TITLE II HIV/AIDS INITIATIVE
MID TERM EVALUATION OF THE TITLE II HIV/AIDS 
INITIATIVE IN 11 SAMPLED DISTRICTS
October 2004
CENTRE
ACDI/VOCA Title II HIV/AIDS Initiative Mid Term report The Ssemwanga Centre Ltd 2
Acknowledgements
The Ssemwanga Centre wishes to acknowledge with thanks the IP staff that helped them during the 
survey. Locating the beneficiaries would have been very difficult without them.
ACDI/VOCA Title II HIV/AIDS Initiative Mid Term report The Ssemwanga Centre Ltd 3
TABLE OF CONTENTS
4
4
5
List of Tables………………………………………………………………………………
List of Figures………………………………………………………………….…………..
Abbreviations and Acronyms…………………………………………………………….
EXECUTIVE SUMMARY…………………………………………………….………… 6
1.0 INTRODUCTION………………………………………………………………. 9
1.1 The Title II Initiative……………………………………………………………... 9
1.2 Study objectives…………………………………………………………………… 9
2.0 METHODOLOGY……………………………………………………………….. 11
2.1 Study design……………………………………………………………………... 11
2.2 Sample size determination……………………………………………………… 11
2.3 Sampling procedure………………………………………………………………... 11
2.4 Data collection methods and instruments…………….…………………………… 12
2.5 Data coding and entry…………………………………………………………….. 13
2.6 Data analysis and presentation…………………………………………………….. 13
3.0 RESULTS AND DISCUSSIONS………………………………………………... 14
3.1 Household food consumption…………………………………………………….. 14
3.2 Ration Utilization…..……………………………………………………………... 16
3.3 Nutritional Knowledge …………………………………………………………… 17
3.4 Nutritional status…………………....…………………………………………….. 17
3.5 Health Status…………………...………………………………………………….. 19
3.6 Water and sanitation…………….…………………………………………………. 20
3.7 Household expenditure ………..……………………………………….………… 23
3.8 School enrollment and retention………………………………………………….. 23
3.9 Attendance of non food services………………………………………………….. 24
4.0 CONCLUSIONS………………………………………………………………….. 25
5.0 RECOMMENDATIONS………………………………………………………… 26
REFERENCES…………………………………………………………………….. 27
APPENDICES…………………………………………………………………….. 28
ACDI/VOCA Title II HIV/AIDS Initiative Mid Term report The Ssemwanga Centre Ltd 4
List of Tables.
Table A Indicator Table………………………………………………………………... 8
Table 1. Areas visited by Implementing Partner…………….………………...………. 12
Table 2.
Table 3.
Frequency of food group consumption………………………….….…………
Frequency of CSB consumption……………………………………………….
15
16
Table 4. CSB recipes reported by beneficiaries……………………………………… 16
Table 5. Prevalence of underweight among children below 59 months by age group…. 18
Table 6.
Table 7.
Prevalence of stunting among children below 59 months by age group….….
Change in mean z-scores for specific age ranges…………………………….
18
19
Table 8. Incidence of illness over the 2 year period…………………………………… 19
Table 9. Distribution of clients by period unable to work in previous 2 months.…….. 20
Table10. Sources of water reported by beneficiaries………………………………….. 21
Table11. Storage container characteristics……………………………………………. 21
Table12 Attendance of non food services…………………………………………….. 24
List of Figures
Figure 1 DDS by districts for 3 studies………………………………………………… 14
Figure 2 Places where beneficiaries sought treatment…………………………………. 20
Figure 3 Source of hygiene information……………………………………………….. 22
ACDI/VOCA Title II HIV/AIDS Initiative Mid Term report The Ssemwanga Centre Ltd 5
List of Abbreviations and Acronyms
ACDI/VOCA Agricultural Cooperative Development International/Volunteers 
Overseas Cooperative Assistance.
AED Academy for Education Development
AFR Africare
AIDS Acquired Immune Deficiency Syndrome
CBO Community Based Organization
CEDO Community Enterprise Development Organisation
CRS Catholic Relief Services
CSB Corn Soy Blend
DDS Dietary Diversity Score
FANTA Food and Nutrition Technical Assistance
FAO Food and Agricultural Organization
HIV Human Immuno-deficiency virus
IEC Information Education and Communication
IGA Income Generating Activities
IP(s) Implementing Partner(s)
KMP Kitovu Mobile Program
OVC Orphans and Vulnerable Children
PLWHA People/Person living with HIV/AIDS
PVO Private Voluntary Organization
Sd Standard deviation
TASO The AIDS Support Organization
TSC The Ssemwanga Centre
UBOS Uganda Bureau of Statistics
UDHS Uganda Demographic and Health Survey
UPE Universal Primary Education
USAID United States Agency for International Development
Ushs. Uganda shillings
VCT Voluntary Counseling and Testing
WAZ Weight for Age Z-score
WV World Vision
ACDI/VOCA Title II HIV/AIDS Initiative Mid Term report The Ssemwanga Centre Ltd 6
EXECUTIVE SUMMARY
The Title II HIV/AIDS Initiative has been operational since January 2002. ACDI/VOCA has been 
providing for and monitoring the distribution of corn soy blend and vegetable oil to people living
with HIV/AIDS (PLWHA) through implementing partners (TASO, World Vision, Catholic Relief
Services and Africare). The overall objective of the program is to alleviate food insecurity and
mitigate some of the impacts of the pandemic on the lives of PLWHA. This mid term study is aimed 
at evaluating the progress of the initiative by comparing the current situation with the baseline using
specified indicators. 
A randomized 30-household cluster survey design was used to capture information from 11 of the 
14 districts previously visited at baseline. A total of 421 households (14 clusters) were interviewed 
using a pre-tested questionnaire and children under 5 years of age had their weights and heights
taken. In addition, focus group discussions and key informant interviews were conducted with the 
PLWHA and IP staff respectively for qualitative information.
Of the 421 households visited 67% were of adult beneficiaries while 33% were of orphan
beneficiaries. This is different from the situation at baseline where 84% were adults and 16% were 
orphans and may explain some trends in the quantitative results. About 67% of the beneficiaries
were female and 33% were male and the mean household size was 6.6.
Household food consumption was assessed using dietary diversity score (DDS) and meal frequency. 
Both these indicators showed a significant increase since baseline (DDS; 4.7 to 5.8 and meal
frequency; 2.9 to 4.1). Beneficiaries reported eating more cereals (94%), legumes (90%) and
vegetable oil (71%) because of the CSB and vegetable oil they receive. In addition, 90% of the 
beneficiaries reported using CSB at least twice a day.
The percentage of children categorized as stunted decreased from 36% at baseline to 32% and those 
categorized as underweight decreased from 18.6 % at baseline to 15.9% at midterm. In addition, 
the mean z-scores for specific age groups showed significant increases since baseline. 
The health status of the primary beneficiaries also shows an improvement. The incidence of disease 
dropped from 82% at baseline to 56% while the percentage of beneficiaries reporting 2 or more
episodes of illness decreased from 38% to 30%. While the changes in beneficiary population may
ACDI/VOCA Title II HIV/AIDS Initiative Mid Term report The Ssemwanga Centre Ltd 7
explain some of these changes the beneficiaries believe that their improved health is mainly due to 
CSB consumption.
