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Background
Description of the national training pyramid
Components of a national advanced training pyramid
Projected needs and functions
Strategies for implementation
Long- and medium-term learning indicators of success
Reference
Developing regions of the world have experienced drastic political, economic, and social changes over the past decade. Democracy is now established in many countries, and free market reforms and trade agreements are now in vogue around the world. Investment in human capital is considered by many as a prerequisite for economic growth. Nutrition and health improvements are now considered an integral part of national development strategies in most countries. Expenditure at the national level and international cooperation in nutrition programmes has grown, and the political support for these actions has regained momentum. The Summit for Children, the International Conference in Nutrition, the Micronutrient Initiative, the World Food Summit, and multiple national, regional, and international activities are examples of this renewed interest.
A critical factor determining the impact of these actions at the national level is the human resources available. The inadequacies of the human resources responsible for the planning, implementation, and evaluation of nutrition programmes is one of the main reasons why nutrition programmes may appear to be of limited success. To reverse this trend, the Working Group proposes that a new approach to advanced training be undertaken at the country, regional, and international levels.
The initial step in this integrated approach is the setting up of national nutrition pyramids for advanced training. A complementary initiative, the Network for Research and Training to improve nutrition programmes, has been launched by some UN agencies, with the support of the International Development Research Centre (IDRC), emphasizing actions at the community level.
The present training opportunities in food and nutrition programmes and planning are not appropriate. There are important limitations in these existing programmes. Most of them are health oriented, with little input from agricultural planners, social scientists, and economists. The alternatives for training in more comprehensive programmes in centres of excellence are also limited by the widening gap between the needs of action-oriented programme and academic demands relevant to traditional disciplinary research and training. The Working Group considered that present nutrition and food problems represent excellent opportunities for interaction among centres throughout the world. Action-oriented research and training has great significance for populations in developing and developed regions of the world alike.
The opportunities for country-level training of fieldworkers, government planners, and even academicians in many developing countries are rare or not available at all. The few well-trained professionals are sometimes outside the programmes or have been marginalized from the process. In many cases, their skills do not match local needs. Thus, the effectiveness of the training system is limited by multiple causes, including, among others, limited commitment and support by national governments, insufficient investment in institutional development by donor agencies, restrictive academic policies, and misplaced incentives. Extensive evidence for the claims presented in this section is available if one examines the operation of nutrition programmes at the country level.
On the other hand, there are several successful food and nutrition applied research and training centres, especially in Asia and Latin America, with great potential to contribute to regional training activities beyond their own borders. There is a lot to be gained by putting these centres to work in advanced training and research activities as organized networks in conjunction with national organizations and international academic institutions.
The implementation of national nutrition programmes needs sustained institutional commitment as well as human and financial resources. The success of the implementation of these programmes is determined by the quality and adequacy of numbers of trained and motivated professionals available nationally. Hence, the development of quality training programmes that can cater to the numerical needs of personnel who have the necessary skills and competencies to implement these programmes becomes a cornerstone of such national endeavours.
The purpose of the national training pyramid is to provide a quantitative estimate of the needs and the different categories for advanced training to meet the requirements for human resources. The training should provide adequate and appropriate knowledge, skills, attitudes, and orientations necessary for professionals to address the various nutrition activities.
For clarity and better understanding, the Working Group defined the following terms at the outset:
Advanced training is training obtained after graduating with an initial degree (usually three to five years after secondary level) or after obtaining the corresponding professional license or accreditation, with the purpose of gaining knowledge, attitudes, and skills to better perform specific actions.
The national advanced training pyramid is a graphic representation of functional categories within an integrated system that includes implementers, planners, researchers, trainers, and policy or decision makers in a given field. The relative number of professionals in each category is represented graphically in the pyramid. The definition of categories is linked to learning objectives and functional needs and is not intended to represent hierarchy.
Multi- and interdisciplinary, problem-oriented training implies the integration of many disciplines and input from significant groups in resolving food and nutrition problems. They will be defined later by the specific subgroup.
A national advanced training pyramid should be based on an understanding of the national nutritional problems and the causal framework of malnutrition in society, both biological and socio-economic, including policies, plans, and programmes that bear on the social and economic development of the nation. The training pyramid needs to respond to the changing nutritional and developmental scenarios. It should project needs based on an understanding of rapid socio-economic and epidemiological changes in society. It should address the qualitative training needs and the quantitative projected numbers that need to be trained.
