Number of HIV-positive clinically malnourished clients who received therapeutic or supplementary food

Export Indicator

Number of HIV-positive clinically malnourished clients who received therapeutic or supplementary food
What it measures

This indicator measures the coverage achieved for food support of clinically malnourished clients. It can be used to plan interventions and allocation of resources for food and nutrition as needed, and also to assess the impact of interventions.

Rationale

PEPFAR-supported programs provide food support to clinically malnourished clients, including therapeutic food products for severely malnourished clients and supplementary food products for moderately and mildly malnourished clients.

Numerator

Number of clinically malnourished clients who received therapeutic and/or supplementary food during the reporting period.

Denominator

Number of clients who were nutritionally assessed and found to be clinically malnourished during the reporting period.

Calculation

Not applicable

Method of measurement

The numerator can be generated by counting the number of clinically malnourished clients who received therapeutic and/or supplementary food.

Therapeutic foods are defined as foods for the management of severe malnutrition and include products such as ready-to-use therapeutic foods (RUTFs), e.g. PlumpyNut, an energy dense, fortified peanut butter/milk powder-based paste, or other locally produced RUTFs equivalent to F100 therapeutic milk, and therapeutic fortified milks (e.g. F75 and F100),. Supplementary foods for continued treatment of severe malnutrition after an initial stabilization and weight recovery period and for patients who are mild-to-moderately malnourished at entry are primarily fortified, blended flours (e.g. corn-soya blend (CSB)). Food provided for household use or as a safety net does not meet the definition of therapeutic and supplementary food for this indicator (i.e. not based on anthropometric assessment of clinical malnutrition).

The denominator can be generated by counting the number of HIV positive clients who were clinically malnourished according to client records at least once in the reporting period. The criterion for malnutrition for this indicator is body mass index (BMI) < 18.5 (wt in kg/ht in m2) for non-pregnant adults and mid-upper arm circumference (MUAC) < 220 mm for pregnant women. Only malnourished pregnant women and children who are HIV positive should be counted in this indicator if they meet the following criteria: for pregnant women - MUAC < 220 mm; for children under age 5 yrs - W/H < -2 Z scores or MUAC <125 mm; for children aged 5-9 yrs W/H < -2 Z scores; and for children aged 10-17 yrs, BMI-for – age < -2 Z scores.

Disaggregation: By sex, age < 24 months, 24-59 months, 5-14 years, 15+, and pregnancy status/postpartum status

Measurement frequency

Continuously

Disaggregation

Age group: < (less than) 24 months, 5 years - 14 years, > (greater than) 15 years, 24 months - 59 months

Condom type: N/A

Education: N/A

Gender: Female, Male

Geographic location: N/A

HIV status: N/A

Pregnancy status: Not Pregnant, Pregnant

Sector: N/A

Service Type: N/A

Target: N/A

Time period: N/A

Type of orphan: N/A

Type/Timing of testing: N/A

Vulnerability status: N/A

Explanation of the numerator
Explanation of the denominator
Strengths and weaknesses

To address malnutrition and strengthen care and support, a number of PEPFAR countries have introduced therapeutic, supplementary and supplemental food provision in their HIV programs. Results from the indicator provide information about the extent that food support is reaching eligible clients and where gaps may exist.

If this indicator is compared across countries, it is important to note that different countries and programs may use different types of food products and possibly even different entry and exit criteria for food eligibility. Also, the indicator provides information about coverage, but not about the duration of food support provided to clients, drop-out rates, quality of the foods, or existence of complementary interventions with the food.

Further information