Knowledge and practice of nutritional principles and their association with nutritional and morbidity status of people with HIV/AIDS. Case for a home based care centre in ongata rongai of Kajiado district, Kenya

Abstract

People with the human immunodeficiency virus need good nutrition to sustain their health and minimize morbidity episodes. Appropriate health care at the hospital level is unaffordable and care has shifted to home based setting. Hence home based care centres have come up offering services to people living with the human immunodeficiency virus. However, the quality of these services is not monitored and there is a possibility that the right information regarding nutrition may not be reaching the people with the human immunodeficiency virus. The study aimed at assessing nutritional knowledge, dietary practices, and food safety and hygiene practices of people with the human immunodeficiency virus and how these relate with nutritional and morbidity status at Faraja trust ( a home based care centre in Ongata Rongai of Kajiado District in Kenya. The outcome of the assessment was a reflection of the extent to which nutritional interventions have been incorporated into the programme. The study was based on the hypothesis that knowledge of nutrition, food safety and hygiene influence nutritional and morbidity status of people with human immunodeficiency virus. Sixty five HIV positive individuals participated in this study. Quantitative and qualitative methods of data collection were employed. Quantitative data was collected using a questionnaire that was designed to collect socio-demographic information of the study group, nutritional status, morbidity experience, dietary practices, food safety and hygiene practices, nutritional knowledge and food accessibility. Qualitative data was collected through a focus group discussion. Data was analysed using statistical package for social sciences (SPSS) version 11.5. Majority (84.6%) of the client? were women About two thirds of the respondents were aged between 30-44 years. Most (66.1%) of them were living below the poverty line. Main source of food for most respondents (72.3%) was through purchase. Average expenditure on food of the average income of respondents was 71.7%. The level of malnutrition was high using both Mid Upper Arm Circumference (31%) and Body Mass Index (32%) respectively. Most of the xii people had medium !evel of nutritional knowledge even though there was no association between nutritional knowledge and nutritional status as well as morbidity. Results based on dietary diversity score elicited that majority were within the average diversity bracket. There was no association between dietary diversity and nutritional and morbidity status. Most of the individuals (68%) had moderate level of knowledge of food safety and hygiene. Food safety and hygiene (hand washing) was associated with nutritional status (8MI) p<0.05 (P 0.038). Morbidity was associated with method of storage of left over food p <0.05 (p=0.036). There was no association between the rest of the hygiene factors that were considered with nutritional and morbidity status. No association was noted between main source of food and nutritional and morbidity status of the people. In conclusion, high levels of malnutrition and morbidity in Faraja Home Based Care Centre are associated with food insecurity, inability to translate nutrition knowledge into practice and poor food safety and hygiene practices. This implies that basic nutritional and food hygiene principles and measures to improve food security have not been adequately implemented at the centre. It is recommended that the Community Based Care Centre and any other Acquired Immunodeficiency syndrome management programme work towards the improvement of nutritional status and morbidity of infected people through integrated programmes of nutrition education and counselling as well as food security and food safety and hygiene initiatives. Programmes should be designed to address the three interventions simultaneously because they are interrelated and addressing them singly among people of low socio-economic status cannot translate into improved nutritional and morbidity status.