Abstract
Introduction: The Federal Democratic Republic of Ethiopia (Ethiopar.net ) is the third most populous country in Africa (WHO 2013b) with a population of 91.729.000 million in 2012 (WHO d). At the same time it is one of the least-developed countries in the world (Gelan 2007). HIV/AIDS is a major public health problem in Ethiopia, and it’s a top priority on the government’s health agenda despite a decline in adult HIV cases, particularly in urban settings, from 2001-2009 (WHO 2013b). In 2012 the number of people living with HIV in Ethiopia was 760.000 (690.000-840.000) (WHO g).
Nutrition is essential (UNAIDS ) to improve the effectiveness of HIV treatment and to keep people (WFP ) affected by HIV/AIDS (UNAIDS ) healthier for longer (WFP ). Therefore, it is fundamental to focus on resources for nutrition as part of a comprehensive treatment for countries greatly affected by the disease (World Health Organization 2003). Often the problem is not just availability of food, but also accessibility. If a person living with HIV/AIDS loses their job because of stigmatization or because they are suffering from wasting and are not able to work, it means that the entire family loses an income and consequently might not have the means to buy food. This is why safety net programs should be a part of the HIV/AIDS treatment. Safety net programs are transfers that come as food aid, vouchers or cash to improve accessibility of food. The safety net program aims to help people out of poverty and create a sustainable livelihood with the food-for-work program, which contributes to economic development in local communities (Frega et al. 2010).
Methods: To gain more knowledge of safety net programs, how they can improve the food security and what the health consequences are for people living with HIV/AIDS in Ethiopia, five interviews have been conducted. After conducting the five interviews they were transcribed and transferred into NVivo10 and divided into notes and sub note. Based on the interviews and by the use of Adele Clarke's situational maps and analysis theory, Situational maps were created
Results: The interviews clearly demonstrate that stigmatization of people living with HIV/AIDS is a major problem in Ethiopia. Because of this stigmatization people living with the disease might not disclose their HIV status. An indirect consequence for people living with HIV is that they can lose their job because of their HIV status and thereby lose their income, which in turn affects not just the individual but entire families when the main provider is ill. There are areas in Ethiopia where it is not the availability of food that is the problem causing undernutrition but it is the accessibility that is the problem. Even if food is available, people do not have the means to buy it as many have lost their income due to stigmatization. Because access to food is very limited or not available, people’s energy requirements might not be met and they suffer from wasting as a result. The food security level has to be raised for the whole family and the Safety net programs might be a possible solution to the food insecurity problem in Ethiopia.
Conclusion: Safety net programs with transfers that come as food aid, vouchers or cash might be a good tool to improve the food security situation for people living with HIV/AIDS in Ethiopia because they focus on the whole family. It is important that people with HIV/AIDS get proper nutrition to prevent them from suffering from wasting. The health consequences of suffering from wasting is that it can lead to a loss of lean tissue mass including a decrease in the muscle mass, which thereby decreases the functional performance. Food security can influence malnutrition if there is no availability of food or if people do not have access to the available food. If the food security level for families in general is being raised it might also improve the living standard for people with HIV/AIDS.