HORIZONS PROJECT
Putting Food on the Table: An Exploration of Livelihood Strategies and Their Role in Maintaining Nutritional Status Among Patients on Antiretroviral Therapy

A picture is emerging of multi- or bi-directional links between HIV and AIDS, food and nutritional security, and livelihoods in general. As antiretroviral therapy (ART) becomes more accessible in Africa, it is expected that some stresses placed on individuals, families, households, and communities may be alleviated. However, we lack understanding of the dynamic relationship between treatment, food security, and nutrition.

The aim of this study is to explore and understand the role that livelihood strategies play—in particular, the ability to achieve food security or adequate access to food—in maintaining nutritional status among patients on ART. This study has direct policy implications as it explores the urgent question of how to put food on the table and provide nutritional support beyond the distribution of food and nutrition supplements.

The study will be nested within two existing Horizons operations research projects exploring issues around ART and adherence: one in Zambia and one in Kenya. The study in Zambia is being conducted in two urban compounds in Lusaka and two urban compounds in Ndola (an intervention and comparison site in each town) and has a community focus. The study in Kenya is being conducted in Mombasa and has a more clinical focus.

This study will consist of a cross-sectional formative assessment. Quantitative, qualitative, and participatory methods will be used. A preliminary qualitative investigation (focus group discussions) will be followed by a quantitative survey (in Zambia only), which in turn will lead to further qualitative probing through in-depth interviews of livelihood networks. The quantitative questionnaire for Zambia will be informed by the formative qualitative work and by existing instruments and indicators for measuring food security. In Mombasa, the existing data will be reviewed and the relevant sections extracted based on the preliminary qualitative investigations.

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Location

Mombasa, Kenya; Ngombe and Bauleni compounds, Lusaka, Zambia

Duration

May 2006–July 2007

Horizons and Population Council researchers

Scott Geibel, Naomi Rutenberg, Susan Cherop-Kaai

Non-Council collaborators

Rick Homan (Family Health International)

Fiona Samuels, Joseph Simbaya (Overseas Development Institute)

International Centre for Reproductive Health

Donor

US Agency for International Development

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Related Projects

• Community Education and Referral: Supporting Adherence to Antiretroviral Treatment and Prevention for People with HIV in Zambia

• Operations Research Around the Introduction of Antiretrovirals in the Management of HIV-infected Individuals in Mombasa, Kenya

See Also

• Kenya

• Zambia

• Horizons Program

• HIV and AIDS

• HIV and AIDS/Consequences for Individuals, Families, and Society

• HIV and AIDS/Policy Development

• HIV and AIDS/Treatment, Care, and Support

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