Why was the guide written? How is the Guide organized? Food Assistance Programming in the Context of HIV Why was the guide written? How is the Guide organized? What is in plan next 10 months? Kenton Kayira FANTA Project

A. Why was the Guide written? 60 million people infected; > 20 million have died; millions more affected Many live in FFP, WFP, or PEPFAR focus countries. HIV is a significant constraint to household food security Impacts ability of food security programs to achieve results Food insecurity and malnutrition contribute to spread and hasten progression of HIV Impacts ability of HIV programs to achieve results

Why was the Guide written? Food assistance has the potential for reducing individual, household and community susceptibility to HIV and its impacts But …lack of guidance on how to respond in various sectors Represents a major challenge for Title II CSs, WFP and PEPFAR implementing partners

What are the basic challenges that the guide addresses? Modifying food aid supported food security programs Account for the constraints and needs faced by PLHIV and HIV-affected households Achieve food security outcomes in a high HIV prevalence context

What are the basic challenges that the guide addresses? Utilizing food and food related resources in HIV prevention, treatment and care and support programs Achieve HIV related outcomes

What are the basic challenges that the guide addresses? Integrating food security and HIV programs Maximize complementarities and synergy Without compromising core objectives

What’s the purpose of the guide? Reference manual help address design and implementation challenges Collection of relevant tools and promising practices A work in progress

Who is the Guide for? Program Directors, Program Advisors and Senior Program Managers directly responsible for analysis and formulation of food assistance strategies and country programs activities USAID Title II PVOs WFP country and regional offices Government and NGOs implementing partners using food assistance as a programming tool. USAID regional and country Missions

B. How is the Guide Organized? Part I: HIV and Food Security: Conceptual and Institutional Framework Part II: Program Design Steps Part III: Sector-Specific Program Design Considerations

Part I: HIV and Food Security: Conceptual and Institutional Framework Focus on understanding dynamic relationships between food security, vulnerability, and HIV using conceptual frameworks (Ch. 1) Understanding the broader programming environment (Ch. 2): National and international agencies’ response to food insecurity and HIV Program and resource coordination mechanisms Challenges in coordinating resources for an integrated response to food insecurity and HIV

Part II: Program Design Steps Covers the basic design steps programmers need to go through, regardless of sector Vulnerability Assessments Developing Integrated Programs Targeting Ration Design Implementation Strategies Monitoring and Evaluation Operational Modalities

Part III: Sector-Specific Program Design Considerations In this section of the Guide: key considerations and program modifications needed for programming in different sectors: Health and Nutrition Education Livelihood Strategies and Social Protection Emergency Food-Assistance

Nutritional Support for HIV-Positive Mothers in Malawi In Malawi, WFP partners with St. Gregory’s Hospital to provide nutritional support to HIV-positive mothers and their families. All pregnant women are offered VCT during antenatal visits. All who test positive are admitted to the PMTCT program and provided nutritional support for 18 months after delivery. The arrangement has allowed both partners to: Monitor the nutritional status of the mother and child; Provide ongoing counseling and educational support; Support the mother with infant feeding choices; Ensure that the infant was fully immunized; Offer VCT on behalf of the infant at 18 months; and Link the women with other support interventions, including income- generation activities

Mobile Farm Schools in Uganda In Uganda CRS has collaborated with the Ministry of Agriculture and Department of Education to establish Mobile Farm Schools for young people living in HIV-affected communities. The program has mitigated the impact of the disease on the inter-generational transfer of agricultural knowledge while promoting skill development and self-esteem among participants. As part of the program: The targeted community provides land for demonstration gardens; The education sector provides school facilities and plots of land next to the school for demonstration purposes; Local agricultural offices provide extension services and help develop the training curriculum; and In addition to coordinating the overall program, CRS provides food rations, seeds and tools to youth participants.

Linking Safety Net, Livelihoods and HIV Treatment Interventions in Kenya Since 2002, AMPATH has partnered with WFP to provide supplementary rations to ART patients in Kenya. The program has also established production farms near four treatment sites to provide locally acceptable, nutritious food to undernourished and food insecure PLHIV. AMPATH’s Family Preservation Initiative is aimed at augmenting the incomes of participating PLHIV as part of a comprehensive strategy to support resilient livelihoods among current and discharged patients. Core activities of the Family Preservation Initiative include: Agricultural microfinance; Business training; Technical support for poultry and horticultural services

HIV Awareness Building in Relief Settings In Swaziland, WFP and UNFPA, in partnership with the MOE, jointly implemented a project to raise awareness and understanding of HIV and related issues through relief committees (RCs). With the aid of training modules, posters, and other IEC materials, relief committee members (the majority of whom are women) educate the general community at food distribution points. Topics include: Nutrition PMTCT Gender issues Sexual/reproductive health Family planning Prevention of sexual and gender-based violence (SGBV)

Three Core Questions How can food security programs account for the constraints and needs faced by PLHIV and HIV-affected households, in order to support the achievement of food security outcomes in a high-prevalence context? How can HIV prevention, treatment, care and support programs better utilize food and food-related resources to support the achievement of their HIV-related outcomes? How can food security and HIV programs integrate their activities in areas of high food insecurity and high HIV prevalence to maximize complementarities and synergy without compromising the core objectives of either program?

C. What would FANTA like to do over the next 10 months? Provide targeted technical assistance in FA and HIV program planning in 1-2 countries where FANTA has ongoing Mission –funded programs of technical assistance. Continue to compile and share promising practices, case studies and new evidence. ICB information and experience exchange among Title II PVOs.

Provide targeted technical assistance in FA and HIV program planning Purpose of TA: Strengthen the application of program design tools, promising practices and other key considerations in Title II FS programs. Strengthen capacity to integrate food assistance in HIV related services. Add value to existing or new Title II FS and PEPFAR -HIV programs in the country.

2. Continue to compile and share promising practices, case studies and new evidence Network and document success stories and promising practices. Setting a taskforce to facilitate the sharing of field experiences (Consultation with ICB Focal Points to be initiated between Jan-March 08. Collaborate with PVOs (DC) and (USAID Mozambique) to organize training of Title II PVOs on FA & HIV programming in Maputo (April -June 2008) .

3. ICB information and experience exchange Plan for ICB information sharing and exchange in the fourth quarter (July-Sept 2008). Facilitate continuous improvements in the use of the guide as a planning tool for both Title II FS & HIV programs. Enhance access and utilization of the guide and other tools and TAs to Title II PVOs – through individualized learning approaches.

Thank You