The Thrive Project Year 5 Quarterly Report No. 1. January 2017

The Project has been supporting the integration of Nutrition Assessment, Counseling and Support (NACS) services in selected health facilities in four provinces for the past four years. The Thrive Project is mandated to trigger the process of operationalizing the integration of NACS into HIV treatment care and support systems in health facilities. The Project provides short-term food supplements to eligible clients. The specific objectives of the Thrive Project are to provide NACS for people living with HIV (PLHIV) and orphans and vulnerable children (OVC), build the capacity of nutrition service providers, and local production of specialized nutrient supplements - High Energy Protein Supplement (HEPS). The Thrive Project has reached its target of 50 health facilities and is providing NACS across 15 districts in the four provinces; Eastern, Copperbelt, Central, and Southern. The Project has met and exceeded all the contract targets and is continuing to provide NACS services. During the reporting period, 2,876 clients received the full NACS services in all the Thrive Project supported health facilities. This has resulted in exceeding the life of project target of 70,000 with the final result of 105,355. A total of 379 malnourished clients received nutritional supplements during this reporting period. The life of Project total for eligible clients receiving nutritional supplements is 26,131, exceeding the life of project target of 21,700. The Thrive Project has continued to provide NACS services to PMTCT clients, with 90 PMTCT clients receiving NACS services during the reporting period. The Thrive Project has also made significant progress in the local production of HEPS. Approximately 34 metric tons of HEPS was distributed to 16 health facilities in Southern and Central provinces. The Project continued to provide technical assistance to COMACO Chipata plant, COMACO – Serenje, and HIPRO plants to build their technical capabilities in HEPS production. The Thrive Project engaged community-based organizations to sell HEPS to both PLHIV and other community members. The Project also supported and collaborated with 34 community organizations to ensure clients consistently received NACS services. The Thrive Project has also supported health facilities in combatting malnutrition by training health workers in nutrition assessment, counseling, and support; strengthening workers' ability to provide care; and increasing access to supplements. The Project is currently supporting 16 Direct Service Delivery - DSD sites and 34 Technical Assistance - TA sites. In DSD sites, the Project is providing the full NACS services including the food supplements, while in TA sites, the direct provision of the food supplements is withdrawn from the health facilities while maintaining all other support and technical assistance. The Thrive Project Provincial teams have continued to mentor and supervise the implementation of NACS services. The priority has been on providing mentorship in the 16 newer DSD sites in Central and Southern Province. During the mentorship and supervisory visits, the Thrive teams together with the health facility staff identify gaps in performance and possible solutions. Based on these interactions, the health facilities generate specific action plans and agree on a time line to address the issues raised. There is a continuing need to improve the quality of NACS services in an estimated 30% of both DSD and TA health facilities.