Although the beneficiaries reported that they had been taught about hygiene and sanitation (64%),
the situation in their households had not changed significantly. The % of beneficiaries with
appropriate hand washing techniques and proper storage of drinking water is still low (15% and
35% respectively). There is a need to employ strategies that will reach the beneficiaries at the
household level. The level of nutrition knowledge had improved since baseline. About 52%
reported 3 correct reasons why food is eaten compared to the 38% at baseline. Focus group
discussions reported this being due to the nutrition education talks they attended during food
distributions.
Household expenditure on non food services has increased from Ushs 43,641 at baseline to Ushs 
65,686 at midterm. This implies improved welfare since beneficiaries are able to spend more
money on non-food items. Their increased productivity is also implied by the lower percentage
(31%) reported inability to work due to illness compared to what was reported at baseline (56%). 
The mean number of children enrolled in school has remained at 3, this is also the mean number of
children between 5 and 15 years in beneficiary households. This shows school enrollment has not 
changed since baseline possibly because it was high even at baseline due to Universal Primary
Education, a government initiative supported by a number of donors. However, the percentage of
households reporting children missing school in the previous 2 months decreased from 52% to 40%. 
The mean number of times non food services were attended in the previous 2 months has decreased 
from 2.3 to 1.96 (p<0.05) possibly because of the reduced vulnerability. However, some IPs do not 
offer the same non-food services over a period of time so low attendance reported may be due to the 
fact that the service was not offered during the previous 2 months. 
In conclusion, the situation in the beneficiary households has improved especially as regards food 
security, nutrition and health. Basing on the proxy indicators of productivity “inability to work due 
to illness” and income “household expenditure” beneficiaries seem to be more productive now than
at baseline. Focus group discussions confirmed that the improved health was mainly due to CSB
consumption.
ACDI/VOCA Title II HIV/AIDS Initiative Mid Term report The Ssemwanga Centre Ltd 8
Table A Indicator table
Indicators Baseline
(FY02)
Midterm
(FY04)
Household Characteristics
Mean number of children enrolled in school per household 3 3
Mean number of school days missed in previous two months per child 
per household
11 11
Household food Security
Mean number of meals consumed per day 2.9 4.0
Mean number of different food groups consumed in the last 24 hours 4.7 5.8
Knowledge of nutritional strategy
% of beneficiaries who know the benefits of consuming recommended 
foods
37 52
% of beneficiaries who know 2 recommended nutritional practices 32 45
Ration Utilization
% of beneficiaries who know at least 2 maize soya recipes 25 88
Health condition
% of beneficiaries ill at least twice in the last 2 months 38 30
Mean number of times beneficiaries have not been able to work in the 
previous 2 months 2 1.6
Attendance of non food services
Mean number of times non-food services are attended in the previous 2 
months
2.3 1.96
% of beneficiaries getting assistance from CBOs 15 25
Household Expenditure
Mean monthly household expenditure on non-food items (Ushs.) 43,641 65,686
Hygiene
% Beneficiaries with proper hand washing techniques 23 15
%Beneficiaries with proper storage and usage of drinking water 34 35
Nutritional status
% of children with low weight for age (Underweight) 18.4 15.9
% of children with low height for age (Stunting) 36 32
ACDI/VOCA Title II HIV/AIDS Initiative Mid Term report The Ssemwanga Centre Ltd 9
1.0 Introduction
1.1 The Title II HIV/AIDS Initiative
The Title II HIV/AIDS initiative is a USAID funded food aid intervention whose primary objective 
is to alleviate the food insecurity among people living with HIV/AIDS (PLWHA). It has been
operational since January 2002 and beneficiary households receive a monthly dry ration of corn soy 
blend and vegetable oil. In addition, a nutrition and hygiene education component was introduced at 
the beginning of 2004 and it is intended to improve the handling and utilization of food and thus the 
impact of the program. The beneficiaries have nutrition/hygiene education sessions at food
distribution points as they wait to receive the food. In addition, information/education materials
with illustrations of what they have been taught are given to them to use for continued reference at 
home.
To monitor the food aid intervention, the implementing partners collect information on the health
status of the beneficiaries, the ration utilization and the food distribution process on a quarterly
basis. ACDI/VOCA synthesizes this information and uses it to improve the food distribution and
nutrition education activities. In addition, annual studies are conducted to give an in depth
assessment of the program. 
This study aims at evaluating impact by comparing the current food security, nutrition, 
socioeconomic and hygiene situation in the beneficiary households to that at baseline. In addition,
it will endeavor to find out any hindrances to the programs objectives so that they can be addressed 
in the remaining part of the phase.
1.2 Study objectives
The main objective is to quantify the beneficiary state of affairs using specific indicators used at
baseline. The specific objectives include:
1. Assess the household food consumption of the beneficiary households using dietary
diversity and meal frequency as the main indicators; 
ACDI/VOCA Title II HIV/AIDS Initiative Mid Term report The Ssemwanga Centre Ltd 10
2. Determine the nutritional status of children below five years of age, expressed as
percentage of children below –2 z scores for weight for age (underweight) and height 
for age (stunting);
3. Determine the level of awareness of proper nutrition for PLWHA looking specifically
at knowledge of appropriate nutritional practices;
4. Assess the level of hygiene and sanitation in the households of PLWHA by looking at 
their hand washing behavior, access to safe water and adequate sanitation;
5. Obtain information on level of utilization of corn soy blend and vegetable oil;
6. Obtain information on school enrollment and retention of children of PLWHA;
7. Obtain information on household expenditure in the households of PLWHA and
8. Obtain information on level of attendance on non food services by PLWHA.
ACDI/VOCA Title II HIV/AIDS Initiative Mid Term report The Ssemwanga Centre Ltd 11
2.0 Methodology
2.1 Study design
A pretest-post test evaluation design was used where the mid term (posttest) survey results are
compared to the baseline (pretest) results in order to determine the difference between the two
periods. No control group was used because we envisaged difficulties in interviewing PLWHA
who are not food beneficiaries and biases resulting from the need to be enrolled on the program. 
2.2 Sample size determination
Sample size of 420 was used i.e. 14 clusters of 30 households each.
This was determined using the equation below.
where:
n = D[(Z1+Z2)
2 *(sd1
2
+sd2
2
) / (X2-X1)
2
] 
n = the required minimum sample size per survey round,
D = design effect (=2 for cluster surveys)
Z1 = z-score corresponding to the degree of confidence with which it is desired to be 
able to conclude that an observed change of size (X2-X1) would not have occurred by 
chance (=2.326).
Z2 = z- score corresponding to the degree of confidence with which it is desired to be 
certain of detecting a change of size (X2-X1) if one actually occurred (=2.320).
sd1 and sd2 = expected standard deviations for the indicators for the respective survey 
rounds (=1.74 and 1.82)
X1= estimated level of the indicator at baseline (= 5.3)
X2 = estimated level of the indicator at a future date (=5.9). 
2.3 Sampling procedure
The two-stage cluster sampling procedure was used to choose 14 clusters from the 21 visited at
baseline. The clusters were based of food distribution points (FDPs) in the program area.
