Tested Changes to Improve Nutrition Assessment, Counseling, and Support in HIV Care in Zambia
From 2014-2017, the USAID ASSIST Project collaborated with FANTA III and LIFT II to support the Government of Zambia to pilot nutrition assessment, counseling, and support (NACS) as part of HIV care in Kitwe and Mkushi districts, representing both urban and rural districts. The pilot activity was funded by the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) through USAID and designed to support the continued adoption, adaptation, and scale-up of NACS as a standard of care within national HIV/AIDS programs in Zambia. Using the NACS platform, ASSIST, FANTA III, and LIFT II also implemented an activity with the objectives of strengthening engagement, adherence, and retention (EAR) of PLHIV in HIV care and ultimately improving the wellness of adults and pediatric HIV patients.
A key component of this work was to improve the delivery of NACS services, share implementation experiences, and identify a set of practices and interventions that lead to desired outcomes and can eventually can be spread to other sites. This report describes the results achieved in Kitwe and Mkushi districts, explains how the quality improvement (QI) work was carried out, and details the effective practices tested by teams in the two districts that can be readily applied by others in Zambia and elsewhere. It describes simple steps that have been proven to work in the Zambian context through the efforts of improvement teams at the facilities, supported by district supervisors and coaches. The changes can be grouped in three areas:
- Changes in data recording and management, including the introduction of new data tools
- Changes in staff roles, task shifting, and engagement of the community volunteers
- Changes in patient flow