGES and Regional Centre for Quality of Healthcare (RCQHC) Kampala, Uganda, 2003, 345 pages.PDF, 4 056 kb.

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Nutrition and HIV/AIDS: A Training Manual: Session 2: Link Between Nutrition and HIV/AIDS (Eng)

A PowerPoint presentation of part two of a training manual on nutrition and HIV/AIDS. This session explains the links between HIV/AIDS and nutrition. The presentation has additional information on the notes pages.
USAID/AED/FANTA (Food and Nutrition Technical Assistance)/LINKAGES and Regional Centre for Quality of Healthcare (RCQHC) Kampala, Uganda, 2003, PPT, 18 pages, 177 kb.

Nutrition and HIV/AIDS: A Training Manual: Session 3: Key Nutrition Actions for People Living with HIV/AIDS (Eng)

A PowerPoint presentation of part three of a training manual on nutrition and HIV/AIDS. This session explains key actions on nutrition that can be taken by people living with HIV/AIDS. The presentation has additional information on the notes pages.
USAID/AED/FANTA (Food and Nutrition Technical Assistance)/LINKAGES and Regional Centre for Quality of Healthcare (RCQHC) Kampala, Uganda, 2003, PPT, 41 pages, 233 kb.

Nutrition and HIV/AIDS: A Training Manual: Session 4: Food Security Components in HIV/AIDS Nutritional Care and Support (Eng)

A PowerPoint presentation of part four of a training manual on nutrition and HIV/AIDS. This session explains the importance of food security in HIV/AIDS nutritional care and support. The presentation has additional information on the notes pages.
USAID/AED/FANTA (Food and Nutrition Technical Assistance)/LINKAGES and Regional Centre for Quality of Healthcare (RCQHC) Kampala, Uganda, 2003, PPT, 36 pages, 554 kb.

Nutrition and HIV/AIDS: A Training Manual: Session 5: Nutritional Management of HIV/AIDS-Related Symptoms (Eng)

A PowerPoint presentation of part five of a training manual on nutrition and HIV/AIDS. This session explains how to use nutrition to manage HIV/AIDS-related symptoms. The presentation has additional information on the notes pages.
USAID/AED/FANTA (Food and Nutrition Technical Assistance)/LINKAGES and Regional Centre for Quality of Healthcare (RCQHC) Kampala, Uganda, 2003, PPT, 17 pages, 111 kb.

Nutrition and HIV/AIDS: A Training Manual: Session 6: Nutritional Care and Support of Pregnant and Lactating Women or Adolescent Girls with HIV/AIDS (Eng)

A PowerPoint presentation of part six of a training manual on nutrition and HIV/AIDS. This session explains how to use nutrition in care and support of pregnant HIV positive women. The presentation has additional information on the notes pages.
USAID/AED/FANTA (Food and Nutrition Technical Assistance)/LINKAGES and Regional Centre for Quality of Healthcare (RCQHC) Kampala, Uganda, 2003, PPT, 48 pages, 263 kb.

Nutrition and HIV/AIDS: A Training Manual: Session 7: Prevention of Mother-to-Child Transmission of HIV and Infant Feeding (Eng)

A PowerPoint presentation of part seven of a training manual on nutrition and HIV/AIDS. This session explains how to use infant nutrition to prevent mother to child transmission of HIV. The presentation has additional information on the notes pages.
USAID/AED/FANTA (Food and Nutrition Technical Assistance)/LINKAGES and Regional Centre for Quality of Healthcare (RCQHC) Kampala, Uganda, 2003, PPT, 36 pages, 1515 kb.

Nutrition and HIV/AIDS: A Training Manual : Session 8: Nutrition and HIV Among Young Children (Eng)

A PowerPoint presentation of part eight of a training manual on nutrition and HIV/AIDS. This session explains how important nutrition is among children with HIV. The presentation has additional information on the notes pages.
USAID/AED/FANTA (Food and Nutrition Technical Assistance)/LINKAGES and Regional Centre for Quality of Healthcare (RCQHC) Kampala, Uganda, 2003, 43 pages,PPT, 5124 kb.

Food Insecurity, HIV/AIDS, and Children (Zambia) (Eng)

This report discusses food insecirty, HIV/AIDS, and children in the Zambian context.
Scott, G. and Harland, C., FHI, 2003, PDF, 29 pages, 231 kb.

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South African National Guidelines for People Living with TB, HIV/AIDS, and other Chronic Debilitating Conditions (Eng)

These nutrition guidelines by UNICEF and the South African Department of Health are for people living with HIV/AIDS (PLWHA) and the people who care for them.
UNICEF/Department of Health South Africa, 2001, PDF, 44 pages, 279 kb.