ACDI/VOCA Title II HIV/AIDS Initiative Mid Term report The Ssemwanga Centre Ltd 12
The same clusters were chosen so as to reduce variability resulting from background characteristics 
and make the task of determining real change easier1
.
At the first stage clusters were chosen using the random systematic sampling technique and at the 
second stage, households were chosen using a purposive sampling technique. This was to ensure
that beneficiaries chosen were not those previously interviewed in the study held last year thus
avoid biases and also to try and include as many children as possible from each area. 
Clusters were chosen from the following areas; Kamwokya, Entebbe, Kituntu, Ssi, Kasangombe,
Bukulula, Kiwangala, Mbarara Kyagaju, Nyenga, Nakaloke and Ntungamo. A total of 11 districts 
spreading from the east to west of Uganda were visited and 421 beneficiary households were
interviewed. The division by IP is shown in Table 1.
Table 1 Areas visited by Implementing Partner
Implementing
Partner
Areas visited
(FDP)
Number of 
clusters
TASO Entebbe, Mbarara, Kyagaju, Nyenga,
Nakaloke and Busia
6
CRS Kamwokya, Gaba, Bukulula and Kiwangala 4
WV Kituntu, Ssi, Kasangombe 3
AFRICARE Rushoka 1
2.4 Data collection methods and instruments
A pre-tested structured questionnaire was used to collect quantitative data during household
interviews and a checklist for focus group discussions and key informant interviews. The latter two 
were aimed at collecting qualitative information on the contextual factors that explain the
quantitative results obtained from the household interviews. In addition, children under five years
old in the beneficiary households were weighed and their heights taken using standardized scales
and stadiometers to enable assessment of their nutritional status. The enumerators were trained and 
standardized to reduce measurement errors. In addition, observations were made of hygiene
practices and sanitation facilities in the beneficiary households. The data collection exercise lasted a 
period of 3 weeks. 
 
1
 Magnani R 1997 Sampling Guide Food and Nutrition technical Assistance, Academy for educational Development, 
Washington DC.
ACDI/VOCA Title II HIV/AIDS Initiative Mid Term report The Ssemwanga Centre Ltd 13
2.5 Data coding and entry
Data coding and entry was done manually and questionnaires were scrutinized for irregularities
before and after data entry was done.
2.6 Data analysis and presentation
SPSS and Epi Info packages were used to analyze data for means, frequencies and z-scores. Cross 
tabulations, stratification and correlations were used to compare the results by gender, geographical
setting, IP and other background characteristics. All data was analyzed at the 95% confidence level. 
Statistical information has been presented using tables, graphs and charts.
ACDI/VOCA Title II HIV/AIDS Initiative Mid Term report The Ssemwanga Centre Ltd 14
3.0 Results and Discussion
3.1 Household Food Consumption
Household food consumption was assessed using two impact indicators; dietary diversity score
(DDS) and meal frequency. In addition, a food frequency questionnaire (FFQ) was used to clarify 
the DDS and give a long-term assessment of the beneficiaries’ diet.
3.1.1 Dietary Diversity score;
Dietary diversity is defined as the number of food groups consumed by an individual or household 
in a given period of time. In this study the food group classification was done according to the FAO 
food groups; Cereals, roots/tubers, pulses/legumes, milk/milk products, meat, fish/sea food, eggs,
poultry, oil/fats sugar/honey, fruits and vegetables and a 24 hour recall period was used to get
information on the beneficiaries’ food intake. 
The analysis shows that DDS has gradually increased since baseline. The mean DDS program-wide 
was found to be 5.8 this is above the target set for this FY04 (5.5). The change by district is shown 
in Figure 1 below. 
Figure 1 DDS by district for the 3 studies.
0
1
2
3
4
5
6
7
Kampala Bushenyi Luwero Masaka Mbale Mbarara Mukono Ntungamo Wakiso
Districts
DDS
Baseline
FY03
Midterm
A high DDS (=6) indicates a varied diet and has been associated with improved anthropometric
status, birth weight, reduced risk of mortality and adequate caloric and protein intake2
. Five out of 
the nine districts had a mean DDS of 6 and above. The common food groups mentioned were 
 
2Hoddinott J and Yohannes Y Dietary diversity as a Household Food Security Indicator Washington DC Food and Nutrition Technical Assistance 
Project, Academy of Educational Development, 2002.
ACDI/VOCA Title II HIV/AIDS Initiative Mid Term report The Ssemwanga Centre Ltd 15
cereals (93%) and legumes (80%), followed by vegetables (79%), fruits (72%) and oil/fats (71%). 
Honey/sugar (55%) and tubers (52%) were next. Fewer beneficiaries. (percentages below 35%)
reported the rest of the food groups. This shows a change in the feeding patterns since baseline 
where 73-90% were consuming tubers, 60% were consuming fruits and vegetables and about 25% 
were consuming oil/fats. The FFQ gave similar percentages with 94% reporting consuming cereals 
more than once weekly, 90% reporting legumes and 75% reporting tubers for the same period.
Results for the FFQ are presented in Table 2.
Table 2 Frequency of food group consumption 
Food Group % reporting consumption of food
groups more than once weekly
Tubers 76
Cereals 94
Legumes 90
Meat 11
Fish 40
Milk 38
Eggs 19
Poultry 6
Vegetables 73
Fruits 65
Sugar 68
The changes in the feeding patterns were attributed to the food distribution and the nutrition
education. Focus group discussions reported the high percentages of cereals, legumes and oils are 
mainly due to CSB and vegetable oil received every month. An increase in vegetable consumption
was reported to be due to availability of oil in the beneficiary households. However, it was not as 
high as cereals or legumes because of the dry season. 
3.1.2 Meal frequency – No of meals per day;
Meal frequency is a proxy for adequacy of caloric intake and can also be used in capturing
transitory food insecurity3
. The mean number of meals across the districts ranged between 2 and 6 
with the majority (³80%) reporting meal numbers between 3 and 5. The mean for the whole
program is 4.1. This is significantly different form what was reported at baseline - 2.9 (p<0.05). 
All of the areas visited had experienced a prolonged drought season and 71% of the beneficiaries 
reported limitations to increasing meal frequency. Lack of money (51%), lack of other food (14%), 
 
3
Food and Nutrition Technical Assistance (FANTA) project and Food Aid Management (FAM) Food Access Indicator Review Washington DC 2003
ACDI/VOCA Title II HIV/AIDS Initiative Mid Term report The Ssemwanga Centre Ltd 16
sickness (11%) and drought (10%) were the most common limitations reported. Meal frequency is 
also affected by cultural practices and livelihoods so even with increased food availability it may
still be limited by these factors.
3.2 Ration Utilization.
Ration utilization was assessed by looking at the frequency of CSB consumption and the number of
different recipes known to the beneficiaries. The analysis showed that CSB consumption has
continued to remain high with a vast majority (>90%) reporting use of CSB twice or more times a 
day. The largest percentage (48%) reported using CSB three times. This concurs with the data 
collected quarterly where the majority report using CSB two to three times a day. Table 3 below
shows frequency of CSB use per day for FY03 and FY04 (midterm). 
