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National pyramid for advanced training
Disciplinary and interdisciplinary breadth required for dealing with food and nutrition issues
Role of training for specific skills through short courses, workshops, and in-service training
Capacity-building for research
Sponsors
Participants
The success of applied science is determined by the short- and medium-term relevance of knowledge developed by researchers and the effectiveness of the implementation of accumulated knowledge. Both of these determinants of success, in turn, depend significantly on the quality and quantity of trained personnel. In recognition of the importance of advanced training and research to nutritional sciences, the Food and Nutrition Programme for Human and Social Development of the United Nations University (UNU) and the International Union of Nutritional Sciences (IUNS) convened an international Workshop on Institution-Building for Research and Advanced Training in Food and Nutrition in Developing Countries in Manila, Philippines, in August 1996.
The last review of this type occurred in 1978 in Cairo at a meeting convened by the UNU and the Subcommittee on Nutrition of the UN Administrative Committee on Coordination. The meeting in Cairo emphasized the special need for regional training institutions in Africa, where few countries have advanced training capacities in nutrition. Several factors argued strongly for a reassessment:
» the steadily growing recognition of the important role of nutrition in the development of human capital;» changes in the nature of the nutritional problems faced by diverse regions of the world;
» rapidly changing global socio-economic conditions;
» the maturity in several regions of the world of institutions that have invested heavily in human nutrition;
» new challenges presented to the food system by the increasingly global nature of national economies;
» demographic transitions throughout the world;
» continued population growth;
» other important developments since the last review in Cairo.
The purpose of the Workshop was eightfold:
» to re-examine the disciplinary and interdisciplinary competence essential for institutions to meet regional and national needs for research and training;» to take stock of progress in strengthening institutions for research and advanced training in nutrition in developing countries since the last Workshop in 1978 convened to examine their development;
» to explore the establishment of strong collaborative relationships among developing-country institutions using modern electronic communications;
» to review opportunities for demonstration and information exchange about training modules and resources for postgraduate training in nutrition and related sciences;
» to define the levels and categories of training required for strong capacities for research and advanced training;
» to review the possibilities for complementary networks of institutions specialized in different types of training and thus reduce the need for professionals from developing countries to seek graduate and other forms of training in industrialized countries as a strategy for enhancing professional and paraprofessional infrastructures;
» to identify the optimal nature of postgraduate training activities of developing-country personnel in industrialized and post-industrialized countries;
» to consider the availability and mobilization of resources for strengthening the research and advanced training capabilities of developing-country institutions, including the need for support by international and bilateral agencies, foundations, and non-governmental organizations.
Most of the Workshop was devoted to issues related to the types of professionals needed to implement the growing knowledge base available to the nutritional sciences and ensure its continued improvement, the supplementary role that short-term training plays in the recruitment and preparation of professionals for specific purposes or upgrading and/or broadening of skills, and the enhancement of national and regional research capacities. These discussions followed a review of the status of training and research programmes for which participants at the Workshop were responsible and reviews of programmes relevant to training and research by non-academic/research agencies represented at the Workshop. Summaries of these reviews and detailed reports of the Workshop follow this summary.
For the purposes of the Workshop, advanced training was defined as training provided beyond the award of an initial degree (usually three to five years after completion of secondary education) or after the award of a professional license or accreditation. Thus the important roles of others with less formal education were not considered. For these discussions, the purposes of advanced training were agreed to be the acquisition of knowledge, attitudes, and skills necessary to perform specific activities, or a broader preparation to enhance an individual’s fund of knowledge, analytical skills, and managerial skills required for lifelong learning and to meet evolving needs related to health and nutrition.
A national pyramid for advanced training is a graphic, roughly proportional representation of functional categories within an integrated system that are required to serve the nutritional needs of a population. Thus, the relative number of professionals in each category is represented by the designated segments of the pyramid. Definitions of categories are linked to learning objectives and functional needs, and the placement of specific categories is not intended to imply hierarchical relationships. Beyond the graphic representation of the qualitative and semi-quantitative guidelines for planning training programmes, professional pyramids also provide guidance for allocating adequate resources for training to achieve a sustainable, largely self-generating critical mass of nutrition professionals.
