New directions

What, then, is the solution? How can nutrition training be improved in a manner that will make a tangible difference? A more targeted approach to the problem of malnutrition is clearly required. Third-world institutions should assess their own strengths and weaknesses relative to their tasks. Each institution should examine its financial, human, political, and organizational resources. This assessment of capabilities may reveal key weaknesses. The institution can then evaluate the relative capabilities of other institutions in carrying out such tasks, their policies, and their willingness to help, and can formulate strategies to obtain assistance from other organizations or institutions. To build such capacity internally without any external support is a major task for third-world institutions. The resources and expertise of centres of excellence in the developed countries should be utilized to accomplish these goals. Such a strategy also promotes the development of centres of excellence throughout the world.

Nutrition training institutions and programmes need to develop self-evaluation techniques. However, the biggest problem for many institutions in the third world often is competition over resources with other institutions. Third-world nutrition training institutes will continue to require external funding assistance. Funds from developed countries should be used to build the capabilities of third-world institutes rather than to finance the formal education of a few individuals from the developing world at institutions in the developed world, as is commonly the case at present. The latter strategy has several disadvantages: it is more expensive, and personnel trained abroad over a long period of time may not fit well into the existing systems upon their return to their home countries and, in some cases, may not even return.

Developing countries require the cooperation of the developed world to upgrade the skills of nutrition experts from developing countries in the use of technology and to encourage these experts to use data from their own countries in training. Specific skills often are provided best through short courses, workshops, and in-service training. Unlike formal education, short-term training is flexible, emphasizes experiential learning, and is more responsive to changing nutritional needs and problems. Such training can be accomplished by concerted, collaborative efforts of local, regional, and international institutions. The local efforts should include training in data management and analysis and the dissemination of specific skills and technologies. Regional efforts require cooperation between institutions within and among developing countries to facilitate and promote the exchange of information and skills. At the international level, institutions in the developed world may upgrade the skills of nutritionists from the developing world or send experts to developing countries to train local nutritionists and other professionals in allied fields. The training institutions in developed countries will continue to attract degree candidates from abroad. Ideally, even nutritionists from the third world who pursue formal degrees in developed-country institutions should be encouraged to use data from their own countries in their training to assess and evaluate local nutritional conditions.