(P09-003-20) Building Clinical Nutrition Capacity in Lao PDR: A Novel Clinical Nutrition Educational Model to Provide Interventions to Treat Malnutrition and Non-Communicable Diseases

Objectives: Malnutrition is the number one health priority in Lao PDR where 36% of children under the age of five are stunted and 27% are underweight.  Compounded by escalating rates of diabetes and non-communicable diseases, hospital-based nutrition interventions are needed.  A partnership between OHSU and the Lao Ministry of Health is working to fill the gap in knowledge and application by providing clinical nutrition education to health care providers.

Methods: A clinical nutrition needs assessment was conducted in early 2016 and informed the design of a 1000-hour, evidenced-based applied clinical dietetics certificate program for health professionals.  Aligning with the 2015 International Dietitian Education Program (IDE) standards, the curriculum was adapted to be culturally relevant and appropriate. Semi-structured interviews, open-ended questions, and pre-and post-tests were used to evaluate the program.

Results: As of January 2020, 32 clinicians have successfully completed the program. At matriculation, the mean pre-test score was 43% and 50% of students could not calculate BMI or waist-to-hip ratio, determine individual energy, nutrient and fluid requirements, provide individualized medical nutrition therapy, or manage severe acute malnutrition.   The mean final exam score was 84% with greatest improvements in malnutrition (+94%) and chronic disease (+62%) knowledge and application.  Upon completion, 98% of students successfully met IDE competency standards, conducted nutrition-focused physical exams, administered culturally appropriate nutrition interventions, and provided nutrition education to medical teams at provincial hospitals.

Conclusions: Providing hands-on training on nutrition assessment, differential diagnosis, and treatment plan design and implementation enables health care providers in Lao PDR to better treat patients with malnutrition and non-communicable diseases that are prevalent within this developing country. This educational curriculum may serve as a model for other developing countries.

Funding Sources: OHSU Global-SE Asia, OHSU Graduate Programs of Human Nutrition and the Vejdusit Foundation