Three professional categories were identified as making up most national training pyramids: category I, implementers (e.g., project managers at the field level who directly serve and relate to communities); category II, mid-level planners, researchers, and teachers (e.g., creative thinkers and advisors who may serve as programme planners, managers, administrators, directors of research and training programmes, active researchers, and teachers); and category III, national policy and macro-planners (e.g., decision makers such as heads of governmental sectors). Although active communication among all three categories is highly valued, it is most likely that mid-level planners, researchers, and teachers will interact most with professionals in the other two categories (fig. 1).
FIG. 1. National training pyramid
Recipients of advanced training represented by the pyramid are expected to function as teachers, researchers, policy planners, programme managers, industrial researchers and developers, nutrition specialists, and communicators (fig. 2). Although it is recognized that most of these groups can be subdivided further (e.g., nutrition policy planners, nutrition programme managers, agricultural policy planners, and health programme managers), advanced training should be specially tailored to appropriate levels, and suitable methods should be applied in the training of specialists and functionaries with broader responsibilities.
FIG. 2. Career paths for professionals and ranges of minimum numbers of professionals per 5 million population in categories I-III
In constructing a national pyramid, learning objectives and training needs should be based on projected functions within and across each category. Definitions of training objectives should include the type, format, and likely duration of training. The level of specificity should be sufficient to permit local and national governments and non-governmental domestic and international sponsors to estimate the resources required for the pyramid’s development. The importance of networking and capacity-building at regional levels across national boundaries and the role of broader international collaborations were emphasized by the Working Group.
The Workshop proposed ranges of minimum numbers of personnel per five million population for each of the three categories: category 1,100-500; category II, 10-50; and category III, 1-5 (fig. 2). The actual numbers and professional mix within each category should be determined for each country on the basis of developmental needs, available resources, and the nature of the food and nutrition problems and opportunities within each country. The extrapolation of these ratios to countries with small populations should consider specific needs and should not be based on linear projections of the ratios.
Process and outcome indicators for assessing medium- and long-term successes and failures were considered carefully by the Working Group, and examples of potential indicators were included in the Group’s more detailed report.
In considering national training pyramids, the Workshop affirmed the long-standing recognition that solutions to contemporary food and nutrition problems require the integration of knowledge from many disciplines. Given the primacy of disciplinary allegiance in institutions dedicated to training and research, outreach to diverse disciplines and recruiting multidisciplinary teams in collaborative efforts are essential. However, it also recognized that, although the integration of disciplinary knowledge is necessary, it is not sufficient. Equally important is the need to integrate the knowledge and interests of whichever significant groups may be affected by the problems and proposed solutions and those whose cooperation and support may be required for the implementation of activities proposed for solving specific problems.
The Workshop concluded that effective professionals are characterized by four attributes, and that these should guide the design of advanced training programmes:
» a broad, interdisciplinary perspective on the nature of modern food and nutrition problems and the range of approaches required for their amelioration and eventual eradication;» specialized knowledge necessary for at least one of the six career tracks identified by the Workshop (communicators, industrial nutrition specialists, health nutrition specialists, policy managers, researchers, and teachers);
» specialized skills required by at least one of the six career tracks;
» a set of professional attitudes and an orientation that fosters the integration and implementation of knowledge from diverse sources and the development of effective working relationships with other professionals and significant groups who are required for identifying and addressing food and nutrition problems of most relevance to the societies served by nutrition professionals identified by national training pyramids.
Although discussions were focused primarily on professionals with priority interests in nutrition issues, the Working Group considered how advanced training could be used to enhance the motivation and ability of professionals from other sectors (e.g., planning, agriculture, health, economics, and administration) to address the nutritional dimensions of their work more effectively, and, conversely, how nutrition professionals could enhance addressing the corresponding dimensions of activities they direct.
Achieving the desired cross-disciplinary breadth and depth was addressed by conceptualizing a core body of knowledge, skills, and attitudes and a variety of functional specialities. The relevant body of knowledge and skills in a recommended core was defined broadly by the Workshop participants (fig. 3). It was recommended that the relevant bodies of knowledge and skills required by the functional specialities (e.g., researchers, programme managers, teachers) identified by the participants should be defined in collaboration with institutions with recognized strengths in specific functional specialities.
