By Esther Onyegbula

In an effort to combat the growing crisis of hospital malnutrition in Nigeria, experts are calling for a multifaceted approach, including education, multidisciplinary collaboration, and federal government support.

This call was made during a press conference marking Malnutrition Awareness Week, focusing on the alarming lack of data on hospital malnutrition in West Africa, particularly Nigeria.

Dr. Teresa Isichei Pounds, President and Founder of the West African Society of Parenteral and Enteral Nutrition (WASPEN), stressed the critical role of education in addressing hospital malnutrition. “Education is key in raising awareness about malnutrition, its impact, prevalence, and complications,” said Dr. Pounds. “Health institutions need to implement Nutrition Support Committees led by physicians and supported by a multidisciplinary team, including dietitians, pharmacists, nurses, social workers, and administrators.”

Dr. Pounds highlighted the importance of setting guidelines for assessing patients’ nutritional status upon admission. “Simple measures such as checking weight loss and evaluating the patient’s clinical profile can help detect malnutrition early,” she explained. “Studies show that malnourished patients stay longer in hospitals and face higher complication rates, especially after surgery.”

Lack of Data in West Africa

Addressing hospital malnutrition in Nigeria and across West Africa is further complicated by the lack of comprehensive data. Dr. Pounds noted that while developed countries like the United States have conducted extensive research on malnutrition in hospitalized patients, West Africa lags behind. “In the U.S., nearly 50% of hospitalized patients are malnourished. In Nigeria, where we lack data, the situation could be much worse,” she said.

WASPEN is leading efforts to change this by initiating research to understand the incidence of malnutrition in Nigerian hospitals. “We are working on a multi-center research proposal to measure the impact of hospital malnutrition,” Dr. Pounds added. “This data is critical for forming effective policies and interventions.”

Federal Government Support

Dr. Pounds also emphasized the need for federal government support, urging financial backing, ensuring the availability of nutritional products, and making them affordable. “The government must ensure these products are readily available and consider local production to reduce costs,” she said. “Raising awareness about hospital malnutrition and ensuring adequate resources are in place is crucial.”

She further highlighted the need to assess the number of dietitians in Nigerian hospitals and ensure that all healthcare disciplines work together. “Without adequate resources and collaboration, addressing hospital malnutrition will remain a challenge,” she noted.

A Multisectoral Problem

Dietitian Akhigbe Evelyn Omolegho of the Niger Delta University Teaching Hospital in Bayelsa State added that malnutrition is a multisectoral issue requiring broad-based solutions. “In Nigeria, the national policy on malnutrition must be adopted at the state level, but unfortunately, hospital malnutrition has been largely overlooked,” Omolegho said.

She underscored the need for policy reform and the inclusion of the primary healthcare system in addressing malnutrition. “Poverty, lack of access to essential food items, and insufficient dietitian support have made this a serious issue,” she added.

Omolegho also lamented the shortage of dietitians in hospitals, saying, “In many hospitals, including teaching hospitals, there may be only one dietitian. This workload is overwhelming and unsustainable.”

Speaking at a recent WASPEN conference, Dr. Nwako stressed that tackling malnutrition requires coordinated efforts between hospitals and outpatient settings, particularly for children and pregnant women. “A malnourished child entering the hospital is already compromised nutritionally, making recovery difficult without adequate nutrition,” he said.Dr. Nwako highlighted the need for a multidisciplinary approach involving physicians, pharmacists, nurses, and dietitians. “Collaboration is essential to ensure proper screening for malnutrition, especially in hospitals. Failure to do so results in poor patient outcomes, like delayed wound healing or extended ICU stays,” he noted.He also emphasized the importance of early education for healthcare professionals and greater awareness about malnutrition. “We must start educating students early on the significance of nutrition, and ensure healthcare workers are equipped with the right tools to screen and treat malnourished patients,” Dr. Nwako added.Dr. Nwako called for increased funding and research, urging stakeholders to prioritize collaboration over fragmented healthcare delivery.

Tevin Klein, Project Director for WASPEN, addressed the need for improved access to enteral nutrition and supplementation. “Hospitalized patients need access to affordable and available nutrients. We are working with pharmaceutical companies to ensure nutrition care products can be locally manufactured and subsidized in Nigeria,” Klein explained.

WASPEN is actively working with stakeholders to promote the inclusion of nutrition care products in the national market. Klein noted, “Many patients arrive at hospitals already malnourished, and often their nutritional deficiencies go unaddressed.”

Moving Forward

WASPEN, with its members across Nigeria, is committed to advocating for better nutritional care in hospitals and raising awareness at the community level. “Our focus is on hospital malnutrition, and we will continue to push for research and policy changes that can improve patient outcomes,” Dr. Pounds affirmed.

The initiative by WASPEN aims to shine a light on a neglected area of healthcare in Nigeria and ensure that hospital malnutrition is addressed at both institutional and governmental levels. Without data, education, and proper intervention, malnourished patients will continue to face unnecessary complications and longer hospital stays, straining the healthcare system.

Dr. Pounds concluded by calling for urgent action. “We need to acknowledge that hospital malnutrition exists and is a serious issue. Together, through education, research, and government support, we can make a difference.”

Nigeria’s ongoing economic challenges have exacerbated malnutrition among hospitalized patients, according to healthcare professionals. With poverty rising, access to essential nutrients has decreased, leading to a sharp increase in malnutrition cases within hospitals across the country.