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Elements and Applications of the NACS Approach Serigne Diene,

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Elements and Applications of the NACS Approach Serigne Diene, Senior Nutrition and HIV Advisor (FANTA/FHI360). Presentation Outline NACS elements Country achievements Challenges and lessons learned Way forward. Integrating Nutrition into National HIV Responses (1).

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Presentation Transcript
slide1

Elements and Applications

  • of the
  • NACS Approach
  • Serigne Diene,
  • Senior Nutrition and HIV Advisor (FANTA/FHI360)
slide2

Presentation Outline

  • NACS elements
  • Country achievements
  • Challenges and lessons learned
  • Way forward
integrating nutrition into national hiv responses 1
Integrating Nutritioninto National HIV Responses (1)
  • National Policy and Coordination
    • National nutrition and HIV guidelines
    • National nutrition and HIV strategy
    • Nutrition incorporated into HIV policies and vice versa
    • Technical coordinating group
    • Nutrition focal point in National AIDS Control Program
integrating nutrition into national hiv responses 2
Integrating Nutritioninto National HIV Responses (2)
  • Capacity Strengthening
    • In-service and pre-service training of health care providers (linking the two ?)
    • Job aids
    • SBCC materials
    • Anthropometric equipment
    • Mentoring and supervision
    • QA/QI
    • M&E
integrating nutrition into national hiv responses 3
Integrating Nutritioninto National HIV Responses (3)
  • Service delivery
    • Nutrition assessment
    • Nutrition education and counseling
    • Specialized food products
    • Micronutrient supplementation
    • Water, sanitation, and hygiene (WASH)
    • Food security support
challenges
Challenges
  • Food and nutrition needs of non-HIV-affected populations (ethical and practical considerations)
  • Overstretched health systems and service provider time constraints
  • Limited scale
  • Geographic overlap with broader food security services
lessons 1
Lessons (1)
  • Health facilities a good entry point for PLHIV nutrition services, but need to integrate NACS into community services and establish two-way referral mechanisms between facility and community services
  • Importance of integration into existing systems (e.g., patient flow, information flow)
  • Importance of ownership by medical stakeholders
lessons 2
Lessons (2)
  • Importance of human resource capacity in nutrition
  • Value of seconding nutrition focal point to government AIDS control program
  • Need to balance meeting HIV objectives and achieving nutrition-specific goals
  • Need for coordination and agreement on a cohesive nutrition approach
  • HIV care and treatment as opportunities to strengthen nutrition capacity and services
way forward 1
Way forward (1)
  • Scale-up of NACS services
    • Site assessments
    • Tailoring service delivery to existing systems
    • Training
    • Materials
    • On-the-job mentoring
    • Coordination among partners
    • M&E
    • Cross-site learning
way forward 2
Way forward (2)
  • Strengthening health system and human resource capacity
  • Integrating NACS into client flow as a routine standard of care
  • Including nutritional status as a criterion in care and treatment protocols
  • Incorporating nutrition information in client registers and health management information systems
way forward 3
Way forward (3)
  • Nutrition care in community-based services and links to acute malnutrition services
  • Introducing basic nutrition services as part of home-based care and other community-based services
  • Establishing linkages between facility and community services for follow-up, referral, and complementary services
way forward 4
Way forward (4)
  • Quality improvement (QI)
  • QI applied to nutrition care services as part of training, service delivery, and monitoring
  • Nutrition incorporated into existing QI systems used in HIV care and treatment
  • Learning sites and centers of excellence to demonstrate QI processes and results
way forward 5
Way forward (5)
  • Enough experience to assess strengths and weaknesses of the NACS approach and critical conditions for effective implementation
  • Evaluation of the impact of nutrition counseling on key health outcomes
  • Evaluation of the of therapeutic and supplementary food in delaying need for initiation of ART
  • Evaluation of different delivery mechanisms
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