TRAINING OF TRAINERS MODULE 
                                                  
                                                  
                                       WOMEN’S NUTRITION 
                                  THROUGHOUT THE LIFE CYCLE 
                              AND IN THE CONTEXT OF HIV AND AIDS
                                                                   
                 
                 
                 
                                            
                             TRAINING OF TRAINERS MODULE 
                                           
                                           
                                WOMEN’S NUTRITION 
                           THROUGHOUT THE LIFE CYCLE 
                       AND IN THE CONTEXT OF HIV AND AIDS 
                                           
                                           
                                           
                                           
                                           
                                           
                                           
                                           
                                           
                                           
                                           
                                           
                                           
                 
                 
                 
                 
                 
                 
                 
                 
                 
                                       March 2005 
                 
                 
                 
                         
                      
                      
                                                  Table of Contents 
                                                           
                       ACKNOWLEDGMENTS II 
                       PURPOSE                                                               1 
                       COURSE OBJECTIVES                                                     1 
                       TRAINING AGENDA                                                       2 
                       TRAINING METHODOLOGY                                                  2 
                       SESSION 1: INTRODUCTION, EXPECTATIONS, OBJECTIVES, AND PRE-COURSE 
                                 ASSESSMENT 3 
                       SESSION 2: CAUSES OF MALNUTRITION (BASIC, UNDERLYING, IMMEDIATE)      7 
                       SESSION 3: UNDERSTANDING NUTRITION THROUGH THE LIFE CYCLE: 
                                 INTERGENERATIONAL MALNUTRITION CYCLE                       10 
                       SESSION 4: INTERVENTIONS TO BREAK THE MALNUTRITION CYCLE: INFANCY 
                                 THROUGH ADOLESCENCE                                        16 
                       SESSION 5: INTERVENTIONS TO BREAK THE MALNUTRITION CYCLE: WOMEN 
                                 OLDER THAN 19                                              18 
                       SESSION 6: ESSENTIAL NUTRITION ACTIONS AND KEY CONTACT POINTS FOR 
                                 IMPROVING WOMEN’S NUTRITION                                33 
                       SESSION 7: MICRONUTRIENT NEEDS AT DIFFERENT STAGES IN LIFE           42 
                       SESSION 8: SYNERGISTIC RELATIONSHIP BETWEEN NUTRITION AND HIV 
                                 INFECTION 49 
                       SESSION 9: NUTRITIONAL REQUIREMENTS OF HIV-POSITIVE PREGNANT AND 
                                 LACTATING WOMEN AND ADOLESCENT GIRLS                       54 
                       SESSION 10: NUTRITIONAL CARE AND SUPPORT OF HIV-POSITIVE WOMEN       64 
                       SESSION 11: INDICATORS OF ADEQUATE WOMEN’S NUTRITION                 67 
                       SESSION 12: BEHAVIOR CHANGE COMMUNICATION                            70 
                       SESSION 13: NEGOTIATING NUTRITION WITH WOMEN                         75 
                       SESSION 14: FIELD PRACTICE                                           83 
                       SESSION 15: IMPROVING NUTRITION AT COMMUNITY LEVEL                   87 
                       SESSION 16: ROLE OF THE BABY-FRIENDLY HOSPITAL INITIATIVE IN IMPROVING    
                                  CARE AND SUPPORT OF MOTHERS                               96
                                                                                               
                       SESSION 17: STORYTELLING                                             99 
                       SESSION 18: PRESENTATION OF TRAINING ACTION PLANS                   100 
                      
                      
                      
                      
                      
                     Training of Trainers Module: Women’s Nutrition                          i
                                                                                      
                                  
                              Acknowledgments 
                               
                              This training module is based on the Guidelines on Maternal Nutrition during Pregnancy 
                              and Lactation within the Context of HIV and AIDS developed by the Republic of South 
                              Africa Department of Health Directorate of Nutrition with input from Nomajoni 
                              Ntombela, Maryanne Stone-Jimenez, Jay Ross, and Luann Martin of the LINKAGES 
                              Project of the Academy for Educational Development (AED). The authors would also 
                              like to express their debt to the following publications: AED’s Food and Nutrition 
                              Technical Assistance (FANTA) Project’s HIV/AIDS: A Guide for Nutritional Care and 
                              Support, the CORE (Child Survival Collaboration and Resource) Group and LINKAGES 
                              publication  Maternal Nutrition during Pregnancy and Lactation (August 2004), the 
                              LINKAGES Project’s Maternal Nutrition: Issues and Interventions, AED’s Support for 
                              Analysis and Research in Africa (SARA) Project’s  Nutrition and HIV/AIDS: Evidence, 
                              Gaps, and Priority Actions (April 2004),  Nutrition and HIV/AIDS: A Training Manual 
                              (October 2003), by the Regional Centre for Quality of Health Care (RCQHC), and 
                              Module III: Woman’s Nutrition – Counsellor’s Guide (May 2004) by 
                              AED/LINKAGES/Ethiopia.  
                                
                               
                                                                                                                       March 2005 
                                                                                   
                                                                                   
                               
                               
                              Training of Trainers Module: Women’s Nutrition                                                        ii