Symposium, World Congress of Public Health Nutrition, Las Palm

« Repenser la formation universitaire en nutrition en Afrique »
Symposium, World Congress of Public Health Nutrition, Las Palmas
11 novembre 2014
Organisateurs: Delisle Hélène, TRANSNUT, Centre Collaborateur de l’OMS sur la transition nutritionnelle
et le développement, Université de Montréal; Sodjinou Roger, UNICEF- Bureau régional pour l’Afrique de
l’ouest et centrale /OOAS (Organisation ouest-africaine de santé), Burkina Faso
Mise en contexte: La nutrition est à la fois un déterminant majeur de la santé et un objectif important du
développement. Pourtant, elle n’a pas bénéficié de toute l’attention qu’elle méritait, ce qui peut expliquer
que la santé maternelle et infantile n’ait pas davantage progressé dans les pays en développement.
Heureusement, il y a depuis peu une mobilisation de la communauté internationale en faveur de la nutrition
et pour atteindre les résultats escomptés, le renforcement des capacités est une condition critique. Même
dans les pays à faible revenu, il importe de se préoccuper non seulement des troubles nutritionnels de
carence, mais aussi des troubles qu’on dit « de surcharge » tels qu’obésité, diabète et maladies cardiovasculaires. La prévalence de ces maladies non transmissibles augmente à une allure vertigineuse, ce qui
représente un obstacle au développement socio-économique et une menace sérieuse pour des systèmes
de santé déjà fragiles. La nutrition est au cœur de la prévention et de la prise en charge de ces maladies
chroniques; elle est également indispensable pour les politiques, les programmes d’intervention et la
recherche. Même si ce n’est pas suffisant, la formation de nutritionnistes professionnels de niveau
universitaire est indispensable au renforcement des ressources humaines en nutrition; cette formation doit
se fonder sur les besoins et les compétences attendues. La pénurie de cette catégorie de professionnels de
la santé est surtout marquée en Afrique francophone. La formation académique initiale et continue en
nutrition d’autres catégories de professionnels, en santé mais aussi en éducation et en agriculture, est
également nécessaire au progrès nutritionnel.
Objectif: Le symposium entend mettre en exergue les besoins de formation en nutrition de même que des
initiatives récentes en la matière, l’accent étant mis sur l’Afrique francophone.
Description: Au cours de la dernière décennie, le renforcement des capacités en nutrition est devenu objet
de préoccupations et d’initiatives variées. On décrira une approche systématique de formation fondée sur
les compétences nécessaires en nutrition. On fera également un bilan des formations et des besoins pour le
renforcement de la nutrition en Afrique, à la lumière des travaux menés conjointement par
Unicef/HKI/OOAS. Différents programmes de formation en nutrition récemment mis en place en Afrique
francophone seront enfin décrits et discutés.
Programme: 90 minutes
Introduction: Le double fardeau nutritionnel et ses implications de formation (5 minutes)
Pour le renforcement des capacités en nutrition en Afrique (20 min)
Vers un Master en nutrition au Mali (10 min)
Programme intégré de formation professionnelle en nutrition au Mali (10 min)
Enseignement de la nutrition dans les formations médicales, exemple de la Mauritanie
(15 min)
Un nouveau programme de licence professionnelle de nutrition au Bénin (15 min)
Discussion et conclusions (25 minutes)
Contact:
Hélène Delisle
[email protected]
Prof H. Delisle
Dr R. Sodjinou
Prof A. Akory
Mme G. Julien
Prof C. Dehah
Prof H. Delisle
TRANSition NUTritionnelle: team of 10 faculty
members, Department of Nutrition
 Mandate of TRANSNUT (2003- )

RETHINKING ACADEMIC TRAINING IN
NUTRITION IN AFRICA
REPENSER LA FORMATION
UNIVERSITAIRE EN NUTRITION EN
AFRIQUE
Hélène Delisle, professor and head of TRANSNUT
Nutrition, lifestyle transition

 Nutrition-related chronic diseases
Technical support to WHO and its partners for training, research
and communication on nutrition transition and the double
burden of malnutrition (2007-….)

Key project: 2008-2014:
Current Momentum for Nutrition

SUN movement, now in 54 countries
– Primary focus remains undernutrition and
micronutrient malnutrition
Food security and nutrition
 Nutrition in emergencies

+
Persistence of undernutrition and
micronutrient malnutrition
=
Double burden of malnutrition
– Global Nutrition Cluster

Nutrition-related non-communicable diseases:
– High Level Meeting of UN (2011)
– Global objective: 25% reduction of prevalence of
chronic diseases by 2025
1
Nutrition Actions Recommended to
Member States to Prevent NCDs

Implementation of WHO Nutrition Strategy:
– Diet, physical activity and health (2004)
» 
» 
fruits & vegetables, fibre, local foods
salt, sugar, saturated fat, trans fat
WHO Nutrition Strategy 2004



– Infant and young child feeding (2003)
» Promotion of breastfeeding

Recommandations regarding food
marketing for children
Some Nutrition Challenges
Lack of integration of programs targetting
undernutrition, food insecurity, nutrition-related
chronic diseases (and emergency nutrition)
 Insufficient coordination among donors and
their programs
 Paucity of well-trained health professionals in
nutrition, particularly to address nutrition
related non-communicable diseases


Balance energy intake to maintain normal weight
Limit energy intake from fat, reduce intake of saturated
and trans fat
Consume more fruits, vegetables, legumes, nuts and
whole-grain cereal
Limit consumption of free sugar
Limit sodium intake but consume iodized salt.
Pyramid of Nutrition Workforce
(WPHNA Capacity Building Task Force)

Academia
(Master’s)
Public Health Nutritionists
Professional nutritionists (B.Sc.),
other health professionals (MDs, nurses…)
Community health workers, non-health sector actors
(teachers, agronomists…)
2
Challenges for Nutrition Training
in Africa
Quality training to address the whole
spectrum of ‘dysnutrition’
 Undergraduate and graduate training
 Accreditation
 Continuous education
 Funding and scholarships
 Recruitment of trained professional
nutritionists in public service.

