HIV, Food Security and Nutrition

OVC, HIV, Food Security and Nutrition A look at where we stand By Kara Greenblott & Kate Greenaway For UNICEF and WFP Situation of OVC &Targeting Findings • Understand terminology • Accept global ambiguity Orphanhood vs nutrition Differences in orphanhood Discrimination Family capacity • Targeting Costly, labour intensive & complex • Steps in targeting © UNICEF/Andrew Situation of OVC & Targeting Recommendations • Focus on local situation • Understand situation and purpose in defining terms • Expand growth monitoring and promotion & nutritional rehab’ services • Seek out paediatric hospices/day care, transition and foster care programmes • Enhance support to PMTCT and PMTCT+ Programming Findings • Food/nutrition integral to comprehensive programme • Higher malnutrition in HIV+ children • Forming/supporting viable partnerships • Reaching out-of-school youth • Dependency and sustainability • Keeping parents alive • Challenges of scaling up Programming Recommendations • Revitalise nutrition/nutrition education • Adapt growth monitoring and care programmes • Improve access to “ready to use therapeutic food” through local production • Focus on ECCD: for nutritional supplements, de-worming, psycho-social support & treatment of HIV+ children Monitoring & Evaluation Findings • Emphasis on care and protection • Standardised food security indicators • Children’s views are important • Time and financial constraints Monitoring and Evaluation Recommendations • Develop holistic child vulnerability indices/scales • Engage children in measuring vulnerability • Develop qualitative approaches • Improve monitoring • Seek out opportunities for prolonged follow-up Overall Findings • No documented successes: “a dearth of honest analysis & exposure of lessons learned” • Lack of attention to nutritional issues • What’s available is contradictory: done to attract media attention & donor funding • No evaluations of exit strategies/ graduation • Categories of interventions identified: further investigation, scalability, replicability Possible Models for scaling up/replication/promotion • Livelihoods & skills training for out-of school youth • PMTCT+ programmes • Integrated growth monitoring, promotion and care programming: adapted to low & high HIV prevalence • Comprehensive, community-led OVC care • Alternative primary education for out-of-school youth Above all: • M&E important in all of the above • Focus on graduation and exit strategies Issues for Consideration (1) • More research on proposed models • Need for different kinds of guidance materials • Revitalise nutrition/nutrition education • Measure nutritional status of HIV-positive infants and children • Increase funds for targeting  Targeting in urban settings Issues for Consideration (2) • Ensure sustainability of OVC programming • Experience to date with food to encourage guardianship • Use of food to enhance enrolment and attendance in secondary schools • Capitalize on the attention to food insecurity and poor nutrition in the global AIDS debate Next Steps? • Form an IATT sub-working group to follow-up on these issues and more • Identify members, prepare Terms of Reference • What else?