Transcending Boundaries to Improve the Food Security of HIV-affected Households in Rural Uganda: A Case Study

This 36-page report provides a case study of a process to bring key technical sectors together with communities in a partnership for reducing food insecurity among HIV-affected households in Tororo, Uganda. The report describes food security as the ability of individuals to consume sufficient quantity and quality of food to meet their daily needs. The National Agricultural Research Organization (NARO), the AIDS Support Organization (TASO), and the International Center for Research on Women, with support from the Horizons Program of Population Council, implemented the Partners for Food Security (PAFOSE) Project to improve household food security in rural Ugandan communities affected by HIV/AIDS. Its overall aim was to address the complexities of food insecurity and HIV/AIDS by forging partnerships across institutions at the district, sub-county, and local levels. This report shares information and lessons learned from the project.

The report suggests that although knowledge and technologies exist in Uganda to better enable households to be food secure, agricultural sector programmes are not promoting them as effectively as they could. Likewise, programmes exist in the health and social welfare sectors to support HIV-affected households, but these do not generally incorporate the kinds of nutritional and agricultural know-how required to meet affected households’ food security needs.

The report outlines how policy and programming related to nutrition, food security, and HIV/AIDS include two approaches: the first approach seeks to improve the nutrition of people living with HIV in the context of health care delivery systems; the second approach seeks to improve their nutrition in the context of their households and communities. The second approach recognises that food behaviour, like sexual behaviour, is influenced by the knowledge, skills, resources, and norms of families and communities. To be sustainable (so that malnutrition does not reoccur when food aid is withdrawn), HIV food and nutrition interventions must be integrated into households and communities where affected people live. This means that family and community members must also gain the knowledge, skills, and resources needed to manage the nutritional needs of people living with HIV in the context of overall household food security.

The report outlines four key findings and lessons from the case study analysis of PAFOSE:

• The case study suggests that capacity for partnership must be built at multiple levels. A key lesson identified from the PAFOSE partnership is that inter-sectoral partnerships between organisations to leverage different sets of expertise and skills for common goals is feasible and practical, but it is essential that management capacity for partnership be built at all institutional levels, and that the process is participatory at all levels.
• The report proposes that coordination around HIV and agriculture is valuable to both groups. It states that the PAFOSE process shows that the coordination of agricultural extension and HIV/AIDS education and awareness can enhance the outcomes of both sets of activities. The integration of these two models into one functional community outreach system enables the delivery of high quality information on agricultural practices, HIV and AIDS, and their inter-relationships directly to community members.
• Another lesson is the importance of linking HIV/AIDS education, information, and sensitisation activities with interventions that are non-stigmatising and which relate directly to issues that impact people’s ability to sustain their livelihoods.
• As part of project activities, participants in the PAFOSE farmers’ groups analysed gender relations in the context of household food security, a topic of salience in their everyday lives. They themselves identified key gender-related obstacles to their household food security and began a shift toward supporting more gender-equitable attitudes. The motivation for making these changes came from the understanding that reducing gender inequities would have a direct benefit in terms of their household’s food security.