3
Current capacity for academic nutrition training in West Africa
Roger Sodjinou
Background: There is a dearth of information on existing nutrition training programs in West Africa. A
preliminary step in the process of developing a comprehensive framework to strengthen human
capacity for nutrition is to conduct an inventory of existing training programs.
Objective: This study was conducted to provide baseline data on university-level nutrition training
programs that exist in the 16 countries in West Africa. It also aimed to identify existing gaps in nutrition
training and propose solutions to address them.
Design: Participating institutions were identified based on information provided by in-country key
informants, UNICEF offices or through internet searches. Data were collected through semi-structured
interviews during on-site visits or through self-administered questionnaires. Simple descriptive and
bivariate analyses were performed.
Results: In total, 83 nutrition degree programs comprising 32 B.Sc. programs, 34 M.Sc. programs, and 17
Ph.D. programs were identified in the region. More than half of these programs were in Nigeria. Six
countries (Cape Verde, Guinea-Bissau, Liberia, Mali, The Gambia, and Togo) offered no nutrition degree
program. The programs in francophone countries were generally established more recently than those
in anglophone countries (age: 3.5 years vs. 21.4 years). Programs were predominantly (78%) run by
government-supported institutions. They did not provide a comprehensive coverage of all essential
aspects of human nutrition. They were heavily oriented to food science (46%), with little emphasis on
public health nutrition (24%) or overnutrition (2%). Annual student intakes per program in 2013 ranged
from 3 to 262; 7 to 40; and 3 to 10, respectively, for bachelor’s, master’s, and doctoral programs while
the number of graduates produced annually per country ranged from 6 to 271; 3 to 64; and 1 to 18,
respectively. External collaboration only existed in 15% of the programs. In-service training programs on
nutrition existed in less than half of the countries. The most important needs for improving the quality
of existing training programs reported were teaching materials, equipment and infrastructures, funding,
libraries and access to advanced technology resources.
Conclusions: There are critical gaps in nutrition training in the West Africa region. The results of the
present study underscore the urgent need to invest in nutrition training in West Africa. An expanded set
of knowledge, skills, and competencies must be integrated into existing nutrition training curricula. Our
study provides a basis for the development of a regional strategy to strengthen human capacity for
nutrition across the region.
Keywords: nutrition; nutrition training; public health nutrition; capacity development; mapping;
curriculum development;
West Africa
11/19/2014
Presentation outline
Current capacity for academic nutrition training in West Africa
Roger Sodjinou, Ph.D.
III World Congress of Public Health Nutrition
Las Palmas de Gran Canaria, Spain
November 11, 2014 West Africa is among the regions that are most affected by malnutrition
•
•
•
•
•
•
Background Rationale for the study
Study objectives
Methodology
Results and discussion
Conclusions
Capacity development: a key factor to the success of nutrition programs
Communication
Communities
Linkages with other sectors
Success factors‐
nutrition programs
Situation analysis
Capacity development
Corporate social responsibility
Black RE, Victora CG, Walker SP, Bhutta ZA, Christian P, de Onis M, Ezzati M, Grantham‐McGregor S, Katz J, Martorell R, Uauy R, Maternal and Child Nutrition Study Group: Maternal and child undernutrition and overweight in low‐income and middle‐income countries. Lancet 2013, 382(9890): 427‐51. Political commitment
Partnership
Resources
Adapted from UNICEF, Tracking progress on child and maternal nutrition, 2009
1
11/19/2014
Momentum built on nutrition capacity development in West Africa
The West African Nutrition Capacity Development Initiative (WANCDI)‐ 2013 Dakar nutrition capacity development workshop, March 2009
Complete consensus amongst the participants about the need to strengthen the capacity for nutrition training and research in the West African region
Address capacity gaps at individual level
Strengthen institutional and human capacity to accelerate progress for nutrition in the West Africa region
ECOWAS Assembly of Health Ministers, Yamoussoukro, July 2009
Adoption of a nutrition resolution calling on the West African Health Organization and partners to implement the recommendations of the Dakar workshop
16 countries covered
Data collected between April and August 2013
•
•
Systematic capacity assessment that looked beyond individual training needs
Performance capacity
Individual
Enable
effective
use of
Focus on capacity gaps/assets at individual, organizational and systems levels
Systemic
Require
Skills
Enable
effective
use of
Organizational
Address capacity gaps at systems level
IMPROVED PUBLIC HEALTH OUTCOMES IN WEST AFRICA Rationale for the study
Tools
Enable
effective
use of
•
IMPROVED CAPACITY TO ACT IN NUTRITION
Build on existing capacities
Region‐wide nutrition capacity needs assessment
•
Address capacity gaps at organizational level
Personal capacity
Require
Infrastructure
Staff
Workload/supervisory
capacity
Facility/support service
capacity
Require
Structures Systems
Structural capacity
Systems capacity
Roles
Role capacity
• There is a dearth of information on existing nutrition training programs in West Africa
• A preliminary step in the process of developing a comprehensive framework to strengthen human capacity for nutrition is to conduct an inventory of existing training programs
Potter, C., and R. Brough. 2004. Systemic Capacity Building: A Hierarchy of Needs. Health Policy and Planning. 19(5): 336‐345.
2
11/19/2014
Study objectives
• To provide baseline data on university‐
level nutrition training programs that exist in the West Africa region
METHODOLOGY
• To identify existing gaps in nutrition training and propose solutions to address them
Participating institutions (2)
Participating institutions
Language used
• Institutions offering a degree‐granting program on human nutrition at the time of data collection