FIG. 3. Bodies of knowledge, skills, and attitudes recommended for the core component
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Nutritional biochemistry -characteristics Ecology of food and nutrition -food and agricultural systems Economics - micro and macro concepts -as part of programme management skills Communication, negotiation, motivation, collaborative
problem-solving, concepts and skills |
The Working Group recommended that universities and other training centres consider implementation of the desired speciality training on a firm foundation characterized by the disciplinary breadth described in figure 3 by initiating the following activities:
» encouraging individual institutions to review their training programmes in light of considerations discussed at the Workshop;» sharing programme descriptions, syllabi, and materials with other institutions with whom closer ties may be advantageous;
» identifying areas requiring strengthening;
» using the contributions of other training institutions to identify mechanisms of mutual support;
» exploring the possible contributions of modern electronic communication.
The range of alternatives for achieving advanced training is broad. They range from formal degree programmes that require several years for completion, to short courses, in-service training, workshops, professional exchanges, and fieldwork. Thus, a successful, sustainable, coordinated effort depends upon the broad participation of universities and training centres in developed and developing countries.
Among these alternatives, short-term training was of interest to the Working Group to meet two specific objectives:
» to provide and/or upgrade specific skills and knowledge required for enhanced performance of expected duties and responsibilities;» to facilitate and/or enhance the development of a critical mass of trained people able to contribute effectively to the improvement of the nutritional status of targeted communities or groups.
When appropriately designed, targeted approaches recognize the constraints of academic and administrative policies of institutions of higher learning, the pressing needs for professional resources imposed by the magnitude and seriousness of malnutrition in many countries, and the understandable demand that training be achieved efficiently in terms of money and time. The efficacy of targeted approaches is dependent on an adequate critical mass of more extensively trained people.
Recognizing that the specific substance and process of short-term training are determined by the needs of programmes that are planned for implementation by countries and/or regions, the Working Group identified common themes (fig. 4) and methods (table 1) most often used to achieve targeted training needs. A strong potential role for modern electronic communication was assumed in these discussions.
FIG. 4. Substantive goals of short-term training
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Leadership development |
|
Approach |
Duration |
Location |
|
Workshop |
3 days to 2 weeks |
on/off-site |
|
Short course |
4 to 12 weeks |
on/off-site |
|
In-service training |
<1 year |
on-site |
|
Apprenticeship |
<1 year |
off-site |
|
Distance-education course |
<1 year |
on-site |
|
Internet course |
<1 year |
on-site |
|
Any combination of the above |
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Research is essential for the sustained improvement of the nutritional situation of all countries, regardless of developmental status. Sound research is the only tool for the identification of nutritional problems and their causes, the demonstration of their importance to a country’s development, the formulation of solutions, and the evaluation of progress.
Unfortunately, the capacity of national and regional academic and research institutions to respond to research needs in human nutrition is seriously limited. Limitations in research capacity relate to a lack of both adequate facilities and appropriately trained professionals. The most pressing need appears to be in category II, as defined in the discussions of professional pyramids. In some regions, particularly Asia and Latin America, there are well-established institutions that deal with nutrition, but even these report gaps in available expertise. In Africa there are very few institutions with any measurable research capacity in nutrition.
The principal objectives of increasing research capacity are to strengthen the ability to respond to national and regional research needs, increase the proportion of nutrition research conducted by national or regional institutions, and augment the level of input of research conducted within a region or country in the identification and solution of the nutritional problems of most national and regional significance.
Realization of these objectives should lead to the development of self-sustaining departments, institutes, and schools of nutrition capable of conducting research and training future researchers in the region. It has been demonstrated that with a strong commitment, building an academic department where none exists can be done within 10 years. But in institutions where established departments need strengthening in limited areas, the time frame is much shorter.
To accomplish these objectives, the Working Group affirmed the need to develop research centres of excellence in institutions that closely link the research mission to educational and training missions. The Working Group found that the quality control, disciplinary breadth, and relative permanence that characterize academic institutions of higher learning present a compelling case in favour of strategies that concentrate resources in units that either exist within such academic institutions or have clear ties to them.
Furthermore, the Working Group recognized that limitations in available resources and the requirement for a critical mass of professionals make it imperative that resources be concentrated in a few highly selected academic or research institutions in each region. Among the recommended criteria for the selection of regional centres of excellence are a demonstrated institutional commitment to problem-oriented research in human nutrition, political and economic stability, and a demonstrated willingness and ability to serve regional needs.