FHI Focus on Reducing Mother-to-Child Transmission of HIV (Eng)

This fact sheet focuses on preventing MTCT during pregnancy, labour and delivery, and breastfeeding, and describes a comprehensive package to reduce MTCT.
FHI, 2003, PDF, 2 pages, 188 kb.

The American Red Cross, Programming Guidance: Food/ Nutrition Discussion Paper Number 2 Food Security - HIV/ AIDS Best Practices/Issues (Eng)

This paper and its nine appendices have been written mainly for Red Cross field management and technical staff and cover the links between HIV/AIDS and food security.
Cekan, J.M., American Red Cross International Services, PDF, 42 pages, 599 kb.

HIV & Infant Feeding: Question & Answer Guide (Eng)

This Question and Answer Guide is designed to help counselors, who already have some formal training on issues related to HIV/AIDS and infant feeding, to provide information and support for preventing HIV transmission among pregnant women, mothers and their children.
Tanzanian Ministry of Health, UNICEF/Tanzania, WHO/Tanzania, Tanzania Food and Nutrition Centre (TFNC), COUNSENUTH, Quality Assurance Project (QAP)/University Research CO., LLC (URC), USAID, 2004, PDF, 18 pages, 385 kb.

How to Breastfeed Your Baby (Eng)

This is a short and practical guide on how to breastfeed a baby with specific focus on issues relating to HIV.
Tanzanian Ministry of Health, UNICEF/Tanzania, WHO/Tanzania, Tanzania Food and Nutrition Centre (TFNC), COUNSENUTH, Quality Assurance Project (QAP)/University Research CO., LLC (URC), USAID, 2004, PDF, 3 pages, 45 kb.

How to Feed Your Baby Fresh Cow's Milk (Eng)

This is a short and practical guide on how to feed a baby with cow's milk with specific focus on issues relating to HIV.
Tanzanian Ministry of Health, UNICEF/Tanzania, WHO/Tanzania, Tanzania Food and Nutrition Centre (TFNC), COUNSENUTH, Quality Assurance Project (QAP)/University Research CO., LLC (URC), USAID, 2004, PDF, 3 pages, 62 kb.

How to Express and Heat Treat Breast Milk (Eng)

This is a short and practical guide on how to express and heat treat breast milk with specific focus on issues relating to HIV.
Tanzanian Ministry of Health, UNICEF/Tanzania, WHO/Tanzania, Tanzania Food and Nutrition Centre (TFNC), COUNSENUTH, Quality Assurance Project (QAP)/University Research CO., LLC (URC), USAID, 2004, PDF, 3 pages, 47 kb.

How to Feed Your Baby Infant Formula (Eng)

This is a short and practical guide on how to feed a baby with infant formula with specific focus on issues relating to HIV.
Tanzanian Ministry of Health, UNICEF/Tanzania, WHO/Tanzania, Tanzania Food and Nutrition Centre (TFNC), COUNSENUTH, Quality Assurance Project (QAP)/University Research CO., LLC (URC), USAID, 2004, PDF, 3 pages, 60 kb.

SCOPE and Family Health International Orphans and Vulnerable Children Baseline Survey, Psychosocial Interviews with Orphans and Vulnerable Children: Questionnaire for 06-12 Year Olds (Eng)

This is a questionnaire from the SCOPE programme in Zambia for use with children aged 6-12 years.
FHI/SCOPE/USAID, 2001, PDF, 9 pages, 494 kb.

SCOPE and Family Health International Orphans and Vulnerable Children Baseline Survey, Psychosocial Interviews with Orphans and Vulnerable Children: Questionnaire for 13-18 Year Olds (Eng)

This is a questionnaire from the SCOPE programme in Zambia for use with adolescents aged 13-18 years.
FHI/SCOPE/USAID, 2001, PDF, 23 pages, 1247 kb.

School feeding programs: Improving effectiveness and increasing the benefit to education. A guide for program managers (Eng)

This guide is designed to assist those engaged in the process of creating new school feeding programmes (SFP) or seeking to improve the effectiveness of on-going ones. It is based on a review of the SFP research and program literature from the last decade.
Del Rosso, J. Partnership for Child Development/World Bank, 1999, 220kb, 45 pages

School Health and Nutrition newsletter (Eng)

This is the first edition of a bi-annual newsletter on school health and nutrition (SHN). It contains general background information on Save the Children’s approach to SHN, both theoretical and programmatic.
Save the Children USA, 2004, PDF, 859kb, 13 pages

Widening the window of hope: Using food aid to improve access to education for orphans and vulnerable children in sub-Saharan Africa (Eng)

This paper discusses the difficulties in addressing educational needs of OVC in areas with high prevalence of HIV/AIDS. It also offers possible food and non-food interventions to improve children’s access to education.
Landis, R. World Food Programme, 2003, PDF, 1400kb, 39 pages