Access to nutrition education and counselling by people living with HIV and aids in Lusaka district Zambia : a hermeneutic phenomenology approach.
Date
2024
Authors
Malama, Esther
Journal Title
Journal ISSN
Volume Title
Publisher
The University of Zambia
Abstract
Proper nutrition plays a crucial role in the well-being of people living with HIV (PLWHIV), impacting their immune system, overall health, and quality of life. Nutrition education and counselling (NEC) are essential components of comprehensive HIV care and support. However, there is limited research exploring how PLWHIV access NEC and how this access influences their nutritional knowledge, motivation, and behavioural skills. The purpose of this hermeneutic
phenomenological study was to uncover the lived experiences of PLWHIV regarding their access to NEC. The study used a qualitative approach and applied hermeneutic phenomenological research design. A purposive homogenous sample of 25 PLWHIV was used in this study. Semi structured interviews were conducted with 25 PLWHIV receiving care at a health care center. The collected data was analysed using Ajjawi & Higgs six stages of data analysis. The study revealed eight major themes which include: knowledge of nutrition education, acquired nutrition knowledge and skills, accessibility and acceptability of nutrition education and counselling, the benefit of nutrition education, types of nutrition counselling, frequency of nutrition counselling, challenges in accessing nutrition education and counselling, and recommendations from participants. Participants demonstrated a good understanding of nutrition education and reported acquiring knowledge and skills related to healthy eating and dietary practices through NEC. The accessibility and acceptability of NEC varied among participants, with some experiencing positive and others negative aspects. Participants received nutrition counselling, including group and individual sessions, focusing on food intake, health conditions, screening, and maintaining a balanced diet. Transportation issues, a shortage of health personnel, and the limited availability of nutritionists were significant barriers for many participants in accessing healthcare. Participants recommended enhancing nutrition education and counselling access, increasing patient-nutritionist interaction, and integrating nutrition support with trained community health workers to address manpower limitations. Overall, participants perceived NEC as beneficial, leading to improved health and nutritional status. The study demonstrates that nutrition education
and counselling play a significant role in improving the dietary practices and overall well-being of PLWHIV. While challenges related to accessibility and acceptability exist, participants generally found nutrition education to be informative and beneficial, leading to positive health outcomes. This study contributes to understanding the strengths and challenges of NEC implementation, supporting the Information-Motivation-Behavioural Skills Model (IMB). It emphasises the importance of tailoring NEC services to meet the specific needs of PLWHIV and enhance their nutritional knowledge, motivation, and behavioural skills. By addressing these aspects, NEC can be an effective tool for promoting better dietary practices and improving the quality of life for PLWHIV. The study's findings offer guidance for improving the accessibility and effectiveness of nutrition education and counselling programmes for PLWHIV. The findings have
implications for HIV care and support programmes in Zambia and similar settings, highlighting the significance of NEC in comprehensive HIV care.