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3ie-LIDC Seminar Series: The impact of a food assistance program on nutritional status, disease progression, and food security among people living with HIV in Uganda

Thursday, September 26, 2013 - 17:00 to 18:30

Venue: LIDC, Upper Meeting Room (103), 36 Gordon Square
Time: 5 - 6.30 pm
Speaker: Dr. Suneetha Kadiyala, Senior Lecturer in Nutrition-sensitive Development, London School of Hygiene & Tropical Medicine/ Leverhulme Centre for Integrative Research on Agriculture and Health (LCIRAH).
Organisers: 3ie, LIDC and Centre for Evaluation - Improving global health practice through evaluation.
Register (free)

This event is part of the 3ie-LIDC Seminar Series 'What works in international development'.


Background: Although the last decade has seen increased access to anti-retroviral therapy (ART) across the developing world, widespread food insecurity and undernutrition continue to compromise an effective response to the AIDS epidemic. Limited evidence exists on the potential benefit of food security and nutrition interventions to people living with HIV (PLHIV).

Methods: We capitalized on an existing intervention to HIV infected individuals in Uganda, to design and conduct a prospective quasi-experimental study evaluating the impact of a monthly household food basket, provided to food insecure ART naïve PLHIVs for 12-months. The outcomes of interest were nutritional status (body mass index (BMI); mid-upper arm circumference (MUAC), and hemoglobin (Hb) concentrations), disease severity (CD4 count), and two measures of food security: diet quality (Individual Dietary Diversity Score (IDDS)) and food access (Household Food Insecurity Access Scale (HFIAS)). We utilize difference-in-difference propensity score matching to examine the impact of food assistance.

Results: Food assistance significantly increased BMI by 0.6 kg/m2 (P< 0.01), and MUAC by 6.7 mm (P<0.05). We find no impact of food assistance on CD4 count, Hb concentrations, or IDDS. When restricting the analysis to individuals with CD4 counts >350 cells/μL, however, we see large significant impacts on Hb concentrations (1 g/dL; P<0.05). At the household level, food assistance improved food security as measured by the HFIAS, by 2.1 points (P<0.01).

Conclusions: This study adds to the scant evidence base and demonstrates the potential for food assistance programming to be part of the standard of care for PLHIV in areas of widespread food insecurity.

About the speaker:

Suneetha Kadiyala joined LCIRAH/LSHTM as a Senior Lecturer in nutrition sensitive development in August 2013. In this role, she will engage in cross-disciplinary research initiatives and supervise LCIRAH post-docs and doctoral students. At the London School of Hygiene & Tropical Medicine, she will be based in the Department of Population Health within the Faculty of Epidemiology.

Prior to joining LCIRAH, she was a Research Fellow in the Poverty, Health and Nutrition Division at the International Food Policy Research Institute (IFPRI). Her main research interests are focused on the  intersection of  structural dimensions of health (especially, HIV and AIDS), food security and nutrition in eastern and southern Africa and South Asia.  As a nutritionist, she has extensive research experience related to HIV, livelihoods, and food and nutrition security in eastern and southern Africa, including leading the HIV and Nutrition Security theme under RENEWAL (Regional Network on AIDS, Livelihood and Food Security). Since November 2008, Suneetha has been based at IFPRI’s Regional Office in New Delhi, where Suneetha led large multidisciplinary research programs such as TANDI (Tackling the Agriculture Nutrition Linkages in India) and POSHAN (Partnerships and Opportunities to Strengthen and Harmonize Actions for Nutrition in India). Under LANSA (Leveraging Agriculture for Nutrition in South Asia) Research Program Consortium, she co-leads a research theme on enabling environment to strengthen agriculture-nutrition linkages and is the interim gender focal point.

Suneetha has a PhD in International Food Policy and Applied Nutrition from the School of Nutrition Science and Policy, Tufts University, Boston. She as a M.SC (Nutrition Science) and B.Sc (Food and  Nutrition) from Maharaja Sayajirao University, Baroda, India.