Nutrition knowledge and practices of trained home based care volunteers for people living with HIV/AIDS in Kakamega, district Kenya.
Abstract
Home-based care includes the care given to the sick and affected in their homes and care
extended from the hospitals or health facilities to their homes through family
participation and community involvement. One of the components of home-based care is
nutritional care and support. In Kakamega district, home-based care volunteers have been
trained from 2000 to date. The main trainers were Pathfinder trains for three weeks, Grass
Root Organization Operating in Sisterhood trains for two days and Joy three days. This
cross sectional study was conducted to assess the nutritional knowledge and practices of
the trained volunteers in Kakamega district.
The study population comprised of 200 trained volunteers. A questionnaire, focus group
guide and observations were used. In the study, 146 volunteers were interviewed and 27
people living with HIV IAIDS participated in focus group discussions. Observations were
made on the condition of people living with HIV/AIDS, time spent on nutrition education
and content in three refresher trainings. Supplies given to volunteers were observed and
recorded.
Various attributes of knowledge were sought. These included knowledge on spread,
symptoms of AIDS that affect the nutrition of people living with HIV/AIDS and nutrition
knowledge needed to take care of the symptoms.
Data were analysis using SPSS computer software. The percentage score was put into
quartiles and used as cut off points to categorise the knowledge of the v olunteers into
adequate (upper quartile), moderate (third quartiles) and inadequate (second and lower
quartile). Their practice was determined by finding out how many clients they saw per
month, how they decided the visits, the interval they took before seeing clients and the
services they offered. The volunteers ranked challenges encountered in the course of their
work. Coping strategies used by the volunteers in their work were documented. The
associations among the variables was determined.
The results from the study showed that only 3.4% of the volunteers had adequate
nutrition knowledge. The education level of the volunteers was positively related to their
nutrition knowledge. The volunteers who had been trained for three weeks had better
nutrition knowledge than those trained for two days and one week. More than half (59%)
of volunteers were committed to their work, they visited clients weekly. The services
offered by most volunteers were environmental and personal hygiene, training 0 f care
givers in the homes, nutrition education and counseling.
The three most important challenges to volunteers in their work were high expectations
from clients and the community, poverty and uncooperative patients. Among the various
coping strategies that were available to volunteers, giving what they had, involving the
community and counseling families and PLWHA were the ones most applied.
In conclusion, the hypothesis that most home-based care volunteers have adequate
nutrition knowledge was not supported by the results of the study. The second hypothesis
that nutrition knowledge does not depend on training time or the trainer was not
supported by the results. The results also showed that nutrition knowledge was associated
with the training time and trainer. Those trained by Pathfinder (3 weeks) and Joy ( 3
days) had better knowledge than those trained by GROaTS (2 days). Volunteers trained
for three weeks had better knowledge than those trained for two days. The last hypothesis
that nutrition knowledge does not affect the practice of volunteers was supported by the
results of the study. There was no association in services given, number seen and interval
before seeing a client between those with adequate knowledge and those with inadequate
knowledge.
It is recommended that for the volunteers to have adequate nutrition knowledge the
agencies who train volunteers ought to consider the education level of volunteers, give
adequate content and time to nutrition during trainings and carry out refresher trainings.
The practice would improve if the volunteers get supportive supervision and some of the
challenges like lack of supplies attended to.
Citation
Master of science degree in applied human nutritionPublisher
University of Nairobi Department of Food and Nutrition Technology