Nutritional care practices in oncology services in Senegal: A multicenter health services research audit.

Abstract

e23115 Background: Malnutrition is a major yet under-addressed determinant of outcomes in cancer care. Its impact on morbidity, treatment tolerance, and survival is well established; however, integration of nutritional assessment into routine oncology services remains inconsistent, particularly in low- and middle-income countries. This study evaluated nutritional care practices as a component of health service delivery in oncology and onco-hematology units in Senegal. Methods: We conducted a multicenter professional practice audit using a structured questionnaire assessing four domains: organization of nutritional services, healthcare providers’ knowledge, clinical practices, and perceived barriers to nutritional care. Physicians and nurses involved in the management of solid and hematologic malignancies were surveyed across major oncology referral centers in Dakar. Descriptive analyses were performed using Sphinx Plus and SPSS software. Results: Forty-eight healthcare professionals participated, including residents (52.1%) and nurses (20.8%). One-third worked in oncology-related departments. Most respondents (64.6%) reported the absence or unawareness of a formal nutrition support structure within their institution. Nutritional screening was primarily considered the responsibility of the treating physician (54.2%), with limited multidisciplinary involvement. Screening relied mainly on body mass index and weight loss (66.7%), while validated tools were rarely used. Nutritional evaluation was more frequently performed at admission (56.3%) than during hospitalization (27.1%). Assessment remained subjective in 37% of cases, and dietitian involvement was inconsistent (40.7%). Structural barriers were prominent, with reported difficulties in implementing enteral (96.9%) and parenteral nutrition (100%). Only 12.5% of participants had received formal training in malnutrition management. Conclusions: Nutritional care delivery in oncology services in Senegal is limited by organizational gaps, insufficient training, and lack of multidisciplinary coordination. Strengthening nutrition services represents a key opportunity for improving quality of cancer care.