• Degree programs heavily weighted to food science, food technology, and biochemistry were excluded
French
English
Total
Countries
Benin
Burkina CIV
Guinea
Mali
Mauritania
Niger
Senegal
Togo
Sub‐total
Ghana
Liberia
Nigeria
S‐Leone
The Gambia
Sub‐total
# of participating institutions # of training programs assessed
2
7
4
12
13
5
23
9
2
77
5
2
24
5
1
37
114
13
26
9
24
18
15
57
34
2
198
15
2
68
22
1
108
306
Methods used to collect information about training programs
Questionnaire (direct interview or self‐admin.)
13
26
9
24
3
15
44
34
2
170
14
2
29
22
0
67
237
Literature review and internet search
0
0
0
0
15
0
13
0
0
28
1
0
39
0
1
41
69
3
11/19/2014
Study variables
Data collection
Compilation of a list of training institutions in each country based on information provided by key informants, UNICEF COs or through internet search Age of program
The process of updating the list continued through the entire data collection period
Respondents completed and returned the survey questionnaire
On‐site visits
Language of instruction
Existing nutrition training programs Program format
Major components of training curriculum
Brief introductory e‐mail/questionnaire sent to the representative of each institution to explain the objectives of the assessment. Appointment for on‐site visit.
Self‐administered questionnaires (when site visit is not possible)
Duration of training program
Main funding source
Detailed inventory of existing nutrition training programs in West Africa
Number of faculty members and their level of training UNICEF COs wrote supporting letter to training/research institutions to encourage response
Information gathered through semi‐
structured interviews with the representative of each institution (or an appropriate respondent identified by him)
Type of degree awarded
School ownership
Student intake
Barriers to improving quality
Graduate outputs
Perspectives for curriculum revision
External relationships
Tuition charged per year
Data analysis
• Simple descriptive and bivariate analyses • Age of training program= 2013 ‐Year of inception of the program
• Student intake was defined as the maximum number of participants enrolled for the program
• Graduate output referred to the annual number of graduates delivered by the program
• A recommended annual output of graduates of 300 bachelor’s level, 30 master’s level, and 2 doctorate level per 5 million inhabitants (UNU/IUNS 2007) and assumed a median professional life span of 10 years
RESULTS AND DISCUSSION
4
11/19/2014
Summary of existing nutrition degree programs (n=83)
Undergraduate nutrition programs (n=32)
Master’s programs in nutrition (n=34)
Doctoral programs in nutrition (n=17)
5
11/19/2014
Mean age of training programs (years)
Characteristics of nutrition training programs
100
90
24,1
80
21,3
70
MEAN AGE (YEARS)
20
60
50
10,5
40
30
10
3,9
4,9
20
0
Government
BACHELOR'S DEGREE
MASTER'S DEGREE
Francophone
25
DOCTORATE
Tuition fees
Other sources
Main funding source (n=62 programs)
Anglophone
Theoretical
Bachelor's degree
Areas emphasized in the curriculum
Probem-oriented
training
S-South or SNorth
Program format (n=66 programs)
S-South and SNorth
None
International collaboration (n=44 programs)
Master's degree
Doctorate
Annual intakes of students (2013)
Number of training programs
20
West Africa countries
15
Benin
Burkina‐Faso
Ghana
10
Guinea
Mauritania
Niger
Nigeria
5
0
Benin
Burkina-FasoCote-d'Ivoire
Nutrition and Dietetics
Ghana
Guinea
Mauritania
Niger
Nutrition and Food Science
Nigeria
Senegal
Sierra-Leone
Public Health Nutrition
Senegal
Sierra‐Leone
Total
Student intakes
Bachelor's degree
Master's degree
Doctorate
Range*
Total**
Range*
Total**
Range*
Total**
20‐25
25
20‐100
50
30
15‐45
3‐262
‐
60
3‐262
45
25
275
50
30
125
940
‐
120
1,610
10‐30
25
10‐15
‐
30
20‐25
10‐40
7‐20
30
7‐40
75
25
3
‐
ND
‐
‐
‐
5‐10
9
‐
3‐10
3
‐
ND
‐
‐
‐
25
9
‐
37
‐
20
45
177
27
30
471
* Per program; ** Per country
6
11/19/2014
Capacity gaps‐Graduate outputs
Country
Population
Bachelor's degree
Needs
# graduates
Master's degree
Needs
# graduates
Doctorate
Needs
# graduates
Benin
Burkina‐Faso
Cape‐Verde
Gambia
Ghana
Guinea
G‐Bissau
Ivory Coast
Liberia
Mali
Mauritania
Niger
9,742,000 17,323,000 511,000 1,794,000 26,441,000 11,861,000 1,699,000 23,919,000 3,881,000 16,678,000 3,461,000 17,493,000 19‐97
35‐173
1‐5
4‐18
53‐264
24‐119
3‐17
48‐239
8‐39
33‐167
7‐35
35‐175
6
‐
0
0
107
‐
0
0
0
0
17
86
2‐10
3‐17
0‐1
0‐2
5‐26
2‐12
0‐2
5‐24
1‐4
3‐17
1‐3
3‐17
42
12
0
0
16
0
0
12
0
10
0
0
1‐5
2‐9
0
0‐1
3‐13
1‐6
0‐1
2‐12
0‐2
2‐8
0‐2
2‐9
1
0
0
0
1
0
0
0
0
0
0
0
Nigeria
Senegal
Sierra‐Leone
Togo
177,096,000 13,567,000 5,823,000 6,675,000 354‐1771
27‐136
12‐58
13‐67
271
0
30
0
35‐177
3‐14
1‐6
1‐7
64
3
15
0
18‐89
1‐7
1‐3
1‐3
18
1
0
0
Total
337,964,000 676‐3,380
517
68‐338
174
34‐169
21
50
Faculty characteristics
B.Sc. (n=17)
Faculty Doctorate or qualification above
Master’s degree or equivalent
Bachelor’s degree or equivalent
Total faculty per program
Average number of faculty per program
Individual level
Perceived needs (n=44 institutions)
Facilitate nutrition workforce preparation
45
Short‐ term
outcomes
40
30
In‐service training of NSP and other cadres
Supportive supervision, mentoring, coaching Ph.D. (n=10)
External
Internal
External
Internal
External
122
56
218
61
101
22
32
13
59
76
0
0
9
13
0
0
0
0
163
82
277
137
101
22
9.6
4.8
11.1
5.5
10.1
2.2
Organizational level
Systemic level
Facilitate nutrition workforce
planning and management
Improve systemic capacity
Job descriptions review for NSP
Regulation of the nutrition profession
Support to develop a nutrition capacity
development strategy
25
Medium‐term
outcomes
20
15
10
5
0
Upgrade nutrition Upgrade and
training curricula empower human
to the latest
resource for
developments nutrition training
Improve
equipment and
infrastructure
Improve funding Development of Access to library
Review and
More exposure of
institutional
and advanced
harmonize
students and
collaboration
technology
training curricula
more courses
(internal/external)
resources
to meet national emphasizing on
for nutrition
(computers,
or regional needs
practical
training
internet, etc.)
knowledge
Long‐term
outcomes
Percentage (%)
35
M.Sc. (n=25)
Internal
Enrich existing nutrition training programs
Improve nutrition training in health professional
schools
Integrate nutrition throughout agriculture school curricula
Establish new training programs, where needed
