Malawi

Use of Nutritional and Water Hygiene Packages for Diarrhoeal Prevention Among HIV-Exposed Infants in Lilongwe, Malawi: An Evaluation of a Pilot Prevention of Mother-to-Child Transmission Post-Natal Care Service

Source:
Xue J et al. 2010. Trop Med Int Health October 2010. University of North Carolina School of Medicine.

Summary:
In Malawi, free fortified porridge and water hygiene packages were offered to mothers to encourage frequent post-natal visits and to reduce diarrheal rates in infants on replacement feeding. Participant retention and infant health outcome were assessed. The majority of participants adhered to their scheduled visits and retention was favorable, possibly because of the introduction of hygiene and nutrition incentives. The infant diarrheal rate was low, suggesting benefits of regular medical care with hygiene package usage and reliable replacement feeding options.

Summary:
Adequate clean water, improved sanitation infrastructure, and better hygiene may significantly improve health outcomes for people living with HIV (PLHIV) in resource-poor settings. Catholic Relief Services Malawi, with support from the World Health Organization and the United States Agency for International Development (USAID), implemented a pilot project to identify household scale changes or actions that could improve WSH conditions for PLHIV. An evaluation showed substantial changes in six targeted behaviors and a reduction in the overall prevalence of diarrhea, suggesting that this is an effective approach to ameliorating WSH conditions for those affected by HIV.

Summary:
The assessment was commissioned by the WHO with the goal of producing evidence-based guidance on water and sanitation needs in home-based care strategies, particularly in resource-poor situations, and to lead to both practical and strategic recommendations at the programme and policy levels, while identifying the most critical measures to be taken by the health sector and the water and sanitation sector to provide short and medium-term solutions in the area of water, sanitation and hygiene support to home-based care. The findings indicate that the water and sanitation needs of HBC clients are severely unfulfilled. The already vulnerable HBC population is regularly falling ill due to diarrhea. Other illnesses and effects of poor water quality are also evident among the HBC clients. In addition, the HBC households are often required to travel long distances to their water sources, which is exceptionally difficult for ill clients.