|Food and Nutrition Bulletin Volume 18, Number 2, 1997 (UNU Food and Nutrition Bulletin, 1997, 118 pages)|
|Role of training for specific skills through short courses, workshops, and in-service training|
Efforts towards improvement in nutrition the world over have not had the desired impact, because scientific knowledge has not been translated into population-specific strategies and interventions. Many national governments have instituted programmes committed to the goal of eradicating malnutrition. To attain this goal, over the years they have sent cadres of young scientists to developed countries for training and have invited skilled expatriates to collaborate with local institutions to upgrade national human resources. Several developing countries now have a second-generation cadre of well-trained nutrition scientists, who are more than equal to the task of directing undergraduate and graduate training in their fields. Even so, their efforts to attenuate the problems of malnutrition have met with little success.
Key reasons for this failure are that an understanding of the culture and behaviour of local populations and the integration of this understanding into programmes and policies often are missing. Until very recently, lessons learned from social and behavioural sciences have not been integrated into nutrition training programmes. Thus, despite the fact that many of these programmes presently are run by local personnel, input from local cultures and behaviour is seldom used to enhance the effectiveness of intervention programmes. The evaluation of the social context of food and nutrition in the community to uncover specific social problems is an essential step to designing problem-oriented approaches to malnutrition .
As a result of the predominance of narrowly focused nutritional science training programmes, descriptive presentations of malnutrition have dominated the concerns of strategic planners in developing countries. However, making progress against malnutrition requires not only the provision of adequate descriptive information, but also the abilities to diagnose the causes of malnutrition, predict changes in malnutrition risk over time, identify populations at risk for malnutrition, design effective and sustainable interventions, and evaluate their impact appropriately.
To combat malnutrition effectively, the appropriate institutions in developing countries must generate knowledge about the communities and the individuals who are nutritionally most vulnerable. This knowledge should then be translated into policies and programmes aimed at alleviating malnutrition. With continuous feedback, an interface between action and research can be maintained, and new knowledge can be generated and used to improve programme effectiveness in a dynamic manner. Evaluation should be an integral part of any planned health-care effort and can be integrated easily into nutrition programmes .
The crucial nature of the problem of malnutrition argues for practitioners of the discipline to have at their disposal the full array of the tools of the social sciences and of evaluation research. It has been suggested that training models borrowed from engineering be considered . Given the multifactorial and multidimensional origins of malnutrition, we should integrate insights and tools from other disciplines that will clarify the nature of the problem and point to possible solutions.