Ensure quality in nutrition training Training opportunities
for nutrition faculty
Infrastructure and equipment upgrade
Partnership for nutrition training
Excellence center for nutrition?
Support to develop
capacity for multi‐
sectoral coordination of nutrition activities
Support to develop
capacity for M&E of nutrition activities/ logistics systems
7
11/19/2014
Conclusions
• There are critical gaps in nutrition training in the West Africa region, especially in francophone and lusophone countries
• There is a lack of focus on public health nutrition
• The results of the present study underscore the urgent need to invest in nutrition training in West Africa
• An expanded set of knowledge, skills and competencies must be integrated into existing nutrition training curricula • Our study provides a basis for the development of a strategy to strengthen human capacity for nutrition across the region
Glob Health Action 2014; 7: 23247
8
Integrated program for professional training in nutrition in Mali
Symposium: Rethinking Academic Training in Nutrition in Africa
(Stream: Building Effective Global Health Education and Training Programs)
Speaker: Gaëlle JULIEN, Project Coordinator, Institut Bioforce Développement
Description: Building capacities of regional, national and local actors is a key factor to ensure a
timely and appropriate response to nutritional emergencies or to address the challenges of
improving access to water in the Sahel. However, the current training offer doesn’t totally match the
needs in terms of qualified and rapidly operational experts in the region (both quantitatively and
qualitatively).
In September 2014, the Institut Bioforce has launched two French-language trainings in Mali in
partnership with UNICEF, and Action Against Hunger, and in consultation with the West African
Health Organization: “Nutrition Project Manager (Nutrition PM)” and “Water, Sanitation and
Hygiene Promotion Project Manager” (WASH PM).
This integrated vocational training program aims at enhancing capacity and capability among local,
national and international nutrition and WASH professionals in French-speaking Africa, therefore
building the resilience of local communities.
The competency-based training program is designed for professionals working both in the public
and private sectors. It is also addressing both “emergency response” and “sustainable access to
services” and is adapted to the regional context.
This new initiative also aims at breaking the common sectorial approach in encouraging links
between the Nutrition and WASH sectors (through joint sessions, and Wash In Nut module).
Length of lecture: 10 minutes
Contact information:
Gaëlle JULIEN
Institut Bioforce Développement
41 Avenue du 8 Mai 1945
69200 Vénissieux
Phone : +33 (0)4 72 89 76 66
Email : [email protected]
INSTITUT BIOFORCE AFRIQUE
19 novembre 2014
SEPTEMBER 2014 : LAUNCHING OF BIOFORCE’S LONG PROFESSIONAL TRAININGS IN MALI
+ Nutrition Project Manager (RPNUT)
+ WASH Project Manager (RPEHA)
Integrated professional trainings in Mali
INSTITUT BIOFORCE AFRIQUE
INSTITUT BIOFORCE AFRIQUE
BIOFORCE INSTITUTE : ACTOR IN TRAINING
COMPETENCY BASED TRAINING APPROACH
+ Bioforce Development Institute: French NGO / 30
years of experience in capacity building of
humanitarian aid, development, and public health
actors.
+ 1st step: Needs’ assessment:
Pressing and recurrent needs
Insufficient number and inadequate training of human resources
+ Bioforce Institute Africa: non profit organization
created in Burkina Faso to accompany and develop
activities in Africa (improve access to professional
training for French‐ speaking African professionals).
1
INSTITUT BIOFORCE AFRIQUE
INSTITUT BIOFORCE AFRIQUE
COMPETENCY BASED TRAINING APPROACH
EXPECTED RESULTS
+ 2nd step: thinking about a “job‐oriented” response
+ 90 public servants, individuals and local NGO, and
IO professionals have access to a recognized
training program
+ 3rd step: design of a job/competency framework «Nutrition Program Manager»
+ The integrated training program (WASH and
Nutrition Managers) addresses priority needs of
WASH and Nutrition sectors in an innovative way
+ 4th step: design of a training program according to the expected competencies
+ Bioforce Institute Africa is able to lead the training
program independently after 3 years
INSTITUT BIOFORCE AFRIQUE
INSTITUT BIOFORCE AFRIQUE
RESPONDING TO THESE CHALLENGES THROUGH VOCATIONAL TRAINING
PARTNERS
+ General Objective: Contribute to the improvement
of sustainable access to quality public health
services, thus building resilience of West African
communities.
+ Specific objective: Enhance capacity among French
Speaking African professionals in nutrition and
WASH sectors to sustainably address priority needs
of these 2 sectors in West Africa.
2
INSTITUT BIOFORCE AFRIQUE
INSTITUT BIOFORCE AFRIQUE
PERSONALIZED TRAINING PATHS AND COSTS
PROJECT LENGTH AND KEY DATES + September to November 2014 (3 months): Training in
Bamako (Charles Mérieux Infectiology Center)
Options
Content
Bioforce Competency Certificate
3 months
Certificate of Attendance
Full technical module (5 sessions) 4 sessions 3 sessions 2 sessions INSTITUT BIOFORCE AFRIQUE
3 000€
2 500€
2 000€
1 500€
Professional expérience
WASH PM
Framework of Humanitarian Aid and Development Practice (Core Module)
Management Essentials (Core Module)
TECHNICAL MODULES
NUTRITION
WASH
Evaluation and monitoring of nutritional Hygiene promotion/ Community situation and food security
participation
Session 2
5 days
Design and implementation of activities for the prevention of malnutrition
Session 3
5 days
Implementation and monitoring of programs for the management of acute malnutrition
Session 4 5 days
Coordination of a nutrition project with internal and external key actors
Sanitation management in emergencies and development
Session 5 7 days
Advanced notions and field exercise
Advanced notions and field exercise
Evaluation and management of the water resource
In national/international
humanitarian aid or development
Level of Training
Training Program
NUTRITION PM
Integration (Core Module)
15
6 months
4 500€
INSTITUT BIOFORCE AFRIQUE
Careers advice, assessments, Evaluation
(5 days)
Training at the Charles Mérieux Centre, Bamako (3 months)
27
Completion of two or more sessions independently
PARTICIPANTS’ PROFILES
10
Session 1
5 days
Price* 3 Competency‐ based sessions (technical module)