The context of the training, including the learning objectives and the relative interactions and movements between the different categories of professionals in need of training, also needs to be outlined. Some industrialized countries that have insufficient human resources may adopt a similar approach in defining their own training needs.
As indicated in the definition, a national advanced training pyramid has categories with functional implications (fig. 1).
FIG. 1. National training pyramid
Category I
Members of this category are programme implementers who by their actions affect the community directly, such as programme or project managers or operations researchers.
Functions
Their functions are to develop operational plans; collect information for evaluation and monitoring; conduct internal evaluation; identify nutrition-related problems in the community; participate in defining programme adjustments; decide on actions on a daily basis; allocate resources and administer projects; communicate and advocate for the nutrition programme; train field trainers; and coordinate and generate synergistic operations among field implementers involved in nutrition and nutrition-related activities in the community.
Non-exclusive list of learning objectives
They have skills in:
» identifying nutrition and food problems in the community and the potential resources to address them using a participatory approach;» assessing and evaluating nutritional status in the community;
» implementing and managing or administering resources necessary for nutrition projects;
» evaluating and monitoring the progress of the project on a day-to-day basis.
They have the ability to:
» collect and manage knowledge, data, and information necessary for project implementation, evaluation, and monitoring;» communicate and advocate for the nutrition project in the community and mobilize resources for project implementation;
» train community leaders and fieldworkers.
They must develop characteristics for:
» active listening;
» working in a team.
Training modalities
The type of training required by category I is best delivered through short courses that should meet specific learning objectives. The description of the nature of short courses is given in another paper in this issue [1]. This modular approach already has been tested and used in the training of operational-level staff in various regions of the world. Training should be problem oriented, integrating knowledge and skills from various disciplines.
The training of category I would occur predominantly in national institutions, with the participation of regional institutions when necessary. These institutions could be university-based or represent centres of excellence within the non-governmental organization or private sector.
Category II
These are planners, researchers, or trainers who by their actions affect both programme implementers (category I) and policy decision makers (category III), for example, nutrition programme directors or directors of research or training programmes.
Functions
Their functions are strategic planning; advising decision makers and supervising implementers; managing data and information systems for evaluation and monitoring; resolving operational problems and suggesting solutions; advocating for defined policies; exercising independent thinking in developing strategies to formulate or reformulate policies; and networking with other sectors and team-building.
Non-exclusive list of learning objectives
They have skills in:
» strategic planning and policy analysis and formulation;
» research and programme design and implementation;
» management, leadership, and negotiation;
» communication and dissemination of relevant information;
» preparation and presentation of proposals for programmes and plans;
» persuasive communication and advocacy.
They have the ability to:
» obtain, analyse, interpret, and integrate information and generate knowledge;» identify new and prospective problems; provide innovative and anticipated solutions;
» mobilize human, economic, and organizational resources from public, private, and community sources;
» monitor and evaluate projects and programmes;
» coordinate and generate teams, working synergistically with others within and beyond any single sector.
They must develop characteristics for:
» self-directed learning;
» retooling.
Training modalities
Category II is the core strength of the pyramid, the most important category for human resource development, since it will influence both implementation and policy and planning. Under ideal conditions, this category should serve as the basis for recruitment of category III (policy planners).
Because of the creative nature of their work, they should have a longer formative period that includes formal advanced training and experience. The training objectives should be delivered by other than short-term course training. It should include tutorial training (mentorship) with experienced individuals; ideally there should be a research component in this training. This category is crucial for capacity-building and for strengthening existing capacity. Advanced training for category II would occur at regional centres, with the potential participation of international academic institutions. During the formation of new national or regional institutions, formal training of this category at the highest level is essential (meeting international standards).
Category III
These are policy or decision makers who influence the national policy- and programme-planning process, defining the course for the other two categories to follow, for example, executive directors of national nutrition councils, directors of national nutrition or food institutes, heads of the agriculture or economic sectors in planning commissions.