Each research centre should have a multidisciplinary orientation, in keeping with the breadth of disciplines required to address most nutrition problems. Nonetheless, each unit should develop its own area of specialization. This expertise should be linked closely to the areas of education and training targeted by the institution. Thus, collaboration within and between regions is essential, because no single institution can have the requisite research capacity in all fields that contribute to the solution of nutrition problems.
Developing research capacity may be accomplished in various ways. Whatever approaches may be taken to develop this capacity, careful consideration should be given to the disciplinary and interdisciplinary breadth and complementary specialization required for dealing with food and nutrition issues. The most common approach for the formation of future faculty and researchers is through graduate and postgraduate training in universities or other institutions where the desired expertise and multidisciplinary breadth exist. An additional, highly desirable component of advanced training is the preferential support of newly trained researchers as an important follow-up of doctoral and postdoctoral training. Such support is strongly encouraged. It may take the form of peer-reviewed programmes specially designed for new graduates. It is recommended that training programmes be research based and that the research be conducted in the country to which the trainee will return.
A second approach is a more targeted, “hands-on” experience that relies on the development of mentoring relationships and faculty exchanges. Enhancing research capacity through the improvement of highly specific skills may be accomplished through less formal approaches or any of the short-term training approaches discussed earlier.
Another essential component of building research capacity is the development of relevant research agendas. For this discussion it is useful to differentiate between basic and applied research: basic research is research undertaken for its own sake, that is, it is not directed at any specific problem; applied research is directed at a specific problem of interest to one or more stakeholder groups. The Working Group did not discuss basic research programmes, beyond recognizing the key role such activities play in science.
Applied research agendas should set priorities on the basis of the significance of present and projected problems specific to countries and/or regions. Thus, researchers, planners, policy makers, and representatives of those that are affected by the problems of interest and projected solutions must participate in priority-setting. Nonetheless, whatever the priority-setting process may be, it must permit investigator-initiated creativity to flourish. Creative thinking provides innovative solutions that are not necessarily obtained by following traditional approaches. Freedom to question and criticize should never be disallowed by priority-setting exercises.
Institutions in developing and developed countries often are inclined to adopt research agendas set solely by government agencies or donor-defined priorities. Although this inclination may seem advantageous, it is usually unwise unless those priorities both address national and regional needs and enhance the development of the institution’s research capacity.
The following recommendations were adopted by the Working Group:
» Individual institutions are encouraged to examine the focus and content of their advanced training programmes to identify areas that require strengthening. Such reviews should be facilitated by the approaches proposed by the Working Group that take into account the disciplinary and interdisciplinary breadth required for dealing with contemporary food and nutrition issues. The publication of the Workshop proceedings was recommended as a useful aid to this review.» Programme descriptions, syllabi, and other similar materials gathered in the preparation of these reviews should be compiled by the UNU. Furthermore, specific institutions should be recruited to gather these materials for their region and for the development of mechanisms for sharing these materials with training institutions worldwide. This effort is intended to serve as a first step towards the establishment of mutual support structures for enhancing globally the effectiveness of advanced professional training in nutrition.
» The Working Group recommends that the UNU and IUNS survey advanced nutrition training institutes to determine the level of knowledge and skills of their faculty and professional staff in specific areas and their capacities for research at national, regional, and international levels. This survey will complement the recommended institutional reviews and aid in building a strong foundation for the identification and establishment of networks of collaborating institutions for advanced training.
» The Workshop concluded that the need for cross-disciplinary breadth and functional depth is addressed most effectively by identifying a core body of knowledge, skills, and attitudes and a variety of functional specialities. A tabulation of core knowledge and skills was drafted by Workshop participants for consideration by the broader academic community. Definition of the relevant bodies of knowledge and skills required by various functional specialities is proposed as a follow-up activity that should be undertaken by the UNU and IUNS in collaboration with institutions with recognized strengths in specific functional specialities.
» The Working Group recommends that the IUNS hold a symposium or workshop at its 1997 international conference in Montreal to inform others more fully of this Workshop held in Manila, invite a wider participation in the development of approaches discussed at this Workshop, and promote the implementation of specific programmes for the improvement of advanced training.
» Countries are encouraged to develop goals of the numbers of persons needed at each level of advanced training in food and nutrition similar to the guidelines developed in the consideration of national training pyramids. These goals should be based on each country’s developmental needs, the nature of the food and nutrition problems that each confronts, and organizational structures, functions, and interactions of the spectrum of personnel that are engaged in nutrition-related activities in both governmental and non-governmental units.
