In spite of financial, human and material resources investment in Nutrition Care, Support
and Treatment programme for close to five years by the Government of Malawi and its
collaborating partners, the programme had never been evaluated to gauge whether it had
been implemented according to originally set objectives and targets.
This evaluative study was conducted from July 2010 to October 2010 in Dowa and
Ntchisi districts in Malawi where the Nutrition Care, Support and Treatment had been
implemented. The main objective of the study was to evaluate the performance of the
programme in the two districts. A total of six health facilities were purposively sampled
because they had implemented the programme. A total of 187 clients receiving
antiretroviral therapy and nutrition care, support and treatment were randomly sampled
from the six facilities using probability proportion to size approach.
The data collection tools used included a pre-tested semi-structured questionnaire, Key
Informant Interview guide, Strengths, Weaknesses, Opportunities and Threats guide,
Focus Group Discussion guide and a secondary data template. Analysis for quantitative
data was done using Statistical Package for Social Scientist version 17, Microsoft Office
EXCEL 2003 and EPI6 while qualitative data were thematically analysed. Statistical tests
employed included chi-square, paired t- test, and F-test and significance in the outcomes
was tested at p<0.05.
Two thirds (66.8%) of the clients in the study sample were females. Most (44.9%) of the
clients were in monogamous marriages and had some formal education. The mean age of
the clients in the study was 38.2±9.1 while the mean household size and dependency ratio
were 5.02±2.2 and 1.07 respectively.
The vast majority of the clients (94.1%) indicated that they usually finished consuming
the entire daily prescribed ration of ready to use therapeutic food and almost all (99.5%)
of the clients never missed their anti-retroviral pills. The programme therefore achieved
its set target of 95% on adherence to drug protocols. On nutrition knowledge, majority of
the study clients (98.9%) scored less than 50%, the expected programme target for
nutrition knowledge.