Paving the way to detect adult malnourished patients in resource-limited settings: the first step to the right to nutritional care

Hospital malnutrition, particularly disease-related malnutrition (DRM), is a significant public health concern associated with increased morbidity, mortality and costs. The recent Global Leadership Initiative on Malnutrition (GLIM) proposed a framework to globally standardise the diagnosis of adult...

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Main Authors: E Van Tonder, FAM Wenhold, R Blaauw
Format: Article
Language:English
Published: Taylor & Francis Group 2025-01-01
Series:The South African Journal of Clinical Nutrition
Subjects:
Online Access:https://www.tandfonline.com/doi/10.1080/16070658.2025.2455287
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author E Van Tonder
FAM Wenhold
R Blaauw
author_facet E Van Tonder
FAM Wenhold
R Blaauw
author_sort E Van Tonder
collection DOAJ
description Hospital malnutrition, particularly disease-related malnutrition (DRM), is a significant public health concern associated with increased morbidity, mortality and costs. The recent Global Leadership Initiative on Malnutrition (GLIM) proposed a framework to globally standardise the diagnosis of adult malnutrition (undernutrition), allowing comparison of malnutrition prevalence across clinical and geographical settings and over time. Despite substantial global progress in using screening and diagnostic tools to identify malnourished patients, some countries and institutions lag behind, particularly in relation to malnutrition screening. This is especially of concern in low- and middle-income countries, including South Africa, where socioeconomic factors can exacerbate the occurrence of DRM. From a human rights perspective, the lack of malnutrition screening and diagnosis followed by appropriate nutritional support denies patients their fundamental right to access adequate food, nutritional care and health. This opinion paper highlights the magnitude of DRM and addresses current challenges in identifying DRM within resource-limited healthcare settings, specifically in the South African public health sector. Framing malnutrition as a human rights and ethical issue, it underscores the urgent need for timely and equitable nutritional care and proposes strategies to improve identification practices. Challenges identified comprise inadequate resources and institutional factors. Collaboration between key stakeholders, including the South African National Department of Health (including representatives from the National Health Insurance), policy-makers, medical aids, researchers and professional societies is needed to identify the most feasible malnutrition screening and diagnostic tools for constrained settings, together with a widespread coordinated implementation strategy. Prioritising nutrition as part of the holistic management of all patients will help safeguard against DRM and the associated adverse effects.
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spelling doaj-art-155da818fa9d41b08f14d8403822dd742025-08-20T02:29:59ZengTaylor & Francis GroupThe South African Journal of Clinical Nutrition1607-06582221-12682025-01-013811810.1080/16070658.2025.2455287Paving the way to detect adult malnourished patients in resource-limited settings: the first step to the right to nutritional careE Van Tonder0FAM Wenhold1R Blaauw2Human Nutrition and Dietetics, Faculty of Health Sciences, Nelson Mandela University, Port Elizabeth, South AfricaDepartment of Human Nutrition, Faculty of Health Sciences, University of Pretoria, Pretoria, South AfricaDivision of Human Nutrition, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South AfricaHospital malnutrition, particularly disease-related malnutrition (DRM), is a significant public health concern associated with increased morbidity, mortality and costs. The recent Global Leadership Initiative on Malnutrition (GLIM) proposed a framework to globally standardise the diagnosis of adult malnutrition (undernutrition), allowing comparison of malnutrition prevalence across clinical and geographical settings and over time. Despite substantial global progress in using screening and diagnostic tools to identify malnourished patients, some countries and institutions lag behind, particularly in relation to malnutrition screening. This is especially of concern in low- and middle-income countries, including South Africa, where socioeconomic factors can exacerbate the occurrence of DRM. From a human rights perspective, the lack of malnutrition screening and diagnosis followed by appropriate nutritional support denies patients their fundamental right to access adequate food, nutritional care and health. This opinion paper highlights the magnitude of DRM and addresses current challenges in identifying DRM within resource-limited healthcare settings, specifically in the South African public health sector. Framing malnutrition as a human rights and ethical issue, it underscores the urgent need for timely and equitable nutritional care and proposes strategies to improve identification practices. Challenges identified comprise inadequate resources and institutional factors. Collaboration between key stakeholders, including the South African National Department of Health (including representatives from the National Health Insurance), policy-makers, medical aids, researchers and professional societies is needed to identify the most feasible malnutrition screening and diagnostic tools for constrained settings, together with a widespread coordinated implementation strategy. Prioritising nutrition as part of the holistic management of all patients will help safeguard against DRM and the associated adverse effects.https://www.tandfonline.com/doi/10.1080/16070658.2025.2455287adultsGLIMhospitalmalnutritionresource-limited
spellingShingle E Van Tonder
FAM Wenhold
R Blaauw
Paving the way to detect adult malnourished patients in resource-limited settings: the first step to the right to nutritional care
The South African Journal of Clinical Nutrition
adults
GLIM
hospital
malnutrition
resource-limited
title Paving the way to detect adult malnourished patients in resource-limited settings: the first step to the right to nutritional care
title_full Paving the way to detect adult malnourished patients in resource-limited settings: the first step to the right to nutritional care
title_fullStr Paving the way to detect adult malnourished patients in resource-limited settings: the first step to the right to nutritional care
title_full_unstemmed Paving the way to detect adult malnourished patients in resource-limited settings: the first step to the right to nutritional care
title_short Paving the way to detect adult malnourished patients in resource-limited settings: the first step to the right to nutritional care
title_sort paving the way to detect adult malnourished patients in resource limited settings the first step to the right to nutritional care
topic adults
GLIM
hospital
malnutrition
resource-limited
url https://www.tandfonline.com/doi/10.1080/16070658.2025.2455287
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