By Christine Nabiryo TASO, Uganda Ensuring continuity of access to food after food support ends; an Experience from Uganda By Christine Nabiryo TASO, Uganda

Presentation outline Background of Uganda and TASO Justification for food support to PLHIV Framework for longer term food security Examples of efforts to establish longer term food security Challenges Recommendations

Uganda High burden of HIV/AIDS First cases detected in 1982 High morbidity and mortality affecting the country’s socio-economic gains

HIV Prevalence by Region 2.3% 8.2% 3.5% Uganda total: 6.4 5.3% 6.5% 6.9% 8.5% Kampala – 8.5% Percent of men and women 15-49 who are HIV positive 5.9%

Impact of HIV/AIDS Health outcomes of individuals Orphans crisis Agricultural productivity Economic productivity of Households, individuals and nations Erosion of gains in economic development

TASO Context NGO established in 1987 to respond to the epidemic Compliments national health system efforts in the fight against HIV/AIDS Core business in psychosocial support, medical care and community capacity building for HIV prevention, care and support

TASO Context Psychosocial Needs ranking: Health Food Security Support for their children – education Sustainable Livelihoods

Justification for food support Average household size of PLHIV (7 members) Beneficiaries mainly 30-49 yrs ( productive age) 36 % could not afford a morning meal 76% unable to make savings in last 3 months

TASO Context 70 % of TASO clients are female 50% of the females are widowed (need to emphasize property ownership in context of gender) 80% of clients are unemployed earning less that a dollar a day

Children looking after children

TASO Food Support beneficiaries BMI Ranges 2007 N =1876

Short and Long term food security Food security and nutrition needs of clients have led to emphasis on Food, Nutrition security and livelihoods programming Nutrition, Food and Livelihoods programming is linked to partnerships e.g TASO/WFP and other livelihoods focused partnerships

Impact of Food support and ART on new clients Registration at TASO

Moving Up: A Holistic Approach SUSTAINABILITY LOANS and SAVINGS CONDITIONAL MICRO-GRANTS: TRICKLE UP CONTRACTS MARKETING SKILLS TRAINING AGRO-BUSINESS: HEIFER PROJ. INTL. ACDI/VOCA FOOD SECURITY COMMUNITY PROJECTS JUMP START FOOD AID FOOD SUPPORT / SOCIAL WELFARE Clients will always need TASO counseling and medical care, but they may not always have to depend on food support or welfare. Imagine if poor clients could graduate from social welfare as they move towards economic independence.

TASO Sustainable Livelihoods programming Goal : To empower TASO clients to be self reliant in their livelihoods 6000 beneficiaries

Demonstration garden at a TASO center

Clients representatives training in backyard farming

Members of a clients group in their demonstration garden

A client supported by a partner agency ( FADEP) in farming

Family support system For the success of SLP, family support has been encouraged. Clients are encouraged to involve their children and other family members in all the activities they do. This enhances sustainability in family projects and support especially when the client is weak.

Family involvement

A herd of goats belonging to one client – A success story Aidah - Client at TASO Jinja: Has 1 cow -12 L of milk/day 49 mature goats 36 local chicken layers 1st born child at University 2nd born child in Secondary school Other 4 benefiting from UPE

Challenges Differing sustainable livelihoods needs amongst clients Few partners to support program-huge demand Taking the efforts to scale from jump starts to effective sustained family projects at individual level Reaching all 80,000 active clients

Challenges Seasonality – climate change Organizational development capacity for beneficiaries Need to diversify projects per beneficiary Limited focus on nutrition and food security as a priority in HIV programming

Dilemmas Nutrition vs food security (individual Vs Family support) Equity – communities affected by poverty When to stop ( 6, 8, 12, 18 months ???) Rising food prices

Recommendations Sustainable livelihoods needs to be included as a component of comprehensive care for PLHIV Partnerships and resources for PLHIV livelihoods needs to be mobilized Advocacy to address exclusion of PLHIV from some development programs

Recommendations Any short term food support programming should incorporate longer term nutrition sustainability planning to be communicated from start of project Need to incorporate gender programming in sustainable livelihoods programming

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