Health advocates across public and private sectors are pushing for improved implementation of the government’s Nutrition Care Process (NCP).
The NCP is a standardized approach used by registered nutritionist-dietitians (RNDs) and healthcare professionals to thoroughly evaluate, diagnose, treat, and monitor patients.
Health advocates recently gathered in a forum organized by international think tank Stratbase Institute and Universal Health Care (UHC) Watch at the Asian Institute of Management Conference Center on April 25.
The forum, titled “Strengthening Nutrition Integration in the Health System: Evaluating the Nutrition Care Process in the Philippines,” gathered representatives from the Department of Health, the Board of Nutrition and Dietetics of the Professional Regulation Commission, as well as professionals from both public and private hospitals. Patients and advocates against malnutrition also participated in the event.
The experts underscored the pivotal role of nutritional care in expediting a patient’s recovery and discharge from hospitals, emphasizing the adage “food is medicine.”
“NCP has been shown to be an effective method for treating various medical conditions,” said Dr. Aguedo “Troy” Gepte IV, a nutrition consultant and author of a policy paper commissioned by the Stratbase Institute to assess the integration of NCP within the Philippine healthcare framework.
“There is a high level of awareness and positive attitudes toward the NCP and NCP terminology. However, actual implementation varies and is influenced by several factors, both individual and contextual,” Gepte said.
In 2019, the Department of Health issued Administrative Order No. 2019-0033, outlining the protocols for NCP. It mandates that upon admission, patients should undergo nutrition screening by registered nurses. Patients identified as requiring medical nutrition therapy are then referred by the physician to the RND for assessment.
Virgith Buena, Chairperson of the Board of Nutrition and Dietetics at the Professional Regulation Commission, clarified that nutritional diagnosis differs from a medical diagnosis as it involves identification and labeling of an existing nutrition problem by an RND, which may evolve over time.
Gepte identified several barriers to implementing the AO, including inadequate staffing, limited experience, and conflicts with existing hospital nutrition care systems.
He stressed the need for legislation to facilitate the universal implementation of NCP in all hospitals.
Human right
Dr. Jose Rodolfo Dimaano Jr., Co-Lead of the Abbott Center for Malnutrition Solutions, emphasized that nutrition is a fundamental human right, and universal access to nutritional interventions is a crucial component of addressing malnutrition.
“We believe that the Nutrition Care Process should be implemented properly and across the continuum of care. When I say continuum of care, I’m talking about when the person is not yet hospitalized — let’s say the elderly person is still in the community – there should be preventive measures, education. Then once the patient gets admitted to the hospital, then that’s where it’s more critical to aggressively treat the patient through nutritional interventions. And post-discharge, there should be monitoring and still continuous care given to that patient,” Dimaano said.
“That’s why we believe that the NCP has a very, very big potential in giving a quality of life for patients, and especially to those who are most vulnerable, especially the aging population,” he added.
Jorge Banal Sr., president of the Federation of Senior Citizens Association of the Philippines-National Capital Region, said “policies aimed at enhancing health outcomes for seniors are indeed of great importance,” considering that the elderly are often marginalized and underrepresented.
A population’s nutritional status is critical in achieving economic security, according to Rupert Paul Manhit, Chief Operating Officer of the Stratbase Group.
“Undernutrition negatively affects the physical health and cognitive development of our country’s children, hindering their ability to effectively contribute to the nation’s long-term sustainable growth,” Manhit said.
Next steps Dr. Ricardo Adriano, a board member of the Private Hospitals Association of the Philippines, representing over 700 member hospitals nationwide, recognized the potential of legislation in tackling challenges related to NCP implementation.
However, he noted, “We need money, of course.
Dr. Gabrielle Ann Dela Paz-Tolang, Chief of the Policy, Planning, and Program Development Division at the DOH Health Facility Development Bureau, highlighted that facilitating the NCP program would not only reduce hospitalization costs for patients, but it also has the potential to generate revenue for the hospital.
“We are now trying to shift the notion that it’s an expensive intervention. Rather we want the hospital management, and the public sector or our leadership to realize it’s a good investment,” Dela Paz-Tolang said.
Recommendations in Gepte’s policy paper include adoption of standardized nutrition screening tools, mandatory training for all professionals involved in nutrition care, augmented budget allocations, improved inter-professional communication, integration of the NCP into the Universal Health Care law, regular compliance audits, policy incentives for NCP implementation, and increased stakeholder engagement.