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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 />

50

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