This discussion on nutrition in NCDs may have expired or shifted to low priority list. Nutrition is short-changed in all health programmes including NCDs. This why we have very slow progress in Africa in nutrition indices in children in Africa. Doctors’ training is geared to curing with tablets, iv medicine or surgery. We perceive nutritional advice as a non- doctor role which anyone can provide. In specialized clinics such as diabetes, nephrology and cancer clinics providing nutritional advice is often relegated to nurses who have been briefed but not trained. It is easier to provide ‘hard’ tangible interventions such as insulin, ARV and immunization shots than address conditions that require deep engagement with the family such as nutrition and sanitation. On a practical level the nurse and doctor in a public facility are probably overwhelmed by the volume of patients and prioritise the easier interventions. The eye health professionals have addressed this by training lay and nurse personnel in counseling patients, explaining procedures that patients are booked for and explaining treatment. The eye care professional examines the patients and provides a brief explanation. The patient is then referred to another health worker who explains in great detail, using a model of the eye ball, the diagnosis and intervention. Perhaps we need nutrition counselors supervised by nutritionists to work in NCD clinics. We could also follow the USA model where nutrition was mainstreamed in daily living where schools, workplaces and many restaurants offer healthy menus, provide gyms and ensure employees and school children exercise regularly.
Dr Alice Baingana Nganwa
WIND Consult Ltd, Uganda.
HIFA profile: Alice Nganwa is Executive Director at WIND Consult Limited in Uganda. Professional interests: Promote equity in development that includes marginalized people and addresses less popular but important development issues such as prevention of road traffic crashes, domestic violence, occupational safety, school health, healthy ageing and minimizing alcoholism and other addictions. windconsultug AT gmail.com