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The first Regional
Workshop:
The
first Regional Workshop on Nutrition Capacity Development was
held in Cairo Egypt, for two consecutive days (14-15 July 2004).
It was organized, hosted and conducted by the National Nutrition
Institute/ Egypt and the Egyptian Task Force for Nutrition
Capacity Building and Development
The workshop was
funded and supported by UNU/FNP. Dr. Cutberto Garza / UNU / IUNS
supported the the workshop and Dr. Osman Galal; Secretary
General of IUNS invited many country representatives through
IUNS Adhering Bodies.
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The
meeting was attended by 33 participants representing 11
countries from the region (Sudan – Kuwait - Lebanon – Oman –
Libya – Saudi Arabia – Yemen – Jordan – Palestine – Egypt) and
various Egyptian Organizations and Institutes under the
patronage of the Egyptian Minister of Health and
Population.(Bahrain-Iran) supported the meeting but the
representatives could not attend. IUNS was represented by two
members, Dr Osman Galal and Dr Ibrahim El Madfaa. FAO and
UNICEF were represented by one member each. WHO representative
could not attend. |
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workshop outcomes:
One of the main workshop outcomes was preparing 10-year
action plan developed by the workshop participants. The plan
was subdivided into 5 core areas (Nutrition Research, Nutrition
Training, Nutrition Academic Education and Accreditation,
Nutrition Advocacy/ Education Communication, Nutrition
Networking) which was based on a pre-developed Conceptual
Planning Framework used as a guideline for identifying regional
Nutrition Capacity Gaps and needs at different levels and then
selecting suitable strategies and activities to fill the gaps.
Core areas and main
objective:
Nutrition
Research:
Promote regional
research capacity to support the role of nutrition in prevention
and treatment of diseases
Nutrition Training:
Strengthen regional training capacity and regional
constellations / organizations with trained professionals in
nutrition.
Nutrition Academic
Education and Accreditation:
Enhance regional
academic capacity in nutrition through defining and
standardizing training requirements for regional accreditation
of nutritionists/dieticians.
Nutrition Advocacy
/ Education Communication: Promote
regional nutrition Advocacy, Communication and Education
activities.
Nutrition
Networking:
Enhance and
strengthen regional inter- country collaboration and cooperation
for NCB.
Background:
The Middle East and North Africa Nutrition Capacity Building
Initiative is part of a global initiative spearheaded by UNU
/ FNP / IUNS for Development of Human and Institutional
Capacity Nutrition.
The Purpose of this initiative is to develop and enhance
nutrition leadership and support regionally driven ten years
plans for Global Nutrition Capacity Development and Building.
This Initiative started in West, East & South Africa Regions,
and South East Asia Region & recently in Latin America.
An Egyptian Nutrition Capacity Building and Development Task
Force was the first to be established in the region. It was
housed at the Egyptian National Nutrition Institute (NNI) which
is one of the top nutrition institutes in the region that
conducts human nutrition research and offers training courses in
the field of nutrition. NNI is affiliated to the Egyptian
Ministry of Health and Population and is one of the units of
the General Organization for Teaching Hospitals and Institutes
in the Ministry of Health and Population.
Members of the task force are distinguished scientists &
nutritionists from different organizations and universities in
Egypt.
Preview:
The meeting was held at Maadi Sofitel (Hotel), Cairo Egypt, for
two consecutive days (14-15 July 2004) .It was organized, hosted
and conducted by the National Nutrition Institute Egypt and the
Egyptian Task Force for Nutrition Capacity Building and
Development
The meeting was funded and supported by UNU/FNP. Dr. Cutberto
Garza, UNU representative facilitated the proposal submitted by
Dr Azza Gohar, Egyptian National Task Force Coordinator for
funding by UNU. IUNS supported the workshop and Dr. Osman Galal;
Secretary General of IUNS shared in organizing the workshop and
invited country representatives through IUNS Adhearing Bodies.
