HIV, Agriculture, Food Security, and Nutrition in western Kenya
Impacts of an Integrated HIV Care and Agricultural Livelihood Intervention on Agriculture, Food Security, and Nutrition in western Kenya Mentors Dr. Sheri Weiser and Dr. Craig Cohen
Smallholder farming is the primary source of income and household food for 75% of Kenyans. However, agricultural outputs are estimated at 30% of potential productivity. Therefore, there is an important need for improved agricultural practices to improve income and nutritional intake from food grown for home consumption. Food insecurity affects 50% of Western Kenyans, increasing risks for malnutrition, opportunistic infections and contributing to the region’s HIV epidemic. Previous studies have shown that food insecurity and poverty worsen HIV outcomes through multiple pathways. Food insecurity among HIV-positive farmers creates obstacles to proper nutrition in part because of fatigue experienced from both food insecurity and HIV that make it difficult to perform the energy-intensive labor of farming; limiting food available for home consumption. Food insecurity, macronutrient and micronutrient deficiencies, can cause more rapid progression of HIV infection and higher rates of morbidity because it interferes with a person’s ability to adhere to, tolerate and metabolize HIV medications, which can worsen HIV outcomes. While numerous agricultural livelihood programs exist, integrated agricultural and health studies are novel and require evaluation to elucidate the pathways between improved agricultural practices and health outcomes. Shamba Maisha (SM) is a multisectoral livelihood-health intervention designed to sustainably address the root causes of poverty and food insecurity while addressing the specific health needs of people living with HIV/AIDS. Here, we aimed to explore the impacts of the multisectoral agricultural and finance intervention on agricultural practices, food security and nutrition and to identify mechanisms and pathways to improved outcomes.