Dietetics in Pakistan: Navigating health challenges

By Shabana Kousar, dietitian in Pakistan

The field of dietetics in Pakistan is complex but rewarding, shaped by the unique culture and the country’s economic and social context. Throughout my experience working in hospitals across Pakistan, I have seen first-hand the vital role dietitians play in enhancing public health. In this blog, I will explore the key priorities for dietitians in Pakistan, highlighting the most common health challenges we face and comparing these with the healthcare landscape of the UK.

The role of dietitians in Pakistan

In Pakistan, dietetics is an emerging field that remains underutilised. Many people lack awareness about the crucial role of proper nutrition in maintaining health, often relying on traditional remedies or incomplete knowledge. The role of the dietitian here extends far beyond clinical practice; we frequently serve as educators, advocates and counsellors. Our work is vital in addressing, malnutrition, managing chronic diseases and supporting patients in their recovery from surgeries or illnesses.

Key priorities for dietitians

  1. Malnutrition - Malnutrition is one of Pakistan’s most urgent health challenges, impacting both ends of the spectrum, undernutrition in children and overnutrition, which contributes to obesity in adults. According to UNICEF, nearly 40% of children under five are stunted, while 18% are wasted. Dietitians frequently collaborate with pediatricians and NGOs to develop feeding programs and educate parents about proper weaning practices.
  2. Chronic diseases - The dietetics priority has shifted towards non-communicable diseases (NCDs), such as hypertension, diabetes and cardiovascular diseases. Globally, the highest rates of diabetes are present and due to growing prevalence of this, the need for medical nutrition therapy is critical. Dietitians play a vital role in supporting patients through lifestyle changes, dietary modification and meal planning to significantly control these conditions.
  3. Nutritional deficiencies - Micronutrient deficiencies, such as iron, vitamin D and iodine, are highly prevalent in Pakistan. There is a dire need to address these issues through a combination of supplementation and dietary changes. The endocrinologist and general physician closely collaborate with the dietitians to significantly address these deficiencies.
  4. Maternal and child health - A balanced nutrition is important for both mother and child during pregnancy and lactation. Dietitians prioritise improving the nutritional status of pregnant women, promoting exclusive breastfeeding and ensuring that a well-balanced diet is received by the children under the age of five.

     

Common Conditions in Hospital Settings

In Pakistan, dietitians usually address different conditions in hospital settings including the following:

  • Digestive disorders – Gastrointestinal disorders, such as inflammatory bowel disease (IBD), coeliac disease and gastric ulcers, are common and made worse by poor dietary choices.
  • Kidney diseases – Patients suffering from chronic kidney disease (CKD) need proper regulation of electrolyte balance like potassium, sodium and protein intake, to prevent further complications.
  • Critical care nutrition – In intensive care units to ensure a proper recovery of critically ill patients, dietitians design an enteral and parenteral nutrition plan.
  • Cancer care – Dietitians play a significant role in controlling the side effects of chemotherapy and radiation, as nutrition is crucial for cancer patients.

Comparing dietetics in Pakistan and the UK

Working as a dietitian in Pakistan comes with particular challenges that are different from those in the UK. Some of the complex challenges include the following:

  1. Healthcare infrastructure

In the UK a well-established National Health Service (NHS) continuously integrates dietetics into both primary and secondary care, while in Pakistan, the healthcare system is fragmented with limited dietetic services in rural areas. In Pakistan, dietitians commonly face resource constraints, with limited equipment and support.

  • Public awareness - Because of ongoing public health awareness campaigns, there is a more awareness about diet and health in the UK. People are highly conscious of seeking dietetic advice on their own. However, in Pakistan, a significant knowledge gap exists, leading to many individuals looking to dietetic services only upon a doctor’s referral.
  • Disease prevalence -The highly prevalent chronic diseases in both countries are diabetes and cardiovascular disease. While malnutrition and infectious diseases like tuberculosis are still major challenges in Pakistan, UK dietitians are primarily focused on controlling obesity and managing other associated metabolic disorders.
  • Cultural and dietary practices - In Pakistan, dietary habits significantly depend upon cultural factors, where traditional meals consist of unhealthy fats, sugars and refined carbohydrates. However, in the UK, dietitians navigate a variety of culinary environments, but due to the prevalence of fast foods and processed meals, they also face similar challenges.

Reflections on my experience

Working as a dietitian in Pakistan has been an immensely rewarding journey. Every day presents a unique challenge, from educating families about the value of balanced meals to helping critically ill patients recover their strength with personalised nutrition plans. It is deeply fulfilling to witness how even small dietary adjustments can make a profound difference to someone’s health and well-being.

When comparing dietetics in Pakistan with that of the UK, I see tremendous potential for growth. By increasing public awareness, providing better integration of dietetics into health care systems and advancing professional development, significant improvements could impact health outcomes. Despite the differences between dietetics in Pakistan and the UK, our mission as dietitians remains the same: to empower individuals with the knowledge and resources to lead healthier lives through proper nutrition.

CONCLUSION

Dietetics in Pakistan presents tremendous opportunities to make a meaningful impact. Despite the challenges, there is unparalleled satisfaction in seeing lives transformed through nutrition. Whether it’s tackling malnutrition, managing chronic conditions, or promoting health, dietitians plays a vital role in improving the nation’s well-being. Dietetics in the UK emphasises the importance of context-specific approaches to services, reinforcing the need for continuous growth and learning in all settings.

Shabana is a dietitian with a master's degree in Philosophy. She has worked in hospitals in Rawalpindi, Pakistan and as a lecturer in a campus affiliated with Government College at the University in Faisalabad. Shabana specialises in obesity, PCOS and weight management, with a research interest in inflammatory bowel disease.,

Shabana Kousar

Lecturer, Dietitian and MPhil Scholar