Workshop
Participants:
The meeting
was attended by 33 participants. Secretary General of the
General Organization for Teaching Hospitals and Institutes was
representing the Minister of Health and Population. 17
participants represented ten countries from the region (Sudan –
Kuwait - Lebanon – Oman – Libya – Saudi Arabia – Yemen – Jordan
– Palestine – Egypt ). IUNS was represented by two members, Dr
Osman Galal and Dr Ibrahim El Madfaa. FAO and UNICEF were
represented by one member each. There were 13 more participants
from various Egyptian Organizations.
Representatives from Morocco, Bahrain and Iran could not make it
for logistic reasons. Representatives from UAE and Tunisia sent
their apology and supported the meeting. WHO /EMRO Nutrition
representative apologized due to duty travel. Prof Dr Mamdouh
Gabr (Chairman of Egyptian National Nutrition Sciences Committee
and Previous President of IUNS apologized due to travel
commitment.
The
workshop was under the patronage of HE the Egyptian Minister of
Health and Population Prof Dr Mohamed Awad Tag El Din who could
not come due to engagement with HE President Mubarak.
Minutes
The workshop went according to agenda
Day 1 Wednesday July 14, 2004
Registration
& distribution of materials (8:30 to 9:00 AM)
·
Registered participants received
portfolio of materials including agenda, name tag, brochures and
country material.
·
A CD with all presentations ,
worksheets, relevant reading material, country data was handed
to each participant at the end of workshop
·
List of workshop participants
identification & contact information was sent to
all participants 2 days after workshop (via email)
Opening Ceremony (9:00 to 9:30 AM)
·
Dr Azza Gohar, Coordinator and workshop organizer, welcomed the
guests, announced the opening of the workshop and introduced the
opening remarks.
·
Dr Hoda Hassan, Director of NNI, gave an introductory remark on
the importance of NCB and D in Egypt and the role of NNI in
Egypt and the region
·
Dr Yassin Wahili gave his remarks on behalf of FAO
·
Dr Osman Galal spoke on behalf of UNU / IUNS
·
Dr Abdel Hamid Abaza welcomed the guests and spoke on behalf
of HE Minister of Health & Population on the importance of both
nutrition and capacity building and their being a priority to
the Egyptian government ,then announced the start of workshop
·
Workshop objectives were described briefly by Dr Azza Gohar.
COFFEE
BREAK
Session I (10:30 to 13:30)
·
Introduction of participants (was made by each one individually)
·
Chairperson was elected ( Dr Ibrahim El Madfaa )
·
2 reporters were nominated (Dr Nahla Hawala- Dr Nawal Hamad)
·
The agenda was adopted
·
Dr Osman Galal clarified the history, origin and purpose of UNU/IUNS
Nutrition Capacity Initiative worldwide, which started in
Africa, then Asia- Latin America and now Middle East & North
Africa.
·
Dr Azza Gohar gave a short presentation on conceptual framework
for identifying regional Nutrition Capacity Gaps and needs at
different levels and how strategies and activities could be
selected with a brief explanation of planning guidelines to
apply in the regional NCB action plan.
·
Discussion
Discussion Outcomes
Main nutrition related problems in the region
The group agreed that the regional problems were well known and
are common. They are the chronic diet related non-communicable
disorders (obesity, diabetes ..etc) – micronutrient deficiencies
(IDA-IDD-VAD) - stunting –nutritional problems throughout the
life cycle (especially infants –preschoolers –schoolers and
adolescents – pregnant and lactating women – elderly )
Major constraints in the region hindering progress;
·
Nutrition is still not seen as a priority among governments
planning agenda.
·
Lack of nutrition policies and minimal investments in nutrition
·
Insufficient allocation of resources for nutrition ( both human
& monetary) compared to other health issues
·
Lack of commitments among policy- makers in sustaining
nutrition programs
·
Low wages for nutrition staff and lack of career opportunities.
·
Lack of coordination and collaboration among various sectors
that deal with food and nutrition issues.