INTEGRATED TRAINING PROGRAM
# of days
3
Modular option
2 Full program without Training at the CICM only
qualification
+ January to August 2015 : Capitalization, adjustments,
inscriptions of the 2nd year.
+ April 2017 : end of project, sustainability through
independent funding sources (training fees &
scholarships) under the management of Bioforce
Institute Africa.
Duration
3 months These options can 5 500€
training at the be completed in CICM one unit of time, or by modules/ sessions, over several years + 6 months (maximum of 3 on the job years), to learning facilitate access (PASP)
for professionals. Training at the CICM (Bamako) & on the job learning (PASP)
+ December to May 2015: On‐the‐job learning period (6
months)
+ September 2015‐2016 : beginning of the 2nd and 3rd
training cohorts.
Qualification
For the RPEHA program: level II professional qualification (equivalent to four years university study)
For the RPNUT training course: Bioforce Competency Certificate.
1 Full program with qualification In another sector
Bachelor Minimum 1 year’s work degree or experience in one of the equivalent required fields (project manager...)
OR Minimum 4 year’s work experience in one of the required fields (project manager...)
Minimum 1 year’s work experience in one of the required fields (project manager...)
OR Minimum 2 year’s work experience in one of the required fields (project manager...)
2 or more years of university training
WASH in NUT ON THE JOB LEARNING
3
INSTITUT BIOFORCE AFRIQUE
INSTITUT BIOFORCE AFRIQUE
PROGRAM’S SUMMARY
MID‐TERM RESULTS
44 Participants trained
+ Integrated vocational trainings NUT/WASH
+ Accessible trainings : West African territory ;
personalized training paths…
+ Contents based on recognized competency
frameworks
+ Program including both
managerial competencies
technical
and
24 NUTRITION PROGRAM MANAGERS
15 QUALIFYING
9 NON QUALIFYING
40% from public sector
50% from NGO sector
10% individuals/private sector
INSTITUT BIOFORCE AFRIQUE
INSTITUT BIOFORCE AFRIQUE
PROGRAM’S SUMMARY
MID‐TERM RESULTS + Trainings allow participants to be operational
right at the end of the cursus
+ Permanent adaptation of contents and training
tools to employers’ needs
+ Pedagogy coming from practice and oriented
towards practice
20 WASH PROGRAM MANAGERS
+ 8 nationalities : Burkina‐Faso, Burundi, Ivory Coast, Mali, DRC, Tanzania, Chad, and Togo. + Recruitment 10 national and sub‐regional trainers/ experts
+ Participants are actors of their own training
4
INSTITUT BIOFORCE AFRIQUE
NEXT STEPS
+ From December 2014: On‐the‐job learning period (6 months)
+ February 2015 : Improvement Committee with all implied stakeholders
+ April 2015: launching of the recruitment of 2nd
cohort of trainees
5
Enseignement de la Nutrition dans les Formations Médicales: Exemple de la Mauritanie
Colloque: Repenser la Formation Universitaire en Nutrition en Afrique
Conférencier: Cheikh Mohamed El Hafed Dehah, Professeur à l’Université des Sciences de
Technologie et de Médecine de Nouakchott, Mauritanie
Résumé du Processus: L’un des défis majeurs que doit relever nos pays en matière de santé publique
ces dix à vingt prochaines années, c’est de pouvoir disponibiliser une masse critique de prestataires de
santé – du Médecin à l’Infirmier – capables d’appréhender, d’évaluer, de prendre en charge et
d’accompagner cette inéluctable transition nutritionnelle et son double fardeau et impact sur le plan de
la santé humaine.
1. Une étude sur l'état des enseignements et enseignants de la nutrition à l'Université et dans les écoles
de santé en Mauritanie a été diligentées par l’UNICEF entre les mois de juillet et Octobre 2009
2. A la suite de la validation de cette étude, l’UNICEF en coopération avec le DRH du Ministère de la
Santé et la Faculté de Médecine de l’USTM de Nouakchott a appuyé, de mars à juin 2010, un
processus d’élaboration de modules de Nutrition en faveur des Ecoles de Sante, et l’initiation d’un
processus de réflexion au sein de la Faculté de Médecine pour l’intégration de la nutrition dans le
cursus des futurs praticiens
Résultats du processus :
Ecoles de Santé Publique
1. Des modules de Nutrition pour les Ecoles de Santé publique (ESP) furent élaborés en avril-mai-juin
2010
2. Réorganisation des modalités d’enseignement de la Nutrition dans les Ecoles de Santé
3. Formation de formateurs sur les nouveaux modules en août 2010
4. A la rentrée universitaire 2010-2011 intégration des nouveaux modules, comme phase pilote, dans
le programme de deux Ecoles de Santé sur instruction du Ministère de la Santé,
5. Septembre 2011, après une année d’enseignement sur la base des nouveaux modules, une
évaluation de ceux-ci fut menée
6. Janvier - avril 2012, réorganisation, correction et traduction en arabe des modules qui sont ensuite
disponibilisés aux niveaux des 05 ESP du pays
7. Octobre 2012, intégration officielle des modules dans le cursus des écoles comme support des
enseignements de Nutrition
Faculté de Médecine
1. Décembre 2011, adoption officielle d’une feuille de route pour l’intégration de la Nutrition dans les
différents cycles d’enseignement, de l’année PREPA à la DCEM4 (6ème année)
2. La mise en œuvre de cette feuille de route a effectivement pris effet dès 2012, par l’intégration et
l’enseignement d’un module de Nutrition dans le programme PREPA (10h de cours)
3. Durant l’année universitaire 2013-2014, l’enseignement d’un module de Nutrition en DCEM4
(6ème année, 12h de cours) a été officialisé et mise en œuvre par le Département de Santé Publique de
la FM
4. Le challenge continue pour 2014-2015
La conduite d’un enseignement en Nutrition à la Faculté de Médecine de l’USTM de Nouakchott et
dans les ESP de la Mauritanie, aura permis de valoriser le concept de la nutrition autant préventive
que thérapeutique dans le mental du futur praticien. Il aura suffit pour cela de transposer des
connaissances théoriques en recommandations concrètes et en actes pratiques en adaptant les
stratégies d’enseignement nutritionnel au profil du praticien de la santé et de son environnement
socio-sanitaire.
Durée de la conférence: 15 minutes
Coordonnées :
Pr Cheikh Mohamed El Hafed Dehah
Responsable Master Nutrition Santé
Université des Sciences de Technologie et de Médecine
Cell : (00222) 46595222 / 36253570
E-mail : [email protected] / [email protected]
Skype : dehahcmh
1
2014-11-19
PREAMBLE

