1. Food and Agriculture Organization of the United Nations.
Food and nutrition security and livelihoods support in hyperendemic areas
Fadzai Mukonoweshuro
Food and Agriculture Organization of the United Nations.
Mexico
August 2008
Objective of presentation is to share some of the interventions that have been tried in hyper countries, discuss the strengths challenges, lessons learnt and recommendations for programmming

2. Context Southern Africa (Swa, Zim, Bots, Moz, Les, SA)
Home to 60% of PLHIV
Agriculture-dependant livelihoods
Protracted food insecurity since 2002
Nutrition insecurity
Because most hhs depend on rural livelihoods, the presentation will focus mainly on agric based livelihoods
Evidence on the strengths of the interventions in hyperendemic countries, possibilities for scale and wider coverage has been drawn from a number of studies, among them, by RENEWAL, RHVP,
Community perceptions on these interventions have been interogated and added to the evidence base

3. Interventions Food aid Community and HH gardens
Nutrition education and communication
Small livestock
Food production (diversified)
Collective Labour action
Social protection - Cash transfers
Life skills
Nutrition counselling and care
Extension, advisory services & input support
HIV strategies for the agriculture sector

4. Strengths in HIV context
Provide immediate support to avert starvation and malnutrition
Improved household nutrition through dietary diversification
Improved behavior and eating patterns
Asset protection
Generate income
Provide safety nets
Less labour intensive
Increased knowledge and skills for OVC and youths
Availability
Access
Utilization
Achieved impacts lead to the food security pillars of access, utilization and availability.
These impacts are beneficial for HIV affected households

5. Effectiveness and appropriateness of interventions
Protect, prevent and promote livelihoods of targeted households
Accessible, predictable, affordable, guaranteed and unconditional
HOW
Target food insecure and nutritionally at risk
Integrated interventions e.g. water and sanitation and livelihoods
Supported by Institutional frameworks
Are gender sensitive
Build on community responses
Give example of study done in Zimbabwe on community perceptions

6. Challenges
Food and nutrition insecurity is highly political and decisions on kind of interventions may be political
Some targeting criteria increase stigma
Lack of clear exit strategies
Quantities distributed often inadequate
Food aid and agricultural inputs dominate responses – little extension support
Cash transfers only work in stable economies
Designing implementation methods that will translate into a reduction in hunger in Southern Africa
Water

7. Lessons learnt
Understanding of the livelihoods of people and their needs is key
Interventions to be based on specific contextual environment according to assets, opportunities and aspirations of target – water is key
Quality of implementation is important for success
Short emergency - little on no impact
Partnerships between agriculture, health and social welfare crucial
Strong policy framework required to support interventions
Cost-effective solutions still a challenge
Inheritance regarding productive assets – education critical
Improving food and nutrition security: Providing support for food security, nutrition and livelihoods of affected households through improved input supply, improved sustainable agricultural practices and the transmission of local knowledge targeted to the food insecure and vulnerable.
Providing training and education relevant to OVCs through Junior Farmer Field and Life Skills (JFFLS) to empower youth and provide agricultural knowledge and life skills such as caring for PLWHA and family nutrition including income generating activities; and
Improving access to social welfare and health services, and
Be gender sensitive as women bear the highest burden of infection while remaining poorly informed. This includes improving women’s access to and control over productive resources and access to education and awareness on HIV/AIDS related matters. Both are essential to our work of preventing the spread of the pandemic and alleviating its impact.

8. Recommendations Support and build on existing livelihood strategies
Target attitudes and knowledge regarding food and nutrition security options
Targeting – Better to target food insecure and nutritionally at risk rather than HIV affected
Link emergency relief (food or emergency cash transfers) with development relief (including social protection)
Create the right policies in agriculture to help farmers grow more food
Document and apply lessons learnt in conducting multi-sectoral interventions – setting up of observatories
Roll out the joint FAO/WHO training course for primary care-givers on the nutritional care and support of PLHIV
Catch them young- Life skills projects to be expanded
Point 1 – eg gardens and livestock projects
Point 2 – This will be beneficial for nutrition outcomes
Pointt 3- more impact if targeting is widened to larger population

9. Thank You