UNU/IUNS workshop on institution building for research and advanced training in food and nutrition in developing countries

Manilla, Philippines
18-23 August, 1996

Executive Summary

The successes of applied sciences are determined significantly 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 upon the quality and adequate numbers of trained personnel. In recognition of the importance of advanced training and research to the nutritional sciences, the United Nations University’s Food and Nutrition Program and the International Union of Nutritional Sciences convened an international workshop on Institution Building for Research and Advanced Training in Food and Nutrition in Developing Countries in Manila in August 1996.

The last review of this type occurred in 1978 in Cairo at a meeting convened by the United Nations University 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 purpose of the workshop was eightfold:

The majority 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 insure is 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 programs for which participants at the workshop were responsible and reviews of programs relevant to training and research by non-academic/research agencies represented at the workshop. Summaries of these reviews and detailed reports of the workshop will be published in the Food and Nutrition Bulletin.

Participants at the meeting are listed at the end of this summary.

For purposes of the workshop, advanced training was defined as training provided beyond the award of an initial degree (usually 3 to 5 years of study 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 for a broader preparation to enhance an individual’s fund of knowledge and analytical and/or managerial skills required for life-long learning and evolving needs related to health and nutrition.

National Pyramid For Advanced Training

A national pyramid for advanced training is a graphical, 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. Definition 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 graphical representation of the qualitative and semi-quantitative guidelines for planning training programs, 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 community or district level who directly serve and relate to communities), Category II, Mid-level planners/researchers/teachers (e.g. creative thinkers and advisors who may serve as program planners, managers, and administrators, directors of research and training programs and 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 likeliest that mid-level planners/researchers/teachers will interact most with the other two professional categories (see Figure 1).

Recipients of advanced training represented by the pyramid are expected to function as teachers, researchers, policy planners, program managers, industry and health sector nutrition specialists, and communicators (see Figure 2). Although it is recognized that most of these groups can be subdivided further (e.g. nutrition policy planners, nutrition program managers, agricultural policy planners, and health program managers), advanced training should be specially tailored to appropriate levels, and suitable methods should be applied in the training of specialists and functionaires with broader responsibilities.

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-government domestic and international sponsors to estimate 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 group.

The workshop proposed ranges of minimum ratios per 5 million population for each of the three categories: Category I, 100 - 500; Category II, 10 -50; and Category III 1 -5, (see Figure 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 by the group, and examples of potential indicators were included in the groups’ more detailed report.

Disciplinary And Interdisciplinary Breadth Required For Dealing With Food And Nutrition Issues

In considering national training pyramids, the workshop affirmed the long-standing recognition that solutions of 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 multi disciplinary 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 significant groups who 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 programs:

Although discussions were focused primarily on professionals with priority interests in food and nutrition issues, the 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 nutrition 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 specialties. The relevant body of knowledge and skills in a recommended core were defined broadly by the workshop participants (see Figure 3). It was recommended that the relevant bodies of knowledge and skills required by the functional specialities (e.g. researchers, program managers, teachers) identified by the participants should be defined in collaboration with institutions with recognized strengths in specific functional specialities.

Throughout the discussions it was clear that a number of developing country institutions, most of them associated or cooperating with the UNU, already have the competence for training and research in nutrition that make them a regional or global resource for interdisciplinary training. Maximum advantage should be taken for South-South cooperation in research and training among these institutions and to increasing their numbers.

The working group recommended that universities and other training centers consider implementation of the desired specialty training on a firm foundation characterized by the disciplinary breadth described in Figure 3 by initiating the following activities:

Role of Training for Specific Skills Through Short Courses, Workshops, and In-service Training

The range of alternatives for achieving advanced training is broad. They range from formal degree programs which require multiple years for completion to short courses, in-service training, workshops, professional exchanges, to field work. Thus, a successful, sustainable, coordinated effort depends upon the broad participation of universities and training centers in developed and developing countries.

Among these alternatives, short-term training was of interest to group to meet two specific objectives.

When appropriately designed, targeted approaches recognize the constraints of academic and administrative policies of institutions of higher learning, 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 upon an adequate critical mass of more extensively training persons.

Recognizing that the specific substance and process of short term training are determined by the needs of programs that are planned for implementation by countries and/or regions, the working group identified common themes (see Figure 4) and methods (see Figure 5) most often used to achieve targeted training needs. A strong potential role for modern electronic communication was assumed these discussions.

The impact of short-term training always should be measured. One general approach for assessing impact is in terms of the efficiency and efficacy of the program to which the trainee returns. In all cases impact should be based on re-entry plans that are formulated and reviewed by the trainee in consultation with his or her supervisor and the training program.

Capacity Building for Research

Research is essential to the sustained improvement of the nutritional situation of all countries regardless of developmental status. Sound research is the only tool for the identification of nutrition problems and their causes, demonstration of their importance to a country’s development, formulation of solutions, and 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 both a lack of adequate facilities and appropriately trained professionals. The most pressing need appears to be in Category II 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 meaningful 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/or 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 centers 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 favor of strategies that concentrate resources in units that either exist within such academic institutions or have clear ties to them.

Furthermore, the 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/research institutions in each region. Among the recommended criteria for the selection of regional centers 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 center should have a multi disciplinary 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 multi disciplinary breadth exists. An additional highly desirable component of advanced training is the preferential support of newly trained researchers as an important follow-up of doctorate and post-doctorate training. Such support is strongly encouraged. It may take the form of peer-reviewed programs specially designed for new graduates. It is recommended that training programs 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 obtained through less formal approaches or any of the short-term training approaches discussed earlier in this document.

Another essential component to 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 programs 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 surmised 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.

Figures

FIGURE 3. Bodies of Knowledge, Skills and Attitudes Recommended for the Core Component

FIGURE 4. Substantive Goals of Short Term Training.

FIGURE 5. Approaches for Achieving Short-Term Training

Any combination of the above

Sponsors (in alphabetical order):

Participants