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Levels and types of training according to proportion and categories of personnel
Florentino S. Solon
The author is the executive director of the Nutrition Center of the Philippines in Manila.
The training pyramid is a system with designated levels corresponding to types of training needed for personnel in a national nutrition programme. Each proportional level refers to the type, purpose, and content of training and the category of individuals to be trained. Level III, the upper part of the pyramid, is intended for a few professionals with masters or doctoral degrees who deal with macronutrition issues and the solution of nationwide nutrition problems through policies, programmes, macroplanning, and legislative action. Short-term training periods provide skills in studying and formulating national policies to solve malnutrition problems and translate research results into policies for the benefit of the population. Training at level II is intended to develop the research capability of professionals to undertake studies for use in formulating national policies, plans, and programmes. This level of training provides knowledge and skills in research design, information technology, statistics, identifying research needs, developing research proposals, planning and managing research activities, and comprehensively communicating technical information and results to policy makers, legislators, macroplanners, programme planners, managers, and implementers. Short courses on laboratory procedures, new methods, and use of the latest equipment should be included. Level I, the base of the pyramid, is for training professionals to translate national policies and macroplans, including research findings, into community-based programmes and projects appropriate to the existing political, economic, and socio-cultural situation. This level of training focuses on efficient and effective programme implementation and management.
A national nutrition programme can be implemented successfully only when sufficient personnel well trained in nutrition are available [1, 2]. The development of training programmes in nutrition in the industrialized as well as in the developing countries has improved the availability of personnel with advanced training in nutrition in the developing countries.
It is, therefore, timely to provide a guide for developing a national training programme capable of meeting the requirements of appropriately trained personnel for various nutrition activities.
A training pyramid is a guide for estimating the need for specific personnel at designated levels by national nutrition programmes. The types of training are defined as to purpose, content, and expected outcome at each level. Training pyramids illustrate at each training level the content areas and the proportion of the types of personnel suited to undertake the indicated training (fig. 1).
FIG. 1. Training pyramid showing the content areas and the proportion of the types of personnel suited to undertake the indicated training at each training level
Important steps in the process of developing national training pyramids are the review of national nutritional problems and the causal framework of malnutrition specific to the country of interest, and its nutrition policies and programmes in relation to national development plans .
The process by which national training pyramids are developed requires an examination of the organizational structures and functions of personnel engaged in nutrition programme activities of governmental and non-governmental organizations and of academic institutions. The personnel, professions, positions, and responsibilities in nutrition and nutrition-related services in the organization should be determined and their training needs assessed. This process provides an opportunity to estimate the personnel needed at each level of the training pyramid and to document the qualifications required by each level.
Figure 2 represents the type of training and the corresponding content areas for each designated level. The types of training and the proportion and categories of personnel at each level are as follows.
FIG. 2. Training pyramid showing the type of training and the corresponding content areas for each designated level
Types of training
Level III in the training pyramid identifies personnel who deal with nutrition issues at a macro level and with the dynamic solution of nationwide malnutrition at the national level. These individuals usually formulate national nutrition policy and engage in macroplanning by a variety of means, including legislative actions.
The most appropriate training for professionals at this level is short courses on the basic principles of food and nutrition. They also should provide analytical skills for diagnosing a countrys nutrition problems and critical reviews of existing national nutrition and nutrition-related policies, plans, and programmes and their implications for human development status at the national level. Such courses are intended to equip professionals with skills in studying and formulating policies and strategic planning for food and nutrition and economic, social, and health policies that are relevant to the solution of hunger and malnutrition .
A special aspect of the training needs of those advising decision makers and legislators is how to better interpret and use the research results of nutrition and related sciences. These skills should improve the translation of research results into policies for the greatest benefit of the population. This will help ensure that nutrition objectives are carried through in policy- and decision-making at the national level.
Legislation has become an important strategy for strengthening national nutrition policies, plans, and programmes. Professionals of various disciplines with nutrition training can play active roles in initiating legislative action or in reacting to legislative requests, such as the preparation of position papers in support of the nutritional objectives of proposed legislation.
Proportion and categories of personnel
Level III in the training pyramid is for professionals with doctoral or masters degrees in various disciplines, such as medicine, biology, economics, agriculture, nutrition, and the social sciences. These are individuals who are members of the highest national policy and planning bodies of national nutrition councils. They are responsible for developing appropriate and effective national nutrition policies and formulating national strategies and plans of action to solve a countrys nutrition problems.
These individuals also are found in various relevant government sectors, such as health, agriculture, social welfare, trade and industry, and education. These national government agencies have specific offices or divisions that undertake nutrition services or formulate nutrition plans, programmes, and projects for their respective sectors consistent with national development plans .
