With Nigeria bearing the world’s second highest burden of stunted children, in addition to about 60 per cent of the country’s women of childbearing age being anaemic, healthcare professional bodies have called on the Federal Government to formulate a national nutrition policy to address the country’s nutritional gaps.
Leaders of the bodies, which included the Nigerian Medical Association (NMA), the Pharmaceutical Society of Nigeria (PSN), and the Dietitians Association of Nigeria (DAN), lamented the poor health conditions of many Nigerians and hospital patients, stressing that such a policy is of urgent importance, as adequate nutrition is increasingly beyond the reach of the masses.
The health leaders, who spoke in separate interviews with Pharmanews, at the 2024 edition of the West African Society of Parenteral and Enteral Nutrition (WASPEN) conference, held at the Lagos University Teaching Hospital (LUTH), noted that critically ill patients, who cannot absorb nutrients through oral feeding and require intravenous feeding, are particularly affected.
NMA President, Prof. Bala Audu, highlighted the need to advance clinical nutrition care for patients’ safety, asserting that adequate nutrition should be a fundamental right for every Nigerian.
Audu, who was represented by the NMA First Vice-President, Dr Benjamin Olowojebutu, argued that without a national policy, multidisciplinary healthcare efforts would be in vain, as proper nutrition is crucial for optimal patient outcomes.
“There is a need for a national policy on nutrition, which must be driven by the Federal Government. We want nutrition to be the right of Nigerians. Just as we have the right to health and education, nutrition should also be a constitutional right. Everyone should feel safe to eat properly and have access to a balanced diet,” he stated.
Audu also criticised the impact of hospital systems on patients’ health, noting that patients often lose weight during hospital stays due to the stress of finding medicines and medical devices, which should be readily available in the hospital pharmacy.
He emphasised that the Federal Ministry of Health must lead in drafting the policy, supported by state and local governments for effective implementation.
The PSN President, Prof. Cyril Usifoh, concurred, stressing that medication alone, without proper nutrition, would not yield positive outcomes.
“I remember very well when I went to a pharmacy, where somebody was brought in. He almost fainted actually and after the pharmacist looked at him, he asked a very simple question, have you eaten today?
“And he answered no. By the time he slowly took a bottle of malt, his countenance came back. He didn’t need any drug. Patients need to be properly fed and when they are properly fed, healing becomes faster.
“We need to ensure that the average Nigerian, especially vulnerable groups like children, receive appropriate nutrition. The PSN is committed to working with the ministry and the government to achieve this goal,” Usifoh said.
Dr Kemi Ogunyemi, special adviser to the Lagos State Governor on Health and keynote speaker at the occasion, emphasised the need for continuous clinical education and research to improve nutritional care across the country. Citing statistics that show at least one in every three hospital patients requires clinical nutrition care, she outlined the four steps involved as nutritional assessment, nutritional diagnosis, nutritional intervention, and monitoring and evaluation.
“Nutritional assessment begins with gathering adequate information to identify nutrition-related problems, including a physical assessment of the patients. Nutritional diagnosis involves identifying necessary interventions, based on the patient’s history, signs, and symptoms.
“Nutritional intervention includes planned actions to positively change nutrition-related behaviour, targeting the cause of the problem. Monitoring and evaluation determine whether the patient meets the nutritional intervention goals, requiring re-assessment to check progress,” Ogunyemi explained.
Also speaking at the conference, DAN President, Prof. Olivia Afam-Anene, addressed the participants on the topic, “Nutrition Assessment: A Comprehensive Approach to Identifying malnutrition.”
She described nutrition assessment as a systematic process of collecting and interpreting information in order to make decisions about the nature and cause of nutrition-related health issues that affect an individual, a group or a population.
Afam-Anene further said the essence of nutritional assessment is to identify those at risk of malnutrition and those who need medical nutrition therapy. She added that it is also to ascertain impediments to nutrient digestion, absorption and utilisation; discover practices that can lead to malnutrition or increase infection; instruct for nutrition education and counselling; and initiate a proper nutrition care plan.
The DAN president, who was represented by Pat Chimah Madubuko, a registered dietitian-nutritionist, mentioned some of the critical factors to consider in dietary assessment to include current food and fluid intake, duration and severity of any changes in appetite and oral intake, presence of factors affecting food and fluid intake, increase or decrease in appetite, alterations in meal pattern, as well as changes in food choices or food consistency.
In a chat with WASPEN convener, Dr Teresa Pounds, she expressed delight at seeing her vision materialise, with a multi-disciplinary assembly of healthcare practitioners addressing clinical nutrition in Nigeria.
Pounds underscored the importance of early screening to identify patients’ nutritional status immediately after admission, guiding appropriate treatment.
She also noted the importance of “getting round pegs in round holes”, noting that with the collaboration of physicians, nurses, pharmacists and dietitians on advancing clinical nutrition care, the campaign will receive the needed action from government and other stakeholders.
“The significance of today’s event is the collaboration of all key disciplines—doctors, nurses, pharmacists, dietitians, social workers – discussing guidelines to ensure patients are screened for nutritional status upon admission. Early screening and identification enable quick and appropriate nutritional support,” she enthused.
