Qualitative exploration of comprehension and experiences of healthcare professionals regarding nutrition care in Karachi, Pakistan

Nutrition care involves providing safe and adequate food and beverages through a systematic, evidence-based approach aimed at enhancing or restoring the nutritional well-being of individuals or populations. In Pakistan, due to structural and economic limitations, doctors and nurses often deliver nutritional care instead of trained dietitians or nutritionists. This study was conducted to qualitatively explore the understanding and experiences of these healthcare providers in delivering nutrition care to a sample of the urban Pakistani population. The study included 15 healthcare professionals working in various hospital settings. Semi-structured interviews were conducted to investigate participants' understanding, current practices, challenges, and suggestions for providing nutrition care in Pakistan. A purposive sampling method was used to enroll participants. Following informed consent, data were audio-recorded, transcribed verbatim, anonymized, and translated into English. Thematic analysis was performed using Braun and Clarke's framework, ensuring credibility, dependability, and confirmability through independent reviews and consensus-based coding. Firstly, deep familiarization with the data was done by researchers. They thoroughly read and re-read the transcripts, listened to the recordings and initial notes were made. Codes were generated by using a deductive approach. color-coded and organized into potential themes. Sub-themes were formulated after extracting data from the narrative excerpts. A consensus by all researchers was reached on every step and discrepancies were resolved after discussion. Three main themes were identified: healthcare professionals are filling gaps beyond their roles or responsibilities, compelled to care despite several bottlenecks, and dissemination of awareness about nutrition care. Ambiguity in the role of healthcare providers in delivering nutrition care, a lack of in-depth knowledge of disease-specific nutrition care, and sub-optimal communication and counseling due to insufficient structural and economic resources may limit healthcare professionals' ability to impart nutrition care. There is a critical need to enhance nutrition care delivery through improved nutrition education, strengthened interdisciplinary collaboration and referral systems, effective stakeholder engagement, and the implementation of system-level interventions. Addressing these obstacles can improve both the quality and accessibility of nutrition care, leading to better health outcomes.