Namibia Ministry of Health and Social Services - A National Focus on Food Security
Food security and nutrition are major factors in clinical outcomes for PLHIV. Through analysis of performance measures and patient feedback, the MoHSS identified food security as a significant barrier to quality of the national care and treatment program. To improve treatment adherence and reinforce the health of PLHIV, the MoHSS determined to prioritize nutritional screening and counseling for all HIV patients, and ensure appropriate referrals for patients with food security deficits.
Commonly identified barriers to adequate nutrition and food security among PLHIV in Namibia include: lack of a food security screening tool in HIV patient care booklets; poor documentation; absence of an effective referral mechanism; no adequate support groups; high staff turnover and heavy workload; high national unemployment and poverty rates; and alcohol abuse.
A series of targeted interventions were implemented to address these challenges. Improvement activities were initiated at the clinic level and
as part of national strategies promoted through the MoHSS at the various clinics, e.g. health edication, referral mechanisms - and advanced through Namibia’s regional QI groups and other peer exchange and knowledge transfer activities. These included: development of a simple food security screening tool, implementation of a patient referral mechanism, training of healthcare workers on the need for food security screening, health education for patients with an emphasis on substance use and its impact on food security, reorganization of patient flow to streamline security assessment, implementation of a national Nutritional Assessment Counseling and Support (NACS) program to support nutrition, provision of food supplements, coordination with social workers, and initiation of community gardens and soup kitchens.
A quality improvement approach to food security can be an effective nutritional support tool for people living with
HIV. Attention to screening and documentation is critical, as well as
training of healthcare workers and patients to appreciate and understand attention to this area of care.
The MoHSS will continue to focus on improving food security screening and alcohol assessment given the close link between these two measures, and continue to focus on this area of care as integral to the success of Namibia’s national care and treatment program.
The MoHSS remains focused on the need to refine and develop interventions aimed at food security. Planned activities include the rollout of a revised HIV patient care booklet incorporating food security screening and other indicators.♦
*This has been adapted from Namibia's country presentation at the 2012 All Country Learning Network.