Various health experts underscored the urgent need to prevent and treat hospital malnutrition as this affects the overall quality of patient care, clinical outcomes, and even admission time and overall hospitalization costs.
This was the consensus reached as experts gathered in a recent roundtable discussion co-organized by Stratbase Institute, an international think tank, and the advocacy group Universal Health Care Watch.
They discussed the importance of strengthening nutrition integration in the health system, starting with the evaluation of the Nutrition Care Process in the Philippines.
Participants included officials from the Department of Health(DOH), the Board of Nutrition and Dietetics of the Professional Regulation Commission (PRC), healthcare professionals, academics, civil society organizations, and patient advocates.
Dr. Emmie Liza Perez-Chiong, DOH Undersecretary for Health Regulation and Facility Development, opened the discussion by highlighting that the Nutrition and Dietetics Law mandates the provision of medical nutrition therapy to patients through the Nutrition Care Process (NCP).
Protocols for the NCP are outlined in DOH Administrative Order 2019-0033. According to the order, patients should undergo nutrition screening by registered nurses upon admission. Patients identified as requiring medical nutrition therapy are then referred by the physician to the registered nutritionist-dietitian (RND) for assessment.
“The effective implementation of NCP is a crucial component of comprehensive patient care, signifying a commitment to the ongoing quality development within Philippine healthcare facilities,” Perez-Chiong said in a video message.
Virgith Buena, Chairperson of the PRC’s Board of Nutrition and Dietetics, stressed the crucial role of RNDs in assessing patients’ nutritional requirements and creating personalized food plans.
“RNDs have a broader concept of wellness, plus the prevention and treatment of conditions by using food as medicine,” Buena said.
However, RNDs from both public and private hospitals shared challenges faced in implementing the NCP. These include insufficient management support, resource and staffing constraints, inadequate training, communication gaps, and duplication of roles with other healthcare professionals, among others.
“We need to take a differentiated approach,” said Dr. Jose Rodolfo Dimaano Jr. of the Abbott Center for Malnutrition Solutions. ”Reducing malnutrition requires genuine partnerships across all healthcare professionals and institutions to make the implementation of the NCP successful. By working together with doctors, physicians, nurses, nutritionists-dieticians, can gain a true understanding of what’s needed to improve patient care, innovation to bring forward new ideas that can deliver collective impact and sustainable solutions.”
For nutrition consultant Dr. Aguedo Gepte IV, moving forward requires not just resolving the current obstacles, but also establishing a foundation for sustainable NCP implementation through legislative actions.
“The aim for a potential law to guide NCP implementation in hospitals is to develop a more comprehensive strategy that would prioritize policy implementation review, interdisciplinary cooperation, and educational programs,” Gepte said.
He is the author of a policy paper commissioned by the Stratbase Institute evaluating the integration of NCP within the Philippine healthcare framework.
Dr. Ricardo Adriano, who represents both the Private Hospitals Association of the Philippines and Philippine College of Hospital Administrators, admitted that the dietary department is often overlooked as hospital administrations tend to prioritize revenue-generating services and departments.
“Legislation can really help,” Adriano said.
Dr. Gabrielle Ann Dela Paz-Tolang, Chief of the Policy, Planning, and Program Development Division at the DOH Health Facility Development Bureau, explained that the NCP should be considered an investment rather than added expense as it has the potential to decrease patients’ admission time and hospitalization costs, thereby alleviating congestion in hospitals.