» The UNU and IUNS are encouraged to assist in the development of goals for advanced training by countries where undernutrition continues to have the greatest impact on the survival of its citizens. Whenever possible, regional networks should be recruited to assist in the development of these goals and in planning for their implementation and regular evaluation.
» The UNU and IUNS are encouraged to explore mechanisms for fostering the development of regional institutional networks through the innovative use of new modes of electronic communications, distance learning, and videoconferencing.
» The UNU and IUNS are encouraged to develop criteria and a process for selecting academic or research institutions to be targeted for capacity-building within regions. The adhering bodies of the IUNS should be invited to assist in these capacity-building efforts and in the formation of consortia to assist with the resources needed for capacity-building. The Working Group stressed that capacity-building requires a strong commitment from the institutions’ home governments and administrative structure and should not be undertaken without it. The consortia should be composed of national, regional, and international members.
Cornell University, Ithaca, NY, USA
DANIDA, Royal Danish Ministry of Foreign Affairs, Copenhagen, Denmark
Deutsche Gesellschaft für Technische Zusammenarbeit (GTZ), Federal Republic of Germany, Jakarta, Indonesia
International Nutrition Foundation for Developing Countries, Boston, Mass, USA
Nancy Meinig Professorship in Maternal and Child Nutrition Support Fund, anonymous donor, Cornell University, Ithaca, NY, USA
Nutrition Center for the Philippines, Manila, Philippines
Wageningen Agricultural University, Wageningen, Netherlands
Corazon V. C. Barba, Director, Institute of Human Nutrition and Food, Los Baños, Philippines
Jacques Berger, Laboratoire de Nutrition Tropicale, Montpellier, France
Abraham Besrat, United Nations University, Tokyo
Sakorn Dhanamita, Institute of Nutrition, Bangkok, Thailand
Rodolfo Florentino, Food and Nutrition Research Institute, Manila, Philippines
Maria-Bernardita T. Flores, National Nutrition Council, Manila, Philippines
Rafael Flores, Nutrition and Health Area, Institute of Nutrition of Central America and Panama/Pan American Health Organization (INCAP/PAHO), Guatemala City, Guatemala
Osman Galal, International Health Program, University of California, Los Angeles, Calif, USA
Cutberto Garza, Division of Nutritional Sciences, Cornell University, Ithaca, NY, USA (co-chair)
Rainer Gross, South-East Asian Ministers of Education Organization-Tropical Medicine and Public Health Project/Deutsche Gesellschaft für Technische Zusammenarbeit (SEAMEO-TROPMED/GTZ), Jakarta, Indonesia
Joseph Hautvast, Department of Human Nutrition, Wageningen Agricultural University, Wageningen, Netherlands (co-chair)
Pham Van Hoan, National Institute of Nutrition, Hanoi, Vietnam
Darwin Karyadi, SEAMEO-TROPMED, Indonesia
Purnima Kashyap, UN World Food Programme, New Delhi, India
Judit Katona-Apte, Department of Humanitarian Affairs Officer, United Nations, New York
Lilian Marovatsanga, Institute of Food, Nutrition and Family Sciences, Harare, Zimbabwe
Mohd. Ismail Noor, Faculty of Allied Health Sciences, Universiti Kebangsan Malaysia, Kuala Lumpur, Malaysia
David Pelletier, Division of Nutritional Sciences, Cornell University, Ithaca, NY, USA
Beatrice Rogers, Tufts University, Medford, Mass, USA
Prakesh Shetty, St Johns Medical College, Bangalore, India, and London School of Hygiene and Tropical Medicine, London
Florentino S. Solon, Nutrition Center of the Philippines, Manila, Philippines
Mercedes A. Solon, Nutrition Center of the Philippines, Manila, Philippines
Shakuntala Thilsted, NATURA/NECTAR, European Union, Frederiksberg, Denmark
Kraisid Tontisirin, Institute of Nutrition, Mahidol University, Bangkok, Thailand
Ma. Antonia G. Tuazon, Regional Training Programme on Food and Nutrition Planning, Los Baños, Philippines
Ricardo Uauy, Instituto de Nutrición y Tecnología de los Alimentos, Santiago, Chile
Aree Valyasevi, Faculty of Medicine, Thammasat University, Bangkok, Thailand