Nutrition as a training subject for
medical students at the university and
at the hospital is a recent concept, still
fragile and little developed
Las Palmas Gran Canaria le 11 Novembre 2014
CHALLENGES (1)
 One of the major public health challenges of
African countries for the next 10-20 years is
to reach a critical mass of health
professionals who are capable of assessing
and managing the double burden of
malnutrition associated with the nutrition
transition.
CHALLENGES (2)
 Two
nutrition-related public health priorities
call for adequate training of all health
professionals in order to improve
management and prevention:


Undernutrition
Obesity.
1
2014-11-19
A recent survey (2007) among members
of an Association of obese subjects
(www.pulpeclub.com) revealed that
nearly half the respondents considered
that their medical doctor did not have
the skills to help them, technically and
from a human standpoint.
Eating is a routine daily activity of
everyone. For this reason, several people
believe that they have adequate skills in
nutrition. This is a barrier to
appropriate intervention, at group and
individual level.
Nutrition competes with other medical
subjects, particularly therapeutic
disciplines, which are more attractive
and better paid, in a context of limited
medical resources.
2
2014-11-19
Medical doctors and medical students are not
much interested in nutrition. WHY IS THAT?

Training-related reasons:

Unsophisticated: no need for highly technical tests
(biological, imagery…)

No obvious results: Nutrition interventions in
general only have long-term effects.
And yet……
There is evidence of
benefit in training health
providers in nutrition
! Impact of Malnutrition on Health,
Education and the Economy !
Lower resistance to
infection
Increased mortality risk
Learning disabilities
 Negative impact of undernutrition
hospitalized patients on:
 the effectiveness of care
 The cost of care
in
 Increasing medical costs of nutritionrelated diseases, which call for therapeutic
nutrition approaches and prevention policies
Reduced activity
3
2014-11-19
We cannot solve a problem with the same
thinking process that created the problem.
Albert Einstein
Status quo is not an
alternative!!!
 A survey on the status of nutrition training and
nutrition trainers at the University and in Public
Health Schools of Mauritania was conducted in July –
October 2009 with UNICEF support
 Following this study, UNICEF, in collaboration with
the Human Resources Division of the Ministry of
Health and the Faculty of Medicine of the University
of Mauritania in Nouakchott initiated the
development of nutrition training modules for Health
Schools and undertook a reflection process for the
integration of nutrition in the curriculum of the
Faculty of Medicine
THE EXAMPLE OF MAURITANIA
4
2014-11-19
SCHOOL OF PUBLIC HEALTH (1)
Nutrition modules for Public Health Schools (ESP)
were developed between April and June 2010
 The approach to nutrition training in ESP was
modified
 Training of trainers on the new nutrition modules
was conducted in August 2010
 During the academic year 2010-2011, the new
modules were integrated into the curriculum of two
Public Health Schools, on a pilot basis, as required by
the Ministry of Health

