1. CURRENT STATUS IN TURKEY TURKISH SOCIETY OF CLINICAL NUTRITION TURKISH SOCIETY OF CLINICAL NUTRITION Mehmet UYAR Chairman of KEPAN

2. TURKISH SOCIETY OF CLINICAL NUTRITION NON-STOP STRUGGLE OF TURKEY AGAINST UNDERNUTRITION

3. First Implementation Meeting – May 2014 KEPAN invited Turkish Nutrition Industry and ENHA’s General Secretary Frank De Man for a brainstorm

4. 2-day Malnutrition Workshop chaired by Social Security Instution – June 2014 Participants: 199 Ministry of Labor Social Security institution Turkish Society of Clinical Nutrition Turkish Pediatric Association National Pediatric Association Pediatric Gastroenterology Association Pediatric Neurology Association Ministry of Health - NGO’s - Policy Makers - HCP’s - Media - State institutions - Nutrition Industry

5. 5 different workshop sections Each group evaluate their topics and deliver possible new guidelines/action items/suggestions Group 1: Ways to develop healthy generations. - Nutrition Assessment - Training programs Group 2: Primary malnutrition policy in pediatrics. - Screening should be must. - Percentile standardization Group 3: Malnutrition policy in adults. - Standard nutritional risk assessments - Reimbursement system revision - Continuous trainings & awareness Group 4: Malnutrition policy in chronic diseases. - Organizing nutrition committees in hospitals - Importance of follow-up in Home Care Group 5: Malnutrition policy in hospitals. - Revision of reimbursement for outpatients. - Performance indicators for hospitals to proactively deal with nutrition

6. Malnutrition Workshop Next Steps Meeting result booklet called ‘Malnutrition Viewpoint of SSI’ will be published in 2015. Local Health Economics Outcome Research of SSI will start with its own patient data. SSI will release public ads about malnutrition to increase public awareness

7. The directive of “Quality improvement at health care services” is being updated Agreement with KEPAN – Nutritional screening is going to be included

8. Collaboration with The Union of State Hospitals Aggred to make the nutritional screening on admittance as an obligation in 200 hospitals out 800

9. To investigate the impact of undernutrition on the national economy To adapt and to modify regulations and standards in collaboration with health authorities National Implementation Meeting in September Next Steps

10. SWOT Analysis StrenghtsWeaknessOpportunitiesThreats Reimburseme nt Multi- disciplinary stakeholders Access to authority Training & education No national secreening policy No audit No economic studies No patient advocacy group Good contact with governmental offices Good collaboration with other societies Increasing public awareness Global budget restrictions Frequent changes in official positions