Table 3 Frequency of CSB consumption 
Frequency of daily 
consumption of CSB
FY03
%
(n= 429)
Midterm
%
(n=415)
Once 4 7
Twice 27 29
Thrice 48 48
More than thrice 21 16
3.2.1 Percentage of beneficiaries who know at least 2 recipes using CSB
About 88% of the beneficiaries reported knowing at least two recipes. Table 4 shows the different 
CSB recipes reported by the beneficiaries during the annual study of FY03 and at midterm. The 
most common recipes for both are CSB porridge and posho.
Table 4 CSB recipes reported by beneficiaries
Recipes FY03
%
Midterm
%
Porridge 97 99
Posho 76 69
Sauce 37 45
Bread 4 32
Pancakes 35 30
Chapati 0 15
Doughnuts 7 11
Bagiya 0 1
Samosa 1 1
ACDI/VOCA Title II HIV/AIDS Initiative Mid Term report The Ssemwanga Centre Ltd 17
Some families, especially those with children reported using it to make snacks for their children like 
pancakes and doughnuts with the oil provided, while others prefer it in the food either as part of the 
sauce or posho. Focus group discussions reported that the demonstrations at food distribution
points (FDPs) led to the increase in recipes used for CSB preparation. 
3.2.2 Storage of CSB
About 63% of the beneficiaries stored CSB on a raised stand. The stands included stools, benches, 
jericans and stones. About 21 % stored it on the floor while 5.6% stored it in a plastic container. 
The latter was common in urban areas. Plastic containers were used to keep away ants and rodents. 
FGDs reported nutrition training at FDPs as the main source of information on CSB storage.
3.3 Nutritional Knowledge
About 77% of the beneficiaries reported knowledge of the food that is recommended for them to
eat. Beneficiaries reporting 3 correct reasons for consuming particular food groups were 52%,
15percentage points higher than those reporting them at baseline. The responses were highest for
cereals where 81% reported at least one correct response, and legumes where 62 % reported at least 
one correct reason. About 45 % reported at least 2 correct eating habits for PLWHA. This is also 
higher than the 32 % at baseline.
3.4 Nutritional status
Nutritional status has been defined in a number of ways; FAO defines it as net outcome of an
individual’s usage of food while Gibson (1999) defines it as the outcome of interactions between
individuals’ genetic potential and environmental factors, which include food, health, income,
lifestyle, and education. Since the beneficiaries have had access to food, the nutritional status is
expected to improve assuming that other environmental factors such as care and health status
remain constant. Nutritional status was assessed using anthropometric measures of children below
five years old and using them to calculate z scores. The percentages of children underweight/low
weight for age (with z-scores < –2) and stunted/low height for age (z-scores < –2) were determined 
and compared to the previous years including baseline.
ACDI/VOCA Title II HIV/AIDS Initiative Mid Term report The Ssemwanga Centre Ltd 18
3.4.1 Percentage of children with low weight for age (underweight) 
Weight for age z-scores were analyzed for 126 children using Epi Info software package and the
results have been compared to baseline and FY03 in Table 5. 
Table 5 Prevalence of Underweight among children below 59 months by age group
Age group Percent of children below –2 z-scores
(months) Baseline (FY02)
(n=289)
FY03
(n=190)
MidtermFY04
(n= 126)
>12 0.6 1.0 3.1
12 - 23.9 3.3 5.3 5.6
24 – 35.9 5.5 3.1 0.8
36 – 47.9 7.3 4.2 4.0
48 – 59.9 1.5 3.2 2.4
Mean 18.4 16.8 15.9
The prevalence of underweight among children below five years of age is gradually decreasing and 
this is more evident among children between 24 and 48 months. Focus group discussions reported 
that it was a common practice among beneficiary households to give children CSB porridge as a 
midmorning and evening snack in addition to their regular meals and this they believed was one of
the main contributing factors to the improvement in nutritional status. The change in feeding
patterns is mainly attributed to the nutrition training received at food distribution points.
3.4.1 Percentage of children with low height for age (stunted)
The prevalence of stunting (low weight for age) among children below 5 years of age decreased
from 36% at baseline to 32%, Table 6 shows the details in the different age groups. The most 
significant change is in the age group of children between 12 and 36 months.
Table 6 Prevalence of Stunting among children below 59 months by age group
Age group Percentage of children below –2 z scores
(months) Baseline
(n=289)
Midterm
(n=104)
< 12 months 1.0 1.0
12 – 35.9 13.9 8.6
36 – 47.9 13.2 13.4
48 - 59.9 8.0 9.0
Mean 36 32
 NB Stunting is not expected to change over a period of a year and it was therefore not assessed during FY03
ACDI/VOCA Title II HIV/AIDS Initiative Mid Term report The Ssemwanga Centre Ltd 19
3.4.2 Mean z scores
The mean z- scores for weight for age (WAZ) and height for age (HAZ) increased from baseline to 
midterm. This also portrays an improvement in the nutritional status of the children on the
program. Table 7 shows the increases in z scores since baseline. 
Table 7 Change in mean z scores among specific age groups
WAZ
6 - 35 months
HAZ
24 - 59 months
p value
Baseline -1.66 -1.33 p>0.05
Midterm -0.81 -0.73 p>0.05
3.5 Health status
Improved health status is one of the outcomes that have been reported on beneficiaries given CSB
or fortified soybean. This study looked at incidence and duration of illness as the main indicators
for assessing health status of the beneficiaries.
3.5.1 Percentage of beneficiaries ill at least twice in the previous 2 months
Beneficiaries reporting two or more episodes of illness in the previous 2 months decreased from
38% at baseline to 30%. While those reporting at least one episode of illness decreased from 82% 
to 56% in the sampled population. Focus group s reported fever as the commonest symptom
suffered. Table 8 below shows the change since baseline.
Table 8 Incidence of illness over the 2 year period
Beneficiaries Baseline
(n=630)
FY03
(n=429)
Midterm
(n=421)
% Reporting = 1episodes of illness 82 68 56
% Reporting = 2 episodes of illness 38 41 30
3.5.2 Mean number of times beneficiaries are unable to work due to illness.
The percentage of beneficiaries reporting inability to work due to illness in the previous 2 months 
decreased from 56% at baseline to 31% at midterm. The mean number of times decreased from 2 to 
1.6 (p<0.05)
ACDI/VOCA Title II HIV/AIDS Initiative Mid Term report The Ssemwanga Centre Ltd 20
The longest periods during which the beneficiaries were unable to work was compared with what
was reported at baseline and for FY03. Table 9 shows the details.
Table 9 Distribution of clients by period unable to work in the previous 2 months
Period Baseline FY03 Midterm
(days) No. % No. % No. %
1 – 7 151 24 74 17 63 15
8 – 14 69 11 31 7 23 5
15 – 30 78 12 15 4 21 5
31 - 60 58 9 32 7 19 4
For almost all the periods the percentages have decreased, this implies the beneficiaries are coping
much better now than at baseline. Focus group discussions concurred with this, they reported
feeling stronger and many of them were returning to work. Some distribution officers reported
using this as a basis of phasing out some beneficiaries from the program. 
3.5.3 Health seeking behavior
The places where beneficiaries sought treatment are shown in Figure 2. Over 50% went to the IP 
center while most of the others went to health centers. 
