Access to recommended diets on the management of HIV and AIDS among infected pregnant and lacting women in Dar es Salaam

Abstract

Background: HIV / AIDS infected pregnant and lactating women form a special group that has peculiar characteristics and needs among People living with HIV / AIDS. The physiological changes that occur during pregnancy and lactation call for additional nutritional needs in order to maintain the health status of the mother, fetus and the newborn. In HIV / AIDS infected pregnant and lactating women those additional nutritional needs are further perpetuated by increased nutritional demand caused by illness. Assuring access to health diets for this special group with unique characteristics forms a fundamental component in the management of the disease. This study was conducted to determine access to recommended diets and its associated factors on the management of HIV / AIDS among infected pregnant and lactating women in Dar es Salaam. Methods: A hospital-based cross-sectional study was carried out in three municipal hospitals of Dar es Salaam in April, 2009 to determine access to recommended diets among 201 HIV / AIDS infected pregnant and lactating women. It also examined the association between access to recommended diets and nutritional status, (as the dependent variable,) and some socio- demographic characteristics, economic parameters and dietary intake as explanatory variables. Study respondents were interviewed using structured interview schedule with closed ended questions. Nutritional status was assessed anthropometrically using Body Mass Index (BMI) and reference was made from the WHO cut off points. The quality of food consumed over the past one month was assessed using a short food frequency questionnaire Results: Results revealed that access to recommended diet was a problem among HIV positive pregnant and lactating women whereby only 46.8% ofthe study participants had access to these diets. A significant proportion of study participants had not received nutritional counseling (57.2%). Moreover, access to recommended diets was significantly associated with Religion (p= 0.05), level of education (p < 0.001), employment (p=0.014) and household assets (p < 0.001). Conclusion: Access to recommended diets to HIV infected pregnant and lactating women in Dar es Salaam is determined by multitude of factors, level of education, occupation, nutrition counseling, were among factors that were positively associated with food access while food price and being Muslims were negatively associated with access to recommended diets, and its only when these factors are addressed then we will witness the impact of good nutrition in the care and management of HIV among pregnant and lactating women.

vi Recommendations: There is a need of strengthening and close monitoring of nutritional counseling process at VCT and CTC so that all eligible patients receive counseling from competent counselors, there is a need of strengthening information, education and communication activities to raise awareness on healthy food choices, nutrition, safe food handling and the importance of cheep indigenous foods to meet dietary needs. Government should set price ceiling for those healthy food items which are necessary for the health of its people and this should be supplemented by establishment of household income boost activities together with provision of food aids to those affected households that have difficulties in accessing foods