Background: Karamoja region has grappled with high levels of food insecurity and this affects PLHIV more prone to malnutrition because of opportunistic infections. The objective of the Expert Clients (ECs) training was to create a peer-to-peer intervention to offer a viable, creative solutions to areas grappling with human resource challenges that often act as barriers to universally accessible, high quality HIV and Nutrition care and treatment in resource limited settings.
Description: Expert Clients were recruited basing on HIV-status, record of ART adherence, education level, ability to be trained and willingness to volunteer. The HIV expert clients were enrolled through the district health offices in all the seven districts of Karamoja. 75 HIV Expert Clients were selected from the seven districts in this training. These were then trained through a week-long course on nutrition assessment counselling and support for PLHIV. To assist in conducting their work, the ECs were also supported with job aids for nutrition in HIV and basic HIV treatment information. District health focal persons for nutrition and HIV were involved at all levels to enable them to understand the model for easy supervision. The HIV expert clients were voluntarily attached to health facilities near their communities and tasked to follow-up PLHIV on issues of Antiretroviral utilization and nutrition.
Lessons learned: There was improvement in awareness on food and nutrition requirements for PLHIV who are breastfeeding. responsiveness and demand for specific nutrition services for PLHIV increased. health facilities with ECs reported improvement in nutrition education and counselling for PLHIV, 75% of the health facilities reported improvement in patient referrals from the community, 92% indicated continued household reporting by ECs on ART and nutrition for PLHIV follow-up, 72% of the health facilities indicated improvement in appointment keeping.
Conclusions/Next steps: The utilization of expert clients in extending household nutrition services is a promising model .Future evidence building studies will be necessary to inform crucial human resource management and task shifting decision in the provision of health and nutrition services in Karamoja.

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