Exploration of nutrition counseling for people living with HIV in follow-up at Popokabaka Hospital

Abstract BACKGROUND AND OBJECTIVES Malnutrition and the human immunodeficiency virus (HIV) are major public health challenges in low- and middle-income countries. In 2016 in the Democratic Republic of Congo (DRC), the national program of nutrition (PRONANUT) and the national program of HIV (PNLS) developed a joint national protocol for management of malnutrition among people living with HIV (PLHIV). This protocol recommends a nutrition assessment, counseling and support (NACS) approach which should be undertaken in health facilities and in the community. However, the way in which this approach is implemented in the field is unknown and so there is a need for further exploration. The aim of this study was to explore the quality of nutrition counseling provided to PLHIV in Popokabaka Hospital. METHODS We conducted a qualitative study among health workers and PLHIV in follow-up at Popokabaka Hospital. Fifteen in-depth interviews were undertaken with PLHIV and three key informant interviews with health workers. A thematic analysis of data was performed. RESULTS The six themes that emerged in the current study are: the nutrition counseling (NC) content which was mainly around improving dietary practices; the NC process which respected several aspects but appropriate NC tools were lacking; nutrition knowledge, in which they had several information about nutrition related to HIV; dietary practices of PLHIV, in which there were several changes with improved health; barriers and enablers to applying nutrition counseling. CONCLUSIONS The current study has found that the quality of the nutrition counseling provided to PLHIV at Popokabaka Hospital was quite acceptable. Even if health care providers were not trained on the nutritional management of PLHIV and there was a lack of appropriate tools for nutrition counseling, patients were given acceptable advice leading to changes of their dietary practices, and their health improved. There is therefore a need for building capacity of health workers on the NACS approach, and for the popularization and effective implementation of the national NACS protocol. KEY WORDS: “nutrition counseling; content; process; knowledge; practices; barriers; enablers”.