Updated: Feb 18
‘Prevention is better than cure’ is an all-time classic wisdom. There is no doubt that prevention of diseases has to be the primary focus all around. Health care institutions have a crucial role to play in this regard. They need to include measures and conscious efforts on preventing diseases. Their focus can no longer be just on medicines, laboratory tests and surgeries to treat illnesses. Education and counselling on health promoting behaviours have to be continuously imparted. That is the real essence of being an institution providing ‘health care’ and not only ‘medical care.’
Good nutrition is an indispensable part of health and well-being. Nutrition promotion hence definitely is a top choice for the health care institutions. This blog is about a hospital’s initiative to embrace nutrition.
Siddhi Memorial Hospital for Children and Women located at Bhaktapur, Nepal has been providing health services since the past 22 years. Last year, the hospital management rightly felt the need to integrate nutrition in their regular services. It has been a wonderful opportunity for me to support them in this endeavor. Free nutrition counselling service has been operational in the hospital from July 2019. A nutrition unit is functional with two trained staff and an intern. They provide nutrition education and counselling for children and mothers who have recently delivered their babies.
Poshan Nanglo (nutrition tray) has been introduced and is being used as a tool for the nutrition counselling. Nutritionally diverse foods that are wholesome, locally available and seasonal are demonstrated to promote healthy diet and help change behaviours. Rather than only telling, Poshan Nanglo is used to showcase what exactly are the types of food that provide good nutrition.
All children below two years of age who are brought for routine immunization first come to the nutrition unit. Pediatricians also refer children who appear malnourished or those who need nutrition counselling from their out-patient consultations. Weights and heights of the children are measured to check their growth and nutritional status. Then nutrition counselling is provided as appropriate for the age groups.
For babies who are newborn and up to six months old, mothers as well as accompanying family members are encouraged and supported for exclusive breastfeeding practices.
Poshan Nanglo is used for counselling on nutritionally diverse diet for the mothers as well as their children. Nutritious, wholesome and home-made complementary foods along with continued breastfeeding are promoted for children above six months up until two years. For older children, the counselling focuses on providing nutritious diet from diverse range of local and healthy home-made foods. Limiting consumption of unhealthy packaged foods and sugary drinks is also emphasized for all children.
Glimpses of nutrition counselling at Siddhi Memorial Hospital
Each month an average of 500 children with their mothers and/or other family members have been receiving the nutrition counselling. Overall, there has been a highly positive response from the mothers and other family members on the initiation of the nutrition counselling service by the hospital. They have also been very appreciative on the use of Poshan Nanglo. They find the use of the familiar real foods as a simple and easy way to understand and remember the good nutrition messages.
A mother shares her thoughts on the use of Poshan Nanglo at the hospital
Daily nutrition counselling rounds are also conducted by the nutrition unit staff for children and mothers admitted in the hospital. In addition, a related research is underway to understand malnutrition and feeding practices of the children. The study is also aiming to document the perception of mothers and fathers on Poshan Nanglo as a nutrition counseling tool. Now, the hospital is ready to expand the nutrition counselling services to pregnant women who visit for routine gyaenocological services. Nutrition behaviour change communication using Poshan Nanglo is also planned as part of community out-reach activities regularly conducted by the hospital.
Siddhi Memorial Hospital has taken a wonderful initiative towards health promotion by institutionalising nutrition education services. It has also set a new milestone through the use of Poshan Nanglo, perhaps the first time that demonstration of real foods is used by a hospital to educate about healthy diet. Three key reasons have led to this successful embracing of nutrition - enabling support from the hospital management, dedicated and hard-working nutrition staff plus enthusiastic and encouraging response from the mothers and families who use the services.
Overall, a model worthy of replication by other hospitals aiming to emphasize and embrace the prevention side of providing health care to people.