Nutri-flour a new recipe for success: Evaluation of a nutritional supplement program for people living with HIV/AIDS in western Kenya

Food insecurity and compromised nutritional status increase the risk of HIV infection, and among people living with HIV/AIDS (PLHA), can negatively impact the effectiveness of antiretroviral (ARV) therapy. Without proper nutrition ARVs: may not be well-absorbed, or metabolized; and could cause adverse effects, adherence, and resistance problems. A 2003 survey of 60 PLHA living in Kisumu, Kenya and receiving home-based care (HBC) showed 35% were severely malnourished, and 65% were underweight.

In 2003, the non-profit Kisumu Medical and Education Trust (K-MET) started a community initiative to produce and distribute enriched nutri-flour (made from local grains) to PLHA to enhance the effectiveness of ARV therapy. From June to September 2006, qualitative and quantitative data were gathered to assess the impact of the program. HBC clients and K-MET staff were interviewed, client hospital records were reviewed, and several focus groups were held. 80% of clients reported improved strength and weight gain after using the nutri-flour and 50% reported the nutri-flour helped them adhere to their drug regimens. However, over 60% of clients stated they would be unable to buy the flour on a regular basis.

It is unclear whether the nutri-flour program can achieve sustainability. Without additional funding the program may be unable to continue and the progress gained may be lost. Given the emerging availability of ARVs in many developing countries policy makers must take into consideration the issues of food insecurity and chronic malnutrition. Failure to do so may result in ineffective programs that are a waste of limited resources.