Figure 2 Places where beneficiaries sought treatment
53%
6%
39%
2%
Health centre
PVO clinic
Self medication
Alternative therapy
3.6 Water and Sanitation
Improved water quality has been associated with up to 20% reduction in diarrheoal diseases4
. This 
can only be achieved by using a protected water source and keeping water in containers that are 
 
4
 International Nutrition Foundation for Developing Countries 1997 Hygiene Evaluation Procedures – Approaches and measures for assessing water 
and sanitation related hygiene practices INFDC 1997
ACDI/VOCA Title II HIV/AIDS Initiative Mid Term report The Ssemwanga Centre Ltd 21
clean and covered to avoid re-contamination. Research shows that hygiene related practices such as 
safe disposal of feaces and hand washing after contact with fecal material can reduce rates of
intestinal infections by 35%5
. This is important for people living with HIV/AIDS since diarrhoea is 
one of the diseases that tremendously affect their health. Information on water source and storage 
and hand washing techniques and facilities was collected and the results are presented below. 
3.6.1 Percentage of beneficiaries with proper storage of water
About 67% of the beneficiaries collected water from a protected source (protected spring, borehole 
tank and tap) while 33% collected it from an unprotected source. Table 10 below shows the sources 
of water since baseline. The slight difference may be only because of changing samples. In
addition, the water source may change in periods of prolonged drought when some rivers/streams
dry up or when facilities like boreholes breakdown. 
Table 10 Sources of water reported by beneficiaries
Water source Baseline
%
FY03
%
Midterm
%
Protected spring 31 29 23
Borehole 17 20 21
Tap/Tank 18 22 23
Unprotected source 34 28 33
Observations of the storage containers revealed that about 79% had separate containers for drinking 
water, slightly higher than the 77% last year. Table 11 summarizes the characteristics of the
container.
Table 11 Storage container characteristics
Storage Container Baseline
(%)
FY03
(%)
FY04 (Midterm)
(%)
Clean 62 60 67
Covered 74 60 66
On a raised surface 33 37 39
Various descriptions were given for the water in the separate container; about 77% described it as 
water “not used for other purposes”, 65% described it as “boiled”, 5% described it as “kept aside” 
 
5
 International Nutrition Foundation for Developing countries 1997 Hygiene Evaluation Procedures - Approaches and 
methods for assessing water and sanitation related hygiene practices INFDC 1997
ACDI/VOCA Title II HIV/AIDS Initiative Mid Term report The Ssemwanga Centre Ltd 22
and another 5% as “clean and safe”. These descriptions give an indication of the treatment the
water is given.
3.6.1 Percent of beneficiaries with proper hand washing practices
About 90% of the beneficiaries washed both hands rubbing them at least 3 times; however only
62% used soap and 24% dried them hygienically. The percentage of beneficiaries practicing all the 
four recommended practices was only 15%. Drying hygienically is the challenge in the rural
setting since it is not easy to have towels hanging outside toilets. In addition, beneficiaries
mentioned that sometimes they do not have soap and thus do without it. Observations in the
homesteads showed that although 93% had toilets/pit latrines only 18.6 % had a hand washing
facilities outside their toilets. 
Beneficiaries mentioned a number of reasons why they thought it was important to wash hands. 
These included killing germs (46%), removing dirt (36%), removing germs and odours (16%) and
cleaning hands (9%). Health workers (41%) and community workers (21%) were the main source 
of the information. Details on the sources of information are shown in chart below.
Figure 3 Source of hygiene information
38%
22%
13%
3%
17%
4% 3%
Health workers
Community workers
Parents
Mass media
General knowledge
School
Other NGOs
3.6.2 Hygiene education
About 63% of the beneficiaries reported that they had been taught about hygiene and sanitation with 
topics ranging from personal, food and kitchen hygiene to waste disposal and construction of racks. 
Observations in their homes revealed that 54% had drying racks, 46% had kitchen racks and 24% 
had compost pits. The kitchen racks were mainly made of wood and reeds. Racks were generally 
more common in the rural areas than urban ones. Focus groups reported that this because of the 
little space available in the urban areas where many of the beneficiaries stay in 1 or 2 roomed
ACDI/VOCA Title II HIV/AIDS Initiative Mid Term report The Ssemwanga Centre Ltd 23
houses. Community workers reported that the hygiene situation was beginning to improve in the
beneficiary homesteads.
3.7 Household Expenditure
This is used as a proxy of household income and welfare. Data on expenditure on food and non￾food items was collected using recall methods of 7 days, 3 months and yearly periods. The values 
were multiplied by factors to get monthly expenditure. The mean expenditures were analyzed for
the whole program and were compared with those at baseline.
3.7.1 Mean household expenditure on non-food items
Mean household expenditure on non-food items was found to be U Shs 65,686 per month. This is 
significantly different from the mean at baseline U Shs 43,641 but not significantly different from
the mean for FY03 (U Shs 68,438). The greatest expenditure is on education while the least is on 
water. About 25% of the beneficiaries reported receiving assistance from children and other
relatives. Household expenditure on non food items for those who did not receive assistance was
found to be significantly lower (U Shs 55,566). 
3.7.2 Mean household expenditure on food items
Data on expenditure on food items shows an increase from U Shs 29,856 at baseline to U Shs
37,052 per month at midterm. It was reported lowest in Ntungamo (UShs 12,053) and highest in
Entebbe (U Shs 98,931). This can be explained by the fact that residents of Entebbe are living in an 
urban setting where they cannot grow their own food but have to buy all that they eat. In addition, 
most of them are employed and can afford to buy food while those in Ntungamo grow most of their 
food and just buy a little extra food on market days once a week. Focus group discussions revealed 
that beneficiaries were getting more productive and able to earn more especially those living in
urban settings.
3.8 School enrollment and retention
School enrollment and attendance were expected to improve with the food distribution and the
annual study (FY03) reported an increase. However, because of the universal primary education
ACDI/VOCA Title II HIV/AIDS Initiative Mid Term report The Ssemwanga Centre Ltd 24
the numbers were already high. Analysis of this data shows that the mean number of children in
school is 3.61 while the mean number of children between 5 and 15 years in the beneficiary
household is 3.4. This implies that most of the children are enrolled in school. In addition, only
39% reported missing school and this is lower than what was reported at baseline (52%). 
3.9 Attendance of Non food services
The beneficiaries accessed a number of different non food services. These can be categorized into 
four including; clinical services, counseling services, nursing care and social support services. The 
attendance varied because of a number of reasons like how often they were offered and what else 
the beneficiary could access at the same time. For example, food aid services are accessed at the 
same time as when they receive food while counseling services are accessed when they seek clinical
services. The attendance rates ranged from 1.3 to 2.2 in the previous 2 months. Attendance at
baseline has been compared to midterm. Table 12 below shows the details.
Table 12 Mean number of times non food services were attended
Non food aid services Baseline Midterm
Clinical 2.50 (n=683) 2.20 (n=223)
Counselling 2.50 (n=572) 2.00 (n=242)
Nursing care 2.30 (n=639) 1.80 (n=479)
Social support 2.56 (n=328) 1.95 (n=248)
Mean 2.45 1.96
The attendance of non food services has decreased possibly because the beneficiaries are improving
and so they do not have to seek the services as often as before. As the beneficiaries are getting
more and more productive they are involved in small income generating activities and will only
seek support services when they are in need. Other reasons reported for not accessing some of the 
services were lack of funds and the long distance they would have to travel to the centers.
