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Experiences <strong>of</strong> the<br />
Nutrition in<br />
Emergencies Regional<br />
Training Initiative<br />
By Abigail Perry, Jessica Meeker, and Andrew Seal,<br />
UCL Centre for International Health and<br />
Development (UCL-CIHD)<br />
Abigail Perry is a nutritionist with<br />
extensive experience in development<br />
and emergency work. She worked as a<br />
Research Associate at UCL and was the<br />
coordinator and lead trainer for the<br />
Nutrition in Emergencies Regional<br />
Training Initiative (NIERTI) project between 2009 and<br />
2011<br />
Andrew Seal is a Lecturer in<br />
International Nutrition at UCL where<br />
he conducts research and training on<br />
various aspects <strong>of</strong> nutrition in emergencies.<br />
He was the project manager<br />
for the work described here and is<br />
continuing the work with NIERTI partners to take<br />
forward <strong>this</strong> initiative<br />
Jessica Meeker is a graduate <strong>of</strong> the<br />
LSHTM Public Health Nutrition<br />
course, coming from a previous<br />
career in IT consultancy management.<br />
Whilst working as a Research<br />
Assistant at UCL, she conducted<br />
much <strong>of</strong> the research on Nutrition in Emergencies<br />
competencies<br />
The NIERTI project started in the Autumn <strong>of</strong> 2009 and<br />
has just concluded. The project was funded by an<br />
OFDA award to the <strong>Emergency</strong> Nutrition Network<br />
(Agreement No. DFD-G-00-09-00289-00) and implemented<br />
by UCL-CIHD.<br />
Part <strong>of</strong> the field work in<br />
the Uganda training<br />
Part <strong>of</strong> the group work in<br />
the Uganda training<br />
A Perry/NIETN, Uganda, 2011<br />
A Perry/NIETN, Uganda, 2011<br />
The upward trend in the frequency<br />
and magnitude <strong>of</strong> humanitarian<br />
disasters is set to continue and<br />
ongoing economic instability, escalating<br />
food and fuel prices, climate change and<br />
urbanisation are predicted to amplify<br />
humanitarian needs 1 . This projection <strong>of</strong><br />
increased vulnerability has implications<br />
for development; losses associated with<br />
humanitarian disasters are thwarting<br />
progress towards meeting development<br />
goals 2 . Central to efforts to protect<br />
communities and reduce vulnerability is<br />
the development <strong>of</strong> capacity to prepare<br />
for and respond to crises effectively 3 .<br />
The 2005 Humanitarian Response<br />
Review noted that the lack <strong>of</strong> capacity in<br />
the humanitarian sector hampers the<br />
quality and appropriateness <strong>of</strong> emergency<br />
response. The review provoked<br />
more detailed examination <strong>of</strong> humanitarian<br />
capacity, including a 2007 report<br />
focusing on ‘nutrition in emergencies’<br />
(NIE) 4 . This review, completed on behalf<br />
<strong>of</strong> the IASC Global Nutrition Cluster<br />
(GNC), identified two key NIE capacity<br />
gaps: (i) inadequate ‘resident’ capacity<br />
and (ii) lack <strong>of</strong> nutritionists able to<br />
handle the demands <strong>of</strong> emergencies.<br />
A number <strong>of</strong> projects have since<br />
emerged that have attempted to address<br />
<strong>this</strong> gap. In 2008, a standard set <strong>of</strong> technical<br />
documents, known as the<br />
Harmonised Training Package (HTP)<br />
were developed 5 . More recently, the<br />
GNC has initiated a capacity development<br />
project for cluster coordinators. In<br />
addition, two projects have been developed<br />
with support from the Office for<br />
Disaster Assistance (OFDA) to the<br />
ENN 6 ; one focusing on in-service and<br />
pre-service training in NIE (implemented<br />
by NutritionWorks) and the<br />
other on the development <strong>of</strong> pr<strong>of</strong>essional<br />
short courses. In <strong>this</strong> report we<br />
discuss the key findings from the second<br />
<strong>of</strong> these projects, the Nutrition in<br />
Emergencies Regional Training<br />
Initiative (NIERTI).<br />
NIERTI objectives<br />
The overall goal <strong>of</strong> the NIERTI was to<br />
increase the availability <strong>of</strong> regular, high<br />
quality training in emergency nutrition.<br />
Two principles underpinned the development<br />
<strong>of</strong> the training model. First, we<br />
viewed capacity development in the<br />
broadest sense and thus as a process that<br />
requires investment in three levels <strong>of</strong><br />