Functions
Their functions are organizing people, ideas, and resources and integrating them for a common purpose; analysing information; defining priorities, goals, and targets; obtaining and allocating resources for policy and research; instituting oversight and evaluation of policies and programmes; advocating with all sectors involved in food and nutrition decision-making (e.g., education, economics, food safety, social planning), politicians, and donors.
Non-exclusive list of learning objectives
This category will evolve mainly from the political process rather than from technical merit. Thus it is difficult to provide a specific format for the training of this professional group. Nonetheless, the main training objectives are identified as follows:
» sensitization to the human consequences of policy and macroplanning decisions;» skills in information processing and interpretation of large bodies of data;
» skills in political advocacy to obtain needed resources;
» managerial skills required to allocate and administer resources;
» critical evaluation of policy alternatives;
» effective communication affecting all members of the professional pyramid;
» leadership and advocacy for food and nutrition policy to influence other sectors, involving decision makers, politicians, and donors.
Training modalities
The need to consider the time constraints of this group and the potentially transient nature of their positions should not be overlooked. They may have advanced training in disciplines not directly related to food and nutrition, or they may have no formal training at all. Thus, any programme will need to be tailor-made to the needs of the target group. Generally, the main purpose of training programmes is to raise awareness and sensitization to the needs and consequences of national nutrition policies and programmes. Advanced training for category III would occur at the regional centres, with the potential participation of international academic institutions.
The Workshop proposed ranges of minimum numbers of personnel per five million population for each of the three categories: category I, 100-500; category II, 10-50; and category III, 1-5. These figures are not intended to be precise estimates but represent the consensus opinion of the Working Group, which included members from Thailand, Indonesia, the Philippines, Chile, the United Kingdom, and India.
The actual numbers should be determined for each country on the basis of its developmental needs and the nature of its food and nutrition problems. The extrapolation to countries with small populations should consider their specific needs. The linear extrapolation of the suggested numbers is not recommended.
Table 1 illustrates the relative emphasis of the respective functions (policy planning, programme management, research, teaching, communication, and industrial research and development) for each category within the pyramid (see fig. 2). Each function could be subdivided in more detail. However, the Working Group considered that for the purpose of addressing the advanced training pyramid, these functions would suffice. No attempt to quantify by specific function has been made, since this will vary from country to country.
TABLE 1. Types of expertise emphasis by category
|
Category |
Policy planning |
Programme management |
Research |
Teaching |
Communications/advocacy |
Industrial research and development |
|
I |
|
+++ |
++ |
++ |
+++ |
+ |
|
II |
+++ |
++ |
+++ |
+++ |
+++ |
+++ |
|
III |
+++ |
+ |
++ |
++ |
+++ |
++ |
The development of human resources for planning and implementing food and nutrition programmes to address the needs of communities in the developing world requires a problem-oriented, integrated approach. It should start at the country level, continuing at the regional level and linking these efforts to applied research centres of excellence in developing and developed countries.
Role of the national advanced training centres/networks
The national centres are institutions linked to universities or represent centres of excellence within the non-governmental organization or private sector. The process by which a national training pyramid is constructed requires both an understanding of the context of the nutritional situation and an examination of the organizational structures, functions, and interactions of the personnel engaged in nutrition-related activities in both the governmental and non-governmental sectors and in academic and community-based programmes.
The position and responsibilities of the individual personnel categories should be determined, along with the role they play in the implementation of the national nutrition programmes to assess training needs. The site and location of training and the methods by which the training can be achieved also should be indicated. The identification of process and outcome indicators will help develop a proper evaluation of the qualitative and quantitative aspects of training. This will enable mid-course corrections and minimize inappropriate duplication of regional and global efforts.
The development of training networks also requires an examination of national organizational structures and functions of governmental and non-governmental personnel engaged in nutrition activities. The professional background, positions, and responsibilities in nutrition of the personnel and the nutrition-related services and training needs are assessed. This process is expected to provide an opportunity to assess the qualifications of available personnel and quantify the individuals needed for each category of a training pyramid.
Local capacity for the development and implementation of food and nutrition programmes and planning also should be developed. Focus should be given to training field personnel, government planners, and university-based professionals. The training activities should be problem oriented and carried out close to the working environments of the trainees. The duration of the training activities should be as efficient as possible and of optimal length, and the contents related directly to the individual needs of the trainee. The advanced training programme should concentrate efforts on those countries which have ongoing food and nutrition programmes or are in the process of developing them.