SCHOOLS OF PUBLIC HEALTH (2)
FACULTY OF MEDICINE
 After one year of implementation of the new
nutrition training modules, an assessment was
conducted in September 2011
 In December 2011, a master plan for the
integration of Nutrition into the curriculum of
medical studies, from premed to the last year (6th)
was officially adopted
 The implementation of the plan started in 2012
with the integration of a 10-hour nutrition module in
the premed curriculum
 During the 2013-2014 academic year, a 12-hour
nutrition training module was officially introduced
in the 6th year of medical studies, and it was given by
the Public Health Department of the Medical School
The nutrition training is on-going in 2014-2015
Between January and April 2012, the nutrition
modules were revised, corrected, and translated into
Arabic before being made available to all 5 ESP of the
country
 In October 2012, the nutrition modules were
officially integrated into the curriculum.
5
2014-11-19
The introduction of nutrition training in the
Faculty of Medicine of the University of
Mauritania in Nouakchott as well as in Public
Health Schools resulted in raising the profile
of nutrition among the future health
practitioners, whether in curative or in
preventive care. This was possible thanks to
the translation of theoretical knowledge into
concrete recommendations and practical
moves to adapt nutrition training strategies
to the profile of health care providers, and to
their social and health environment.
RECOMMENDATIONS

To introduce compulsory nutrition training in the
basic curriculum of medical doctors, dentists,
pharmacists, nurses and assistant-nurses. The
training should encompass food groups,
recommended intakes, and information on
screening and management of obesity and
undernutrition

To foster continuous education in nutrition for all
health professionals.
6
New academic training programs in nutrition and health in Benin. Delisle Hélène,
University of Montreal, Department of Nutrition, Faculty of medicine.
Background: Non-communicable diseases (NCD) are now a major health issue in lowand middle-income countries. Diabetes and cardiovascular diseases are among the four
NCDs now recognized as a priority. Nutrition is central to NCD management and
prevention, as well as for adequate policy, program delivery and research. In sub-Saharan
Africa and particularly in French-speaking countries, academic training in nutrition has
tended to focus on undernutrition and other deficiency diseases, as well as on food. In
order to also address nutrition-related NCDs and to promote good nutrition, a public
health and a clinical nutrition focus are required.
Purpose: In the framework of a university partnership project on the double burden of
malnutrition funded by Canada (2008-2014) and involving academic partners of Benin,
Burkina Faso and Mali, two new training programs in nutrition were developed at the
Abomey-Calavi University in Benin: a regional Master’s program and an undergraduate
professional program. The purpose was to strengthen the professional workforce in
nutrition in order to address the whole spectrum of nutrition disorders from a public
health perspective, thereby contributing to nutritional health of the population.
Methods: Following needs assessments, the Master’s and Bachelor’s programs were
developed according to the LMD reform (licence, master, doctorat), based on
competencies to develop and keeping in mind the complementary nature of these
professional levels. The new regional Master’s program in nutrition and population health
offered at the Regional Public Health Institute (IRSP) of Benin is a two-year program
open to university graduates preferably with a few years of relevant practical experience.
Following a common training core of a few months with other public health disciplines,
the nutrition program is primarily based on problem solving and the required knowledge
and attitudes : community-based food security and nutrition diagnosis, intervention and
evaluation, along with advocacy for policies and programs, and social marketing. The
undergraduate professional program in nutrition and dietetics for college (or paramedical)
graduates is the first of its kind in French-speaking Africa. The students are trained
during three years as professional generalists in nutrition, in order for them to perform
adequately in clinical and public health settings, whether in public or private institutions.
Their competencies encompass the management of all forms of malnutrition, the nutrition
management of clinical conditions, the promotion of healthy eating and lifestyle, and the
administration of food and nutrition programs. Several months of internship in hospitals,
communities and food catering facilities are integrated in the program. Intensive training
of trainers took place on-site through mentoring and at University of Montreal.
Results and conclusion: The Master’s and the Bachelor’s programs are now in full
operation. Two cohorts of Master’s students from 5 different countries (n=20) have now
graduated and are involved in nutrition work. The bachelor’s program has produced a
first cohort of 17 graduates and a second one of roughly the same size is soon to complete
the program. Challenges are for Master’s students to obtain a scholarship and for the
Bachelor’s program to meet the high demand from candidate students whereas their
number has to be limited to 25 per cohort in view of space and internship placement
requirements. It is too soon to tell whether the graduates will find appropriate
employment.
The Department of Nutrition,
Faculty of Medicine


New academic programs in nutrition and
health in Benin


Hélène Delisle, PhD
Professor, Founding member of TRANSNUT, University of
Montreal

1942: Institute of Dietetics and Nutrition opened by
the Faculty of Medicine
1946: First Master’s program offered
1956: Quebec first province to register dietitians as
professionals
1974: The Institute becomes the Nutrition
Department of Faculty of Medicine
1979: Ph.D. program initiated
Department of
NutritionTraining Programs
The Department of
Nutrition
Other Faculties
& Schools
Other Departments (18):
-Clinical Sciences
-Basic Sciences
-Health Sciences
Faculty of Medicine
Department of
Nutrition
University Hospitals
Faculty of
Graduate Studies
School of Public Health :
-Social & Preventive
Medicine
-Health Admin.
- Environ. &
Occup. Health
Research centres

Undergraduate
~ 230 students
B.Sc. (nutrition) + professional registration as
dietitian/nutritionist
 Post-graduate
~ 130 students
– Certificate (15 credits)
6
– Diploma of specialized studies (30 cr.)
15
– M. Sc. (45 cr.)
89
» Research
» Professional (clinical /international/community)
– Ph.D. (84 cr.)
30
1
Department of Nutrition « Architecture » of the program
Themes
Nutrition Nutrition and Nutrition and
and disease
lifecycle
food systems
A Hub on the Double Burden of
Malnutrition in French-speaking
Africa
CIDA-funded UPCD project 2008-2014
Areas
Public Nutrition
Communities,
populations
Applied Nutrition
Individuals, groups
Fundamental
nutrition Cells,
organs, animal models
Epidemiology; Policy & programming;
Surveillance & Advocacy; Food security and
Safety; Education & Communication
Clinical
nutrition
Preventive
nutrition
Biochemistry; Physiology &
metabolism; Genetics;
Molecular biology
Management,
Marketing,
Consumer
behaviour
Food sciences
Partners of DFN Project