About 13% of the beneficiaries reported receiving assistance from community based organizations
(CBOs). Nature of assistance included school fees (6 %), medicines (5%), household items (1%) 
and domestic animals (1%).
ACDI/VOCA Title II HIV/AIDS Initiative Mid Term report The Ssemwanga Centre Ltd 25
4.0 Conclusions
1) The food security situation has improved in the beneficiary households as shown by the 
improved DDS and meal frequency. Focus group discussions reported that this was mainly 
because of the CSB and vegetable oil. Some efforts to improve production of food among 
beneficiary households were reported in Bukulula with the help of a CBO-CEDO. However, 
it was not possible to ascertain how much the beneficiaries had gained because the crops had 
been destroyed by the prolonged dry season.
2) The nutritional and health status have improved as demonstrated by the nutritional indices 
for stunting and wasting and the incidence of disease. Focus group discussions reported that 
beneficiaries are beginning to produce their own food and a lower percentage reported 
inability to work due to illness.
3) Although hygiene education has been conducted in some areas percentage of beneficiaries 
adopting new hygiene practices are still low as shown by the percentages practicing 
recommended hand washing practices and appropriate storage of drinking water.
4) Attendance of non food services has decreased implying reduced vulnerability among the 
beneficiaries. Beneficiaries are getting productive and are involved in other activities other 
than the specific non-food aid services offered by the IPs.
5) Utilization of CSB has increased since FY03 and more respondents reported knowledge of 
different CSB recipes.
ACDI/VOCA Title II HIV/AIDS Initiative Mid Term report The Ssemwanga Centre Ltd 26
5.0 Recommendations
1. Strategies that will reach beneficiaries at household level need to be explored so that 
hygiene practices at household level are improved. This may involve working more 
with community workers who will reach the beneficiaries at household level. 
Community workers reported that this could improved by increased facilitation to
enable more home visits and follow up.
2. More CBOs that can work with the beneficiaries to help them improve on their
productivity should be encouraged as the beneficiaries are getting stronger and some 
of them are being phased out of the program. IPs may consider exploring the
possibility with existing CBOs in their areas of operations.
ACDI/VOCA Title II HIV/AIDS Initiative Mid Term report The Ssemwanga Centre Ltd 27
REFERENCES
1. Magnani R Sampling Guide Food and Nutrition technical Assistance, Academy for
educational Development, Washington DC 1997.
2. Hoddinott J and Yohannes Y Dietary diversity as a Household Food Security Indicator 
Washington DC Food and Nutrition Technical Assistance Project, Academy of Educational
Development, 2002.
3. Food and Nutrition Technical Assistance (FANTA) project and Food Aid Management
(FAM) Food Access Indicator Review Washington DC 2003
4. International Nutrition Foundation for Developing countries 1997 Hygiene Evaluation
Procedures - Approaches and methods for assessing water and sanitation related hygiene 
practices INFDC 1997
ACDI/VOCA Title II HIV/AIDS Initiative Mid Term report The Ssemwanga Centre Ltd 28
ACDI/VOCA PL-480 LIFE INITIATIVE.
MID TERM SURVEY QUESTIONNAIRE. 
Date of interview. _______________
Time: Start __________________________End ___________________________
Enumerator’s code _______________ Supervisor’s code________________
Section 1. Household identification
This section is to be completed by the enumerator
101 Name of the district _________________________________________
102 Name of the sub county _________________________________________
103 Name of the village ____________________________________________
104 Name of the IP_______________________________________________
105 Cluster #__________________106 Household #______________________
107 ID # _________________________________________________________
108 – 111. INSTRUCTIONS: This information is available either on the card or from the primary beneficiary or 
caregiver and should be filled in by the interviewer. 
# Questions Code
108.
Identification No. of the primary beneficiary ________________________ 
 
1: HIV+
2: Orphan
109. Status of Beneficiary (Tick one answer)
3. Both
110. Gender (Tick one answer) 1: Male
2: Female
111. Date of birth of primary beneficiary ____/_____/_____
(estimate if necessary) Day/month/ year 
Age (in years) =
Use past events to ascertain this date
Section 2. Household characteristics
INSRUCTIONS: The respondent is the primary beneficiary or caregiver
# Questions Code
1: Beneficiary him/herself 
2. Spouse
3. Parent
4: Elder sibling >15 
5: Elder sibling < 15 
6: Other relative adult
201(a) Household head 
What is the relationship of the household head 
to _________________? 
 (name of beneficiary)
(Tick one answer)
7: Non relative 
ACDI/VOCA Title II HIV/AIDS Initiative Mid Term report The Ssemwanga Centre Ltd 29
202 –
207.
(b)
Family structure (write the number in each category in the right 
column)
How many members does this household have?
(write number)
202. How many boys <5 are there in the household?
203. How many girls <5 are there in the household?
204. How many boys between 5 - 15 are there in the household?
205. How many girls between 5 - 15 are there in the household?
206. How many male >15 are there in the household?
207. How many female >15 are there in the household?
208. How many children are in school? (write number) # :
209 If the number is less than the total of 204 and 205 ask
Why aren’t the other children in school? (write reason)
210 Did any children miss any school last month?
(Tick one answer) 
1 Yes 2 No
-> Go to 
section 3
 # days:
211. Child 1 
212. Child 2
213. Child 3
211 –
214.
If yes which children missed school last month and how many days 
did each of them miss? 
(write the number of days missed by each child in the right column)
214. Child 4
Section 3. Dietary diversity
INSTRUCTIONS: The respondent is the primary beneficiary or caregiver.
301 - 306. Yesterday, did you or anyone in your household consume…?
Eating occasion
(tick yes or no)
Yes No Limitations
301. A morning meal?
302. Any food between morning 
and Lunch?
303. Lunch?
308 (a) Is there anything that limits the 
number of meals you have in a day? 
1. Yes 2. No 
304. Any food between Lunch and 
Supper 
 305. Supper
306 Any food after supper?
308(b) If yes what are these things? 
_____________________________________
_____________________________________
307 Total number of meals 
(Confirm and write figure)
_____________________________________
_____________________________________
_____________________________________
ACDI/VOCA Title II HIV/AIDS Initiative Mid Term report The Ssemwanga Centre Ltd 30
309 – 319Yesterday did you or anyone in your household consume any of the following foods?
Food Group
Yesterday, did you or 
anyone in your 
household consume 
any of the following 
foods?
Food Group
Yesterday, did you or 
anyone in your 
household consume 
any of the following 
foods?
CEREAL: 
Maize ,Millet, Sorghum
Rice, wheat,,
CSB
309.
1. Yes
2. No
FISH: 
Ngege, Mukene, 
Mputa,…
315.
1. Yes
2. No
ROOTS / TUBERS:
Cassava, Yams, Irish 
Potato, sweet potato, 
310.
1. Yes
2. No
OIL /FAT: Ghee, 
Eshabwe, Simsim, 
Sunflower 
USA veg oil
316
1. Yes
2. No
LEGUMES:
Peas, G.nuts, Soya, 
Beans Pigeon Peas
CSB
311.