capacity: (i) the individual, (ii) the<br />
organisation and (iii) the enabling environment<br />
7 . Keeping <strong>this</strong> in mind, we<br />
elected to focus on strengthening the<br />
capacity <strong>of</strong> relatively senior national and<br />
international individual practitioners.<br />
This group represents the ‘tip’ <strong>of</strong> the<br />
human resource capacity pyramid.<br />
Although investment is needed in NIE<br />
capacity at every level, building <strong>this</strong><br />
cadre will improve organisational<br />
capacity and create an enabling environment<br />
for effective capacity development<br />
among the other cadres. Second, the<br />
training would be implemented in partnership<br />
with academic institutions. Our<br />
aim was to develop a model that has<br />
News<br />
financial and market sustainability and<br />
that can be owned and maintained by<br />
partner institutions, rather than being<br />
dependent on (unpredictable) external<br />
funding. The three partner institutions<br />
were the American University <strong>of</strong> Beirut<br />
in Lebanon, the University <strong>of</strong> Makerere<br />
in Uganda and the Asian Disaster<br />
Preparedness Centre in Thailand. All<br />
three institutions were already running<br />
nutrition courses as well as the Public<br />
Health in Complex Emergencies short<br />
course 8 . The NIERTI sought to work in<br />
partnership and strengthen and develop<br />
their training capacity in NIE.<br />
Development <strong>of</strong> the training<br />
model<br />
Cost<br />
Financial sustainability was identified<br />
from the outset as a key factor in the<br />
success <strong>of</strong> <strong>this</strong> initiative. As such, we<br />
worked closely with our partners to<br />
develop realistic budgets that ensured<br />
all the costs associated with running the<br />
courses would be covered by course fees<br />
alone. The fee level for each course was<br />
based on estimated cost and anticipated<br />
participant numbers. The<br />
budgets were reviewed and revised<br />
following each course to ensure that on<br />
one hand, course fees are kept at a<br />
minimum and access is maximised, and<br />
on the other, that the courses are financially<br />
sustainable.<br />
Content<br />
Three courses <strong>of</strong> varying duration (6, 10<br />
and 12 days) were developed and pilot<br />
tested. This process enabled us to determine<br />
the optimal duration and balance<br />
<strong>of</strong> topics. A set <strong>of</strong> learning objectives<br />
was developed for each course module.<br />
This helped to shape the content and to<br />
select appropriate course exercises. The<br />
technical content was based on the HTP,<br />
supplemented where necessary with<br />
exercises developed specifically for the<br />
initiative. Each module consisted <strong>of</strong> a<br />
technical reference document (compiled<br />
in a course manual for participants),<br />
generic PowerPoint presentations and<br />
practical exercises.<br />
Previous reviews <strong>of</strong> NIE capacity<br />
development and interviews with NIE<br />
practitioners highlighted the importance<br />
<strong>of</strong> including activities that enable<br />
participants to apply knowledge. As a<br />
1<br />
UN General Assembly Economic and Social<br />
Council (2011) Strengthening the coordinaton <strong>of</strong><br />
emergency humanitarian assistance <strong>of</strong> the United<br />
Nations. Report <strong>of</strong> the Secretary General,<br />
Geneva, July.<br />
2<br />
UNDP (2004). Reducing disaster risk: a challenge<br />
for development. UNDP, New York.<br />
3<br />
Capacity for Disaster Risk Reduction Initiative<br />
(2011) Basics <strong>of</strong> capacity development for<br />
disaster risk reduction.<br />
4<br />
Gostelow L (2007). Capacity development for<br />
nutrition in emergencies: beginning to synthesise<br />
experiences and insights. NutritionWorks / IASC<br />
Global Nutrition Cluster.<br />
5<br />
NutritionWorks, ENN, GNC (2011). Harmonised<br />
Training Package revised modules, v2.<br />
http://www.ennonline.net/htpversion2<br />
6<br />
See ENNs 5 year strategy that reflects capacity<br />
development on NiE as one <strong>of</strong> ENNs priority<br />
activities, http://www.ennonline.net/pool/files/<br />
reports/enn-5-year-strategy-2010-to-2015-final.pdf<br />
7<br />
See footnotes 3 and 4<br />
8<br />
http://www.phcetraining.org/<br />
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