Benin
– IRSP - Regional Institute for Public Health, &
Faculty of Health Sciences, U Abomey-Calavi
– ISBA - Institute for Higher Biomedical
Sciences
Burkina Faso
– IRSS – Institute for Health Science Research
Pr Victoire
– University of Ouagadougou
Agueh, IRSP
– HKI Helen Keller International
Mali
– Department of Endocrinology U of Bamako
– Santé Diabète (NGO)
WHO: AFRO; country offices; Inter-country
Technical support Office, Ouagadougou
Institut régional de santé
publique, Ouidah, Bénin,
principal partner
Strategy of the DFN Project
2. Research
3. Advocacy &
Communication
Partnership
1. Capacity
Building/Training
Improved Nutritional
Health of Population
2
Component 1 - Human resources
training in Nutrition

Training of trainers
– University of Montreal
– In the field

Expected competencies
M.Sc. in Public Health
Nutrition
New regional academic programs in Bénin:
– Master of Public Health Nutrition, IRSP, 2y program
2009 (n=30)
– Professional B.Sc. (licence) in Nutrition and Dietetics,
UAC, 3y program 2010 (n=30)

New regional academic programs Bénin
Intensive short courses
– Nutrition transition and the double burden of
malnutrition
– Management of severe malnutrition
 To design policies, programs  To contribute to the development
and projects
of programs and projects
 To identify food and
nutrition problems and their
determinants particularly at
community/population level
 To select appropriate
interventions for the
population
Professional B.Sc. in
Nutrition and Dietetics
 To develop communication
 To communicate effectively
plans to influence policy
with patients, clients, other
(advocacy) and change
professionals and the media
behaviours
 To develop partnerships with
 To collaborate efficiently with
other sectors involved in nutrition other professionals
To train other professionals in
nutrition


To conduct research
To train field workers in
nutrition (health, agriculture,
community development…)
 To apply research results for
better practices

 To identify food and nutrition
problems and their determinants at
individual, household and
community level
 To contribute to on an intervention
plan at individual (clinical nutrition) or
community level (public health
nutrition)
Job profile
Expected competencies (cont.)
M. Sc. in Public Health
Nutrition
Professional B.Sc. in
Nutrition and Dietetics
M.Sc. graduates, specialized in
public health nutrition
(IRSP)
 Nutrition officers in charge in:
B.Sc. graduates, professional
nutritionists (UAC)

– Government bodies
– NGOs, international agencies
– Programs or projects

Consultants for:
– Project/program planning
– Evaluation

– Management of clinical Nutrition
units/services
– Counseling in Nutrition

Executing agents in Nutrition
projects/programs in:
– Government bodies
– NGOs, international agencies
Trainers/researchers in:
– Academic programs
– Informal training programs
Members of health care teams in
hospitals and health centres

Educators/communicators
– Training of field workers
– With the media
– In private companies
3
Professional B.Sc.
Lab Food Standardization
Integrated internship
7 months total during the program
1st year, before
practicum in Group
Feeding
Year
Domain
Weeks
1st
Institutional feeding
4
2nd
Clinical Nutrition I
6
Community Nutrition I
6
Clinical Nutrition II
6
Community Nutrition II
6
3rd
14
Pediatric Unit, University
Hospital Cotonou
Training of Trainers, Clinical
Nuttrition, Montreal
Dr Florence
ALIHONOU
and Dr
Adebayo
ALASSANI
4
TRANSNUT-DFN Ph.D.
graduates
Charles
Charles
Daboné 2012
Sossa 2013
Burkina
Bénin
Colette
Azandjèmè
2014 Bénin
Technical support, University of
Montreal
Augustin Zeba 2013
Burkina
18
First Graduates (17), B.Sc. Program in
Nutrition and Dietetics, FSS, Benin
December 2013
Benin Food Guide as
Communication Tool
5
Sustainability Perspectives
Trainers trained
School of Nutrition and Dietetics created at
Abomey-Calavi University
 Training program on-going and high demand
 However:


– Limited hiring of B.Sc. nutritionists by
government: more advocacy required
– Facilities insufficient to accomodate more
students from Benin and other countries
www.poleDFN.org
Beyond Human Resources, in
order to Tackle the Double
Burden of Malnutrition

Poverty reduction for food security

More sustainable local food systems and
promotion of traditional foods

Lifecycle approach to prevention, with
emphasis on mothers and children

Promotion of healthy weight and physical
activity as social norms.
Institut régional de
santé publique
(IRSP), Bénin
Thank you!
Université de Montréal
23
24
6
Suite au symposium sur le renforcement des capacités en nutrition en Afrique de
l’ouest, Las Palmas, 11 novembre 2014
Voici les recommandations faites pendant ou en marge sur symposium, afin de
renforcer les capacités en nutrition :
•
•
•
•
•
•
Il faut mettre l’accent sur une formation niveau licence, la base de la pyramide de la main
d’œuvre, et faire du plaidoyer pour la création de cette filière professionnelle au niveau
du Ministère de la santé et de la fonction publique
Des bourses sont nécessaires pour le Master
Un Master international ou tout au moins régional devrait être créé, dont une partie en
ligne et une partie en présentiel
Il faut poursuivre les efforts pour rapprocher les secteurs de l’agriculture et de la santé
autour de la nutrition, qu’il s’agisse des formations ou des interventions
Les formations continues ou pour le personnel en fonction devraient autant que possible
être logées aux universités, ce qui aurait pour résultat de renforcer ces dernières
Les ONG absorbent une large part des diplômés de nutrition, niveau licence (Mauritanie,
Bénin) comme niveau Master. Il ne serait que légitime qu’elles contribuent à un fonds de
bourses.