1. Yes
2. No
SUGAR / HONEY / 
MOLASSES: 
317
1. Yes
2. No
MILK / MILK 
PRODUCTS:
Yoghurt, Whey, 
(Amacunda)
312 
1. Yes
2. No
FRUITS:
Matooke, Water melon,
Banana, mango, 
papaya, pineapple, 
guava, jackfruit, orange, 
318.
1. Yes
2. No
EGGS: 313 
1. Yes
2. No
VEGETABLES:
Ovacado, Carrots, 
Cabbage,Onion,
Greens, eggplant, 
pumpkin, tomato, 
squash 
319.
1. Yes
2. No
MEAT
Beef, mutton, pork 
rabbit ,Goat Meat Offals
314
1. Yes
2. No
POULTRY:
Chicken, duck, pigeon 
Turkey, Guinea fowl
320
1. Yes
2. No
Other/ Miscellaneous
Spices seasonings
321
1. Yes
2. No
Question: Which foods are eaten in your household? How often (Use scale below)
Food group Frequency of consumption
(Clarify using examples 
above and tick where 
appropriate)
>Once 
daily
Once 
daily
>Once 
weekly
Once 
weekly
>Once 
monthly
Once 
monthly
Never
322 Tubers
323Cereals
324 Legumes
ACDI/VOCA Title II HIV/AIDS Initiative Mid Term report The Ssemwanga Centre Ltd 31
325 Meat and meat products
326 Fish
327 Milk and milk products
328 Eggs
329 Poultry
340 Vegetables
341 Fruits
342 Sugar, Honey, 
Molasses
343. Matooke
Section 4: Knowledge of the nutrition strategy for living positively 
INSTRUCTIONS: The respondent is the primary beneficiary or caregiver 
401.Do you know what type of foods are good for PLWHA ?
 1 Yes (If Yes fill in table below)
 2 No (Go to next section)
Types of Food. Reasons (Why is this food important? Write reason below) 
What types of food do you know? 
(Tick food gp below)
Reason 1 Reason 2 Reason 3 Reason 4
402 CEREAL: 
Maize ,Millet, Sorghum
Rice, wheat,, CSB
403 ROOTS / TUBERS:
Potato, sweet potato, Cassava 
Yams Irish potatoes
404. FISH: Mukene, Mputa, 
405 OIL /FAT: Ghee, 
Eshabwe, Simsim, Sunflower 
USA veg oil
406 LEGUMES:
Peas, G.nuts, Soya, 
Beans Pigeon Peas CSB
407 MILK / MILK PRODUCTS 
408 EGGS:
409 MEAT
Beef, mutton, pork rabbit ,Goat 
Meat Offals
410 FRUITS:
Water melon,
Banana, mango, papaya, 
pineapple, guava, jackfruit, 
orange,
ACDI/VOCA Title II HIV/AIDS Initiative Mid Term report The Ssemwanga Centre Ltd 32
411 VEGETABLES:
Ovacado, Carrots, 
Cabbage,Onion,
Greens, eggplant, pumpkin, 
tomato, squash
412 POULTRY: Chicken, 
Turkey, 
413 SUGAR / HONEY / 
MOLASSES: 
 Matooke
(Ask about Matooke 
separately)
1: Community volunteer / counselor
2: Health worker
3.Herbalist
4 General Knowledge
5.Mass media
414. Where did you get that information?
(Mark all that are mentioned)
6. Other (specify)
1: Eat small but frequent meals
2: Eat a variety of foods
3. Drink plenty of fluids (including water)
4. Eat plenty of fruits
5 Same as non HIV+
6. Other (specify)
415. What kinds of eating habits are good for 
PLWHAs? (Mark all that are mentioned)
7: Don’t know -> Go to Section 5
1: Community volunteer / Counselor
2: Health worker
3.Herbalist
4.Mass media
416Where did you get that information?
(Mark all that are mentioned)
5: Other (specify)___________
Section 5: Ration utilization
INSTRUCTIONS: The respondent is the person responsible for food preparation for the household.
# Questions Code
501. How long have you used CSB flour? (Write period in years)
502. How many times a day do you use it? (Write number)
1: Porridge
2: Sauce
3. Posho
4:Mandazi/doughnuts
5.Samosas
6.Pancakes
503. What recipes do you know?
(Mark all that are mentioned)
7.Other (specify)
1: Community leader
2. Community worker
3: Health worker
4. Food Project officer
504. Who taught you the different recipes?
(Mark all that are mentioned)
5: No one
ACDI/VOCA Title II HIV/AIDS Initiative Mid Term report The Ssemwanga Centre Ltd 33
6: Other (specify)
505(a) Has CSB changed your diet? 1. Yes 2. No (If No Continue with 505(c))
505(b) If Yes, in what ways has it changed __________________________________________________________
______________________________________________________________________________________________50
5(c)_If No why do you think it has not changed____________________________________________________
Section 6: Household expenditure
(The enumerator will work with the respondent to get the total of the money spent on the items for mentioned below for 
the specified period)
INSTRUCTIONS: The respondent is the beneficiary or person responsible for food preparation for the household.
600(a) Is there anyone in this household who is employed /earns some wages regularly? !. Yes 2. No
b) If yes what kind of employment is this ________________________________________________________ (If 
there are more than one include for all.) ____________________________________________________
c) Do you receive any assistance (e.g financial assistance ) from a child or any other relative? 1 Yes 2 No 
If Yes what kind of assistance?______________________________________________________________
Questions Amount Spent
601. Food (include 
tealeaves, salt, sugar )
602. Water
603. Fuel (Parrafin, 
charcoal)
How much did the household spend last week for 
…?
(write in amount in local currency)
604. Transport
605.Soap toothpaste 
toilet paper, other 
toiletries
Questions Amount Spent
606. Clothes
607. Health
608. Rent
How much did the household spend in the last 3 
months for …?
(write in amount in local currency)
609.Household supplies 
Pans, Jericans, Brooms, 
Plates, Cutlery ,Pots 
610.Other locally 
important item e.g 
security
Questions Amount Spent
611 Education
612. House repairs
613. Funeral savings or 
expenses 
(Munnomukabi)
How much did the household spend in the last 12 
months for …?
(write in amount in local currency)
614. Insurance/Saving
Section 7: Hygiene
INSTRUCTIONS: The respondent is the beneficiary or caregiver.
# Questions Code
1: River/Spring
2: Well
701(a). Where does the household collect its water?
(Mark all that are mentioned)
3: Protected Spring/Well
ACDI/VOCA Title II HIV/AIDS Initiative Mid Term report The Ssemwanga Centre Ltd 34
4: Borehole
5: Tap
6: Other (specify)
701(b)
701(c)
Are there any months when water is scarce? 1.Yes 2.No
If Yes what does this water scarcity lead to? (Tick all 
mentioned)
1.Less meals
2.Less washing and cleaning
3.Walking long distances
4. Other specify _______________
702. Can you please show me where you store your drinking 
water and CSB? 
1: Yes 2: No -> Go 
to 711
703(b)
703(c)
If Yes is the container for water separate ?
Where is CSB stored? (Write what you observed ________
1…Yes 2..No
1. Small Jerican
2. Bucket
3. Pot
4. Saucepan
704. What container is used to store drinking water
(Tick what you observe)
5. Other (specify)
705. Clean 1. Yes 2. No
706. 
