RECORDER REPORT

KARACHI: The Economist Intelligence Unit (EIU) recently released a report on the state of malnutrition and clinical nutrition in Pakistan with the support of Abbott. The report explores the current state of clinical nutrition in Pakistan’s hospitals and clinics, and probes how outcomes can be improved for patients.

The report brings forward reasons for the currently bleak situation that includes; food insecurity, a dearth of nutritionists and dieticians, getting patients to eat more, nutrition is not the priority and the fragmented policy landscape in Pakistan.

The report states, food insecurity, a condition in which households lack access to adequate food because of limited money or other resources, afflicts almost 37 percent of households in Pakistan. About half of adult women in Pakistan suffer from anaemia, over a third of children are stunted, and about 30 percent of under 5-year-old are underweight.

Some of the nutritional interventions that can reduce malnutrition and improve outcomes, range from medically tailored meals, medically tailored groceries and produce prescriptions, through to meal replacements and nutritional supplements of various kinds.

“Nutrition is at the base of good health,” said Prof Javed Akram, Vice Chancellor, University of Health Sciences, Lahore and founding President of the Pakistan Society of Internal Medicine while addressing a webinar on Wednesday. “Getting the important nutrients through an adequate nutrition is instrumental for people to grow and stay healthy at all stages of life. Among solutions that can remedy malnutrition and improve outcomes, are medically tailored meals, meal replacements and nutritional supplements.”

Most patients are not screened for malnutrition upon admission into hospital. As a result, many commence their stay facing a hurdle, and more than two thirds of those with malnutrition decline further during their stay. If afflicted patients were identified early on and provided with a suitable diet by a trained dietician, then complications, length of stay, readmission rates, mortality and cost of care would all be reduced.”

The report from EIU also discusses that giving food to the patients is the simplest, safest, and cheapest way to provide nutritional care and support. It also gives the reason for the hospitals in Pakistan not serving quality food and around 30-50 percent of the hospital’s food being wasted.

A lack of nutritional knowledge among clinical staff is also discussed in the report as another persistent issue in Pakistan. Lieutenant Commander Rabia Anwer, Vice President of the Pakistan Nutrition and Dietetic Society (PNDS), informs that pharmacists and therapists are working as dieticians in some of the hospitals who prescribe their own diet plans, whereas about 10-15 percent hospitals that do focus on nutrition are getting positive results.

The report concludes with, Dr Baseer Khan Achakzai, Director of Nutrition Program and Director of Regulations, Ministry of National Health Services, Government of Pakistan, mentioning that there is no concrete and single clinical malnutrition policy in Pakistan. As hospitals come under the provincial government’s domain, the healthcare services are decentralised to the provinces and that the federal government officials are aware that a paradigm shift related to clinical nutrition needs to occur.