Assessment Of Nutritional And Health Interventions On Hiv Infected Children Under Five Years In Mathare North Health Centre, Nairobi

ABSTRACT

About 33.4 million people were living with HIV as of 2008 globally; 2.1 million of them were children under 15 years, and about 15.7 million were women. In certain parts of the world, HIV infection has significantly affected child survival. The World Health Report 2005 estimated that HIV infection contributed 3% to the global mortality among children younger than 5 years of age in 2005. According to UNAIDS and WHO 2004, there were more than 1.3 million people infected with HIV and AIDS in Kenya; and more than 100,000 children below the age of 15 years. In the recent years, growth, nutrition and metabolism of HIV infected children have received increased attention, as it has been recognized that HIV infected children generally do not grow as well as their uninfected counterparts. According to the 2005-2010 Kenyan National HIV/AIDS Strategic Plan, the government identified good nutrition as a key component of the national response to the HIV/AIDS epidemic. This study therefore sought to establish the effectiveness of nutritional and health interventions on the health and nutritional status of HIV infected children in Mathare. Respondents to the study included mothers of HIV positive children under five years seeking medical care at Mathare health centre, as well as staff offering services to the caregivers. The objectives of the study were to establish the sociodemographic and socio-economic status among care-givers of HIV infected children, identify nutrition and health interventions in place at Mathare health centre and the proportion of population accessing these interventions, determine the nutrition and health status of the HIV infected children attending clinic at Mathare health centre, assess the relationship between health and nutrition interventions, health status and nutrition status. Data was collected using a structured questionnaire administered on mothers and staff at the facility. These were then entered and analysed by Statistical Package for Social Sciences version 12.0. Descriptive statistics used to summarize the sample population included percentages, frequency distributions and charts. Chi-square was used to determine the relationship between categorical variables namely up-take of health and nutrition interventions versus nutrition status and presence of illnesses. From the study findings, marital status, mother‘s education and income level were the main factors that influenced access to interventions. The interventions at Mathare health centre include: nutritional counselling, micro-nutrient supplementation, food by prescription, immunization, ART and provision of prophylaxis. Twenty two percent of children in the study were stunted, eleven percent wasted while nineteen percent of the children were underweight. The most frequent illnesses and symptoms in the area were diarrhoea (38%), loss of appetite (29%), cold (28%) followed by cough and fever respectively. There was a significant relationship between nutritional counselling and nutrition status of children, there was also a relationship between food by prescription and nutrition status. Up-take of prophylaxis and ART showed a significant relationship with presence of illness but not with nutrition status. There was significant relationship between nutritional counselling and nutrition status. Nutritional counselling is cheap compared to provision of ART and therefore it can be extended that all children may receive as it is cheap yet it has shown to be effective.