Professionals in this category also are found in non-governmental organizations that undertake policy and nutrition investigations and programmes and in academic institutions specializing in nutrition and related courses of study and research.
Professionals at level III who work for governmental organizations, non-governmental organizations, and academic institutions usually are heads of offices. More of them have masters than doctoral degrees. Heads of offices usually are assisted by technical staff, a few of whom also have masters degrees but most of whom have baccalaureate degrees. Many of these technical staff, with or without nutrition backgrounds, are qualified to undertake courses designated as level III by the training pyramid.
There are relatively few professionals in this category. Nonetheless, they play important roles by providing vital nutritional content to national policies and plans. They also play key roles by providing technical input in support of nutrition programmes and in the drafting of important laws by legislative bodies.
Types of training
Level II in the training pyramid focuses on the development of capabilities of professionals. The expected outcomes of training at level II are individuals who are capable of undertaking science-based studies in support of the formulation of national policies, plans, and programmes. This level gives priority to the training of those who undertake applied and operational food and nutrition research, and research in other disciplines that interface with nutrition.
Level II training focuses on the provision of knowledge and skills in research design, information technology, statistics, and the planning and management of research activities. Vital to the research training component at this level is the capability to identify research needs, develop research proposals, and contribute to the solution of malnutrition through the discovery of new knowledge.
Some people in related disciplines with research skills may not have sufficient nutrition background to contribute meaningfully at this level. For such individuals, courses on the basic principles of food and nutrition, including problems and solutions and areas of current research interest, are important.
Level II in the training pyramid also may have short courses for the teaching of laboratory procedures and new methods that exploit state-of-the-art technologies.
Useful training for those at level II enables the effective communication of technical information and research results to individuals with level III responsibilities, such as policy makers, legislators, and macroplanners, and to those at level I, such as programme planners, managers, and implementers.
Proportion and categories of personnel
Training at level II targets nutrition professionals and those in nutrition-related disciplines in governmental organizations, non-governmental organizations, and academic institutions. These individuals are found in research institutes, various government sectors at the national and subnational levels, universities, and non-governmental organizations. Many hold baccalaureate degrees and function as research assistants, medical technologists, biochemists, horticulturists, statisticians, and so forth.
Some of these professionals are already specialists in their own disciplines. A few hold masters degrees, and fewer hold doctoral degrees. Many are involved in research and influence those who plan and direct national programmes. Their educational backgrounds include medicine, economics, engineering, nutrition, statistics, agriculture, community development, and so forth. Many more professionals are targeted for level II training than for level III training.
Types of training
Level I of the training pyramid focuses on the elements and basic principles of community-based planning and management of nutrition programmes at the subnational level, that is, in regions, provinces, cities, and administrative bodies below that of municipalities.
The training content areas allow professionals to translate national policies and macroplans, including research findings, into community-based programmes and projects applicable to various community conditions that account for political, socio-economic, and cultural environments .
The training core is management related and includes scientific components for the efficient and effective implementation of nutrition programmes. Training should include the basic principles of food and nutrition and a review of relevant nutritional problems, causes, and interventions, and of evaluation and surveillance methods.
Proportion and categories of personnel
The individuals targeted for level I training are professionals who are heads of agencies that are responsible for the management of only nutrition programmes or for wider programmes that include nutrition as an integral component of their responsibilities. In the Philippines, provincial, city, and municipal nutrition action officers are designated by local executives to manage integrated nutrition programme activities of diverse sectors, namely health, welfare, and agriculture [6, 7]. Such action officers and their counterparts in various sectoral services are appropriate targets for level I training.
Non-governmental organizations and the faculty of universities in relevant disciplines, including medicine, nursing, midwifery, agriculture, social welfare, and other disciplines, also should undertake such training to strengthen the community nutrition aspect of curricula and of the services they may provide.
Level I training targets more individuals than levels II and III. Most have baccalaureate degrees. Some have masters degrees, and a few have doctoral degrees.
The most important consideration for national training pyramids is that they should be based on the long-term national nutrition and development plans. The national training pyramids should be viewed as a prototype to be adapted as particular needs and situations of countries evolve. They are meant to undergo modification over time. As national training programmes develop and diverse needs arise, the foci may gradually shift to special skills training beyond basic courses. National training pyramids should be viewed in their entirety, as carefully laid out blocks balanced from the base to the top. Each block represents special skill training beyond basic courses normally undertaken by nutrition professionals. Then they should be inclusive of short courses, seminars, and workshops. National training pyramids, once implemented, should undergo continuous evaluation at each level for strengths, weaknesses, opportunities, and threats.
Looking beyond national training pyramids with a regional perspective, one might expect that countries in specified regions would excel in certain levels of the training pyramid. Particular situations in individual countries offer possibilities for developing regional networks of institutions that specialize in different types of training relevant to the needs of specific regions.
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