Special emphasis should be placed on the poorest and neediest countries, where malnutrition still has a direct impact on survival. Efforts to develop national advanced training pyramids should be concentrated on the most affected countries in a given region, not on the countries where it is easiest to establish them.
Role of the regional advanced training centres/networks
Regional centres are institutions linked to universities or centres of excellence within the non-governmental organization or private sector. They should be encouraged to develop training opportunities for planners, technical-level professionals at the sectoral agencies, and national leaders in health and nutrition. Teaching programmes should be problem oriented and focused on successful national experiences of nutrition within their regions. Modular frameworks should be examined to improve the time efficiency of programmes.
In successive fashion, modules may lead to a postgraduate degree granted by regional centres. Selection processes of degree programmes should take into account the needs of the country and the professional experience of individual applicants. Interactions with academic staff from other centres within the region or with international centres should be sought to complement areas that are weak or lacking at regional centres.
In addition, regional centres should develop and implement new methodologies and strategies that are relevant to the solution of nutrition and health problems of high priority. For example, trainees should be capable of the assessment of community perceptions of nutrition and food problems, evaluation of programmes and policies, and impact and cost-effectiveness analysis of intervention.
Role of the international advanced training centres/networks
These institutions should be linked to universities. The role of the international centres is to transfer and develop new concepts and methodologies for the implementation of food and nutrition programmes. International centres should make visiting staff available to regional centres and participate in national training programmes and regional research networks. Visiting staff should be capable of reviewing training programmes of regional centres. This is necessary because of the limited number of persons trained at the doctoral level in most regional and national centres.
The international centres should recruit appropriate candidates for postgraduate (master’s and doctoral) programmes from individuals with whom they interact in regional training networks. This will enhance local capacity-building. Their knowledge of local and regional realities should improve the relevance of training programmes and applied research activities.
Support from international agencies and donors
The role of the international agencies in the implementation of a national advanced training pyramid requires coordinated efforts based on specific agency interests and priorities. Those that support specific projects and programmes should include training of category I professionals in project funding, because those personnel are a prerequisite for programme success. Presently most agencies are investing insufficiently in advanced training of human resources and institutional development.
To sustain programmatic efforts over time, it also is vitally important to train individuals from category II, the group responsible for research and programme planning and development. These are the institution builders, who support the training of individuals in category I and significantly influence those in decision-making policy roles. The mandate of the UNU and of other international and bilateral agencies addresses the need for advanced training of categories II and III. The training of these individuals is important for successful policy and programme implementation in the medium and long term.
The potential impact of regional networks in strengthening the development of a national advanced training pyramid is significant. New modes of electronic communications, distance learning, and videoconferences enhance the feasibility and cost-effectiveness of regional networks. Whenever possible, regional networks should include a mix of academic centres from industrialized and non-industrialized countries with interests in common nutrition problems or in those more specific to developing countries.
The Working Group identified the following examples of medium-term, process-related indicators of success:
» community contribution to the project (resource mobilization);» number of participants in the nutrition and food programme;
» efficiency of resource utilization;
» number of participants in the training programme matched with projected needs by category and function;
» evaluation of the quality of the planning process and design of programmes;
» career advancement of the trainees.
Examples of longer-term, outcome-related indicators of success that were identified by the Working Group are the following:
» match between projected need in the training pyramid in different categories and the actual number who have received advanced training;» number of trainees in each of the nutrition-related sectors, for example, health, agriculture, education, women, and children;
» design and efficacy of the sectoral programmes that trainees have implemented;
» community perception of food and nutrition problems and actions taken;
» capacity of national centres to self-sustain training efforts over time;
» improvement of nutrition and food situation of the community after the pyramid has been in place some time (at least 10 years).
Chairperson: Prakesh Shetty
Rapporteur: Ricardo Uauy
Participants: Darwin Karyadi, Bernie T. Flores, Abraham Besrat, Florentino Solon, Aree Valyasevi
1. Working Group report on the role of short-term training for institutional capacity-building. Food Nutr Bull 1997;18:172-4.
