Food by Prescription

Great strides have been made over the last 20 years in the long-term management of HIV infection in developing countries, resulting in improved immune function, reduced mortality, and prolonged survival. However, underlying malnutrition continues to impede positive health outcomes, and HIV infection in turn worsens malnutrition. The Ethiopia Food by Prescription (FBP) program, implemented by Save the Children US (SC US), USAID/Ethiopia, and the Ethiopian Ministry of Health since 2010, provides therapeutic food along with nutritional assessment and counseling to malnourished HIV+ individuals. The Tufts University Friedman School of Nutrition Science and Policy was contracted by SC US to research the effectiveness and cost-effectiveness of this intervention, in order to contribute much needed evidence to guide programming and policy, both in Ethiopia and worldwide.

Patients who received food were significantly more likely to recover from malnutrition than those who did not receive food, and treatment with supplementary food was much more successful, and more cost-effective, when malnourished individuals were identified and treated early. Additionally, patients who recovered through the addition of supplementary food experienced long-lasting positive effects on their health and nutrition status. While the marginal cost per patient recovered in the FBP program was high, the marginal cost of improving nutritional status by at least one BMI point was much lower—an important finding considering the link between weight loss and increased risk of mortality. In addition, our hypothetical costing models show that a focus on improving supply (health service delivery) and demand (client adherence, participation, compliance) would further strengthen the effectiveness and cost effectiveness of this strategy, and this study makes several recommendations as to how this might be done. In light of these results, the authors recommend that nutritional assessment counseling and support remains an integral component of ART programs in Ethiopia. The current (2008) version of the National Nutrition Program in Ethiopia supports the implementation of nutrition support for pre-ART/ART HIV/AIDS patients, and this should remain a priority in the 2012/13 version being developed by the Ministry of Health now.

ASSOCIATED PROJECT

SUBJECTS

PUBLICATION TYPE

LOCATION

RELATED PUBLICATIONS

thumbnail image of report cover

This report outlines an anticipatory insurance product designed to support farmers in the drought-prone regions of Malawi and Zambia.

thumbnail image of report cover

This report presents the final findings from the USAID Nawiri longitudinal study, which investigated the drivers of the persistently high rates of acute malnutrition from September 2021 to September 2023.

Thumbnail image of report cover

This study examines how anticipatory action was perceived and experienced among Ethiopians living with drought alongside other crises.

Thumbnail image of cover

This learning brief presents preliminary findings on strategic mobility and its nutritional benefits to pastoral and agropastoral communities in select sites in Isiolo and Marsabit Counties, Kenya.

Thumbnail of Report "Do Famine Declarations Really Lead to Increased Funding?

This policy brief examines the relationship between famine declarations and funding since 2011. It shows that, with that one exception, there is little evidence that famine declarations actually result in a rapid increase in funding.

Cover of Report "Sex, age (and more) still matter"

This report reviews progress, outlines barriers to further progress, and makes recommendations to advance gender equality in the humanitarian system.

Load more