PETALING JAYA: A serious non-communicable and chronic disease (NCD) problem is looming, with an acute shortage of dietitians at government health clinics nationwide.
Those who suffer from NCDs may not be able to receive a proper evaluation due to time constraints or long periods between checkups, say public healthcare experts and groups.
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The shortage could limit dietitians’ ability to effectively assess and evaluate each patient’s condition, says Malaysian Dietitians’ Association (MDA) president Prof Dr Barakatun Nisak Mohd Yusof.
“Most NCD patients have diet related causes, which is why early nutritional care and education management are so important.
She explained that most first-time dietitian checkups usually take at least 45 minutes to properly gauge the risk of a patient developing an NCD.
Follow-ups and checkups may also need as much time.
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“This means a dietitian can only see eight or nine patients a day, leading to long waiting periods of sometimes months.
“We won’t be able to track patients’ monthly progress, and provide appropriate dietary counselling,” she said.
This, Barakatun said, could lead to patients turning to a reliance on short-term medication to suppress or deal with their NCD symptoms.
“NCD medication must be combined with lifestyle modifications under the guidance of a dietitian for permanent improvement of a patient’s health.
“Just relying on medication alone could lead to further complications such as kidney failure, and other NCDs in the long term,” she said, adding that NCD medication was also expensive.
With a shortage of healthcare professionals, including dietitians, she said the government should consider investing in enhancing digital e-health services such as tele-consultation, as well as integrating dietitians into multi-disciplinary clinics.
“Basic health assessments can be done by other healthcare experts before patients are passed to dietitians,” she added.
Public healthcare specialist Prof Dr Sharifa Ezat Wan Puteh of Universiti Kebangsaan Malaysia said the shortage of dietitians would impair patients’ literacy on proper food intake.
She said dietary management was important in the healthcare system and this shortage could reduce the impact of any pharmacological treatment.
The government, she said, should consider giving training to other non-dietitian healthcare professionals on at least the basics of dietary after-treatment.
Universiti Malaya public health expert Prof Dr Sanjay Rampal said the government could have locum dietitians at its clinics.
“The limited access to dietitians is likely due to limited positions rather than the number of registered dietitians. So, having locum positions would help address this shortage,” he said.
Malaysian Medical Association (MMA) president Datuk Dr Thirunavukarasu Rajoo said the current dietitian shortage was a symptom of the government’s push to expand services of clinics that has far outpaced the creation and filling of posts.
“This has left primary care teams without the multidisciplinary support they need to effectively help NCD patients.
“The government needs to increase the number of dietitian and allied health posts in primary care,” he said.
On Feb 25, Parliamentary Special Select Committee (PSSC) on Health chairman Suhaizan Kaiat revealed that only 50% of the 1,100 government health clinics nationwide had access to dietitians, with the shortage affecting the country’s ability to tackle disease-related malnutrition nationwide.
