The Impact of Food Assistance on Dietary Diversity and Food Consumption among People Living with HIV/AIDS
- 173 Downloads
Little is known about the outcomes of food assistance targeted to food insecure people living with HIV/AIDS. Using primary data from Zambia, we estimated the impact of food assistance on the dietary diversity and consumption expenditures of households with HIV infected members receiving antiretroviral therapy. Propensity score matching estimates show that food assistance increased dietary diversity by 9.8 points (23%) mainly through the consumption of food items provided in the ration. Food assistance recipients were 20% points more likely to have acceptable food consumption and 15% points less likely to have poor food consumption than non-recipients. Food assistance also increased food consumption expenditures but had no significant impact on food purchases and total consumption expenditures. Overall, our findings demonstrate that food assistance can be an effective instrument for improving diets and enhancing the food security of people living with HIV/AIDS.
KeywordsHIV/AIDS Food assistance Dietary diversity Food consumption Zambia
This study was financed by UNAIDS, the World Health Organization, the Ford Foundation and the Poverty, Equity and Growth Network. The authors acknowledge the support received from the Zambian Ministry of Health, the World Food Program Regional and Zambia offices, the Central Statistical Office of the Republic of Zambia, the Program for Urban Self Help and the enumerators. The funding bodies were not involved in the study design, data collection, analysis, interpretation, or manuscript preparation.
This study was funded by the UNAIDS, the World Health Organization, the Ford Foundation and the Poverty, Equity and Growth Network.
Compliance with Ethical Standards
Conflict of interest
The Authors declares that they have no conflict of interest.
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
Informed consent was obtained from all individual participants included in the study.
- 1.Weiser SD, Tsai AC, Gupta R, Frongillo EA, Kawuma A, Senkungu J, Hunt PW, Emenyonu NI, Mattson JE, Martin JN, Bangsberg DR. Food insecurity is associated with morbidity and patterns of healthcare utilization among HIV-infected individuals in a resource-poor setting. AIDS. 2012;26:67–75.CrossRefPubMedPubMedCentralGoogle Scholar
- 3.Wang EA, McGinnis KA, Fiellin DA, Goulet JL, Bryant K, Gibert CL, Leaf DA, Mattocks K, Sullivan LE, Vogenthaler N, Justice AC. Food insecurity is associated with poor virologic response among HIV-infected patients receiving antiretroviral medications. J Gen Intern Med. 2011;26:1012–8.CrossRefPubMedPubMedCentralGoogle Scholar
- 5.Johannessen A, Naman E, Ngowi BJ, Sandvik L, Matee MI, Aglen HE, Gundersen SG, Bruun JN. Predictors of mortality in HIV-infected patients starting antiretroviral therapy in a rural hospital in Tanzania. BMC Infect Dis. 2008;8(52)Google Scholar
- 9.Cantrell RA, Sinkala M, Megazinni K, Lawson-Marriott S, Washington S, Chi B, Tambatamba-Chapula B, Levy J, Stringer E, Mulenga L, Stringer J. A Pilot Study of Food Supplementation to Improve Adherence to Antiretroviral Therapy among Food-Insecure Adults in Lusaka, Zambia. JAIDS J Acquir Immune Defic Syndr. 2008;49(2):190–5.CrossRefPubMedGoogle Scholar
- 18.Wiesmann D, Bassett L, Benson T, Hoddinott J. Validation of the World Food Program’s food consumption score and alternative in-dicators of household food security. 2009. IFPRI Discussion Paper 00870. Washington, DC: IFPRI.Google Scholar
- 19.World Food Program (WFP). Food consumption analysis: calculation and use of the food consumption score in food consumption and food security analysis. Technical Guidance Sheet. Rome: World Food Program; 2007a.Google Scholar
- 20.Gilligan DO, Margolies A, Quiñones E, Roy S. Impact evaluation of cash and food transfers at early childhood development centers in Karamoja, Uganda. Washington, DC: IFPRI; 2013.Google Scholar
- 24.Leuven E, Sianesi B. PSMATCH2: Stata module to perform full Mahalanobis and propensity score matching, common support graphing, and covariate imbalance testing. Version 3.1.5. 2003Google Scholar
- 28.Rosenbaum PR, Rubin DB. Constructing a control group using multivariate matched sampling methods that incorporate the propensity score. Am Stat. 1985;39:33–8.Google Scholar
- 30.Becker SO, Caliendo M. Sensitivity analysis for average treatment effect. Stata J. 2007;7(1):71–83.Google Scholar
- 31.Caliendo M, Hujer R, Thomsen S. The employment effects of job creation schemes in Germany—a microeconometric evaluation. In: Millimet DL, Smith JA, Vytlacil E, editors. Modeling and evaluating treatment effects in econometrics, advances in econometrics, vol. 21. Amsterdam: Elsevier; 2008. p. 381–428.Google Scholar
- 35.World Food Program (WFP). HIV and AIDS and OVC beneficiary profiles: vulnerability analysis from six countries in Southern Africa. Rome: World Food Program; 2007b.Google Scholar