Covered
1:Yes 2: No
705 –
707.
Observe if the container is 
(Tick what you observe)
707. Put on 
Shelf/stand
1. Yes 2. No
1: Using a long handle dip
2: Tilted and poured
3. Using a cup
708. How is the water drawn from the container?
(Tick what you observe)
4: Other (specify)
709 Is the water in this container used for other purposes? 1. Yes 2. No -> Go 
to 711
1: Cooking
2: Cleaning
710. if yes what?
(Mark all that are mentioned)
3: Other (specify)
711 Why do you call it drinking water?
1: Community volunteer
2: Health worker
712 where did you get this information?
(Tick all that are mentioned)
3: Other ( Specify)
1.After gardening
2.After doing household chores 
3.Before food preparation
4.Before eating
5. Before feeding children 
713.
When did you wash your hands yesterday?
(Tick all that are mentioned Do not prompt)
6. After visiting the toilet
ACDI/VOCA Title II HIV/AIDS Initiative Mid Term report The Ssemwanga Centre Ltd 35
7.After eating food
8.Other specify
714 Can you show me how you wash your hands? 1. Yes 2. No 
-> Go to 719
715 
719.
Observe the washing techniques and tick yes if you see this 
technique. Tick no if you do not see this technique
715 Uses soap or ash 1. Yes 2. No
716 Washes both hands 1. Yes 2. No
717. Rubs hands together at least three times 1. Yes 2. No
718. Dry hands hygienically by air drying or using a clean cloth 1. Yes 2. No
719.
 What is the importance of washing hands with soap before eating or handling food?
1 Community volunteer
2 Health worker
3.Mass media
720. Where did you get this information?
4 Other (specify)
721. Have you been taught about sanitation this past year? 1. Yes 2. No (If No continue )
(b) If yes what did you learn about?________________________________________________________________
_____________________________________________________________________________________________c) 
who taught you__________________________________________________________________
Household sanitation
Take a look around the household and observe which of the following items listed below are available
Item Present
722. Drying rack for cups and plates 
723. Hand washing facility possibly near latrine
724. Compost pit 
725. Pit latrine/Toilet
726. Kitchen rack/shelf/cupboard
Section 8: Health condition
INSTRUCTIONS: The respondent is the HIV+ or the caregiver if the HIV + is very sick. 
If the beneficiary is an orphan child < 15 go to section 10
If the beneficiary is an orphan >15 go to section 9
801. How many times has___________(name of the HIV+ 
beneficiary) been sick in the last two months?
(write in the number of times in right column)
# times
1. Health centre/Hospital/clinic.
2.PVO clinic
3.Alternative therapy
4. No treatment
5. Own treatment
802. Where did ______________(name of HIV+ beneficiary) go 
for the treatment? 
(Mark all that are mentioned)
6 Other (specify)_____
ACDI/VOCA Title II HIV/AIDS Initiative Mid Term report The Ssemwanga Centre Ltd 36
802 (b) Are you accessing any different treatment (ARVs) ? (DAAD. ) 1. Yes 2. No
c) If yes when did you start accessing this treatment?(Month and year) _________________
d) Has it affected you in any way ? Include any details especially as regards the two main areas; diet 
___________________________ or health _____________________________________
______________________________________________________________________________________
______________________________________________________________________
803. Has ___________(name of the HIV+ beneficiary) been 
unable to work in the past two months due to illness?
Yes: 1 No: 2-> Go to 
section 9
804. If yes how many times?
(write in number of times in right column)
# times:
805. What was the longest period you were unable to work?(write 
in number of days in right column)
# days:
Section 9: Attendance in non-food aid services
INSTRUCTIONS: The respondent is the beneficiary (HIV+ or orphan above 15 years .)
If the HIV+ beneficiary is very sick, the caregiver may answer these questions.
900. Do you receive any other services provided by the IP apart from receiving food? 1. Yes 2. No
901 – 913. If Yes, which of these activities have you attended in the last two months and how many times have you 
attended them? (Fill in responses in table below) 
If No, why haven’t you attended other services.? (Fill in responses in table below) 
Activities No. of 
Times
Reason for not attending
(Check the appropriate box)
1. Too 
Sick
2. Too 
Much 
Work
3. Not 
Interest
ed
4. Too 
Far
5. Not 
Availab
le
6. 
Never 
Heard 
of 
Service
7. 
Other 
(specify
)
901. Medical services
 All
902. Testing for HIV
903. Counseling 
sessions
904. Nutrition talks
905. Demonstration of 
food preparation
906. Health talks
907. AIDS awareness 
seminars
908. Micro finance: 
(Revolving Funds, 
loans)
909 Mobile farm school
ACDI/VOCA Title II HIV/AIDS Initiative Mid Term report The Ssemwanga Centre Ltd 37
910.Vocational skills 
training
911. Agriculture 
Extension
912.Legal services
913.Child/Orphan 
support
914..Other (specify)
915. Do you receive any assistance from other Community Based Organizations? 
1.Yes 2.No -> Go To Section 10
916. If Yes, outline the nature of assistance received.__________________________________________
______________________________________________________________________________________
________________________________________________________________________________________________
___________________________________________________________________________
Section 10: Anthropometry
INSTRUCTIONS: Collect information for all the children below five in the household.
This section can be skipped if there is no child under five in the household
Sex Reported 
age (in 
months)
Date of 
Birth
Weight 
(kg)
Height
(in cm)
1 Child
2 Child
3 Child
4 Child
5 Child
Some events that will help you ascertain the ages include;
· 1999 Kabaka’s wedding
· March 2001 Presidential elections
· Sept 2002 Population Census
ACDI/VOCA Title II HIV/AIDS Initiative Mid Term report The Ssemwanga Centre Ltd 38
FOCUS GROUP DISCUSSION QUESTIONS – MID TERM EVALUATION
Qn 1. Have you received any training in hygiene during the food distributions?
Qn 2. What was involved in this training?
ß Anything about hand washing
ß Anything about hand washing facilities?
ß Anything about storage and usage of drinking water?
ß Anything about refuse disposal?
ß Anything about usage of racks?
Qn 3. Have you found this information useful?
Qn 4. Have you found this information easy to apply in your homes?
Qn 5. Is the information difficult to use or apply in any way?
Qn 6. Have you received in any training on vegetable growing?
Qn 7. Do you have vegetable gardens at home?
Qn 8 If so how have they been helpful in you meal preparations?
Qn 9. If you do not have gardens what are the major hindrances?
Qn 10. Many beneficiaries reported eating more vegetables than the years before why do you think 
so?
Qn 11. Do you feed your children on exactly what you eat or are they some changes in their diet?
Qn 12. If there are some differences what are these differences?
Qn 13. Are any of these affected by the food you receive or the nutrition education you get? 
Qn 14. How have your lives changed since you started getting food – as regards your health,
productivity, income/expenditure?
Qn 15.Does it have to do with the food you get or is there anything else you can associate this
change to?
Qn 16. Do these changes have any impact on the education of your children?
Qn 17 How has your attendance of non food services been affected by the food distribution
programme? Do you attend counseling, nutrition education, capacity building services more
or less? What are the reasons for these changes?