Nutrition Capacity Building to Meet National Priorities: Lessons Learned in Developing and Implementing Malawi's First Dietetics Program.

Shibani Ghosh,Bernadette Chimera,Alexander Kalimbira,Lynne M. Ausman,Molly Uebele-Harrigan,Sanele Nkomani,John Phuka,Elizabeth Marino-Costello,Agnes Mwangwela

doi:10.9745/ghsp-d-20-00687

Abstract

The current nutrition situation in Malawi, characterized by high rates of malnutrition in communities and hospitals and a rapidly increasing burden of overweight/obesity and diet-related noncommunicable diseases, highlights the urgent need for registered dietitians, who have a proven track record in the prevention and management of all forms of malnutrition and improving patient outcomes. However, dietetics practice has been described as underdeveloped and fragmented in many parts of Africa, exacerbated by a severe and chronic shortage of dietetics professionals and a lack of nutrition and dietetic education programs in most African countries.We share early lessons learned in the development and implementation of the first dietetics program in Malawi. Within 6 years, the program produced 10 graduate dietitians who have filled the first clinical dietitian posts in Malawian public hospitals. This early success can be attributed to the model used to develop and implement the program, which included early stakeholder engagement to define the priority skills and competencies of a Malawian dietitian, the use of internationally recognized training standards, and the development of strategic institutional partnerships that brought together complementary skills and expertise. Furthermore, using existing resources and recruiting students with a nutrition and health background accelerated implementation. The current dietetics curriculum responds to the national nutrition and health policy direction and strategic objectives. Early and sustained government engagement was crucial in creating demand and securing career prospects for graduates. Although still in its infancy, dietitians in Malawi are poised to contribute significantly to alleviating the country's complex nutrition challenges.

Highlights

Registered dietitians are recognized globally as being essential to delivering preventative and curative health services and integral members of multidisciplinary health care teams.[1,2] A dietitian’s skills and competencies rest on their ability to interpret and effectively communicate complex theoretical nutrition knowledge to health care providers, policy makers, communities, and individuals, to promote and maintain health across the lifespan and in different disease states.[3]
Dietetic interventions have shown to be highly efficacious in Clinical Nutrition Capacity Building in Malawi www.ghspjournal.org improving health outcomes and reducing costs for numerous conditions at all levels of health care.[3,4,5,6]
We reviewed the existing Bachelor of Science degree in nutrition and food science at Lilongwe University of Agriculture and Natural Resources (LUANAR) to determine areas where course content merged with the minimum requirements for dietetics and gaps that needed to be filled by the dietetics curriculum

Summary

Introduction

Registered dietitians are recognized globally as being essential to delivering preventative and curative health services and integral members of multidisciplinary health care teams.[1,2] A dietitian’s skills and competencies rest on their ability to interpret and effectively communicate complex theoretical nutrition knowledge to health care providers, policy makers, communities, and individuals, to promote and maintain health across the lifespan and in different disease states.[3]. We undertook a needs assessment that highlighted the lack of dietitians in Malawi and determined what gaps would be filled through the development of this cadre of health care workers.

Results

Conclusion