·
Lack of local academic support in universities for offering
specialized disciplines in field of nutrition ( graduate – post
graduate levels)
·
Lack of specialized organizations/ institutions in nutrition (
in many countries )
·
Lack of regional standardized nutrition parameters/indicators
·
Lack of predictive research, most are still descriptive in
nature.
·
Lack of effective nutrition education/ communication programs
·
Lack of regional advocacy materials
·
Need to use tools of modern information technology need for
pooling of resources through network of regional centers of
expertise and learning
·
Need for more innovative training programs geared to problem
solving
·
Need for physical resources allowing knowledge and skills to be
applied in nutrition fields
·
Need for more collaboration in multi country researches
·
Need for data base on human resources in nutrition
·
Need for developing regional nutrition leadership program
·
Need for standardized training needs assessment tools for the
region
·
Need for appropriate short and medium term skill- based
training programs to overcome urgent shortfalls in nutrition
capacity
·
Lack of appropriate, clear standardized job descriptions for
nutrition workers and professional to enhance institutional
capacity
·
Need to strengthen nutrition program planning, implementation,
monitoring & evaluation.
·
Need to enhance existing institutional infrastructure in many
countries
·
Need to build nutrition information systems & data base of
intra-country & inter country surveys, researches & publications
·
Need for regional standardized research instruments & tools
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Need for assessment tools of HR & institutions in region
·
Need for adequate education, training & accreditation of
nutritionists and dietitians in the region
Areas of nutrition in need of capacity building in the region
The constraints discussed were categorized into six main areas
that capacity building should concentrate on, which are:
1)
Advocacy
2)
Training
3)
Research
4)
Networking
5)
Academic education and accreditation of nutritionists and
dietitians
6)
Nutrition education
Opportunities available for capacity building in the area.
The need of more international support similar to the UNU/IUNS
Nutrition Capacity Building initiative. Organizations/agencies
such as WHO/ UNICEF – ILSI – USAID- European Community should be
involved and support financially & technically the UNU/IUNS
initiative.
Put more emphasis on increasing awareness on nutrition in the
region. Expanding on social marketing discipline and expanding
on courses in that area.
Recommend international organizations to use regional qualified
experts in nutrition as consultants. Use also expatriates.
Upscaling the infrastructure of Nutrition Institutions /
organizations in the region as many of them are potentially
centers of excellence.
Conviction and commitment of the participants of the workshop to
achieve Nutrition Capacity Building by advocating in their local
environment to importance of nutrition.
The main regional challenges discussed were;
The changing, unstable political situations of some
countries
Instability of some countries (wars or crisis)
Increasing poverty among populations
Conviction of policy makers to support other health problem
rather than nutrition
LUNCH BREAK
Session II (14:30 to 17:30)
Country Presentations
Dr Nahla Hawala
(Lebanon)
Presented training &
Academic programs for Dietetics and accreditation requirements
and how they could be used at regional levels to upgrade &
standardize dietetics (which is a huge gap in the region)
Dr Ibrahim ElKhateeb
(Jordan)
Explained the diversity of nutrition sciences, specialties,
disciplines and even definitions of nutritionists in the region.
Also the defects in dietitians' academic programs & how to
overcome them .Also the use of survey outcomes for nutrition
advocacy.
Dr Abdel Aziz. Othaimain (Saudi Arabia)
Discussed the importance of dietetics accreditation & Role of
dietitians in promoting nutrition. Also he explained the role of
KSA council for health specialists & the scientific board for
applied medical specialties such as clinical nutrition, physical
therapy which also offers registration & training to dietitians
to build their capacity & reputation.
Dr Deena Al Asfor (Oman)
After the coffee break she presented the experience of Oman in
institutionalizing dietetics practice she also explained the
tools & requirements for HR assessment in health services & how
it could be applied at regional level .Also she described the
strengths and weaknesses of community level NCD experiences
specifically CSG volunteers (community support group) in Oman.
She distributed a copy of the Manual of Clinical Dietetics (
part I ) prepared by MOH /Oman to the country representatives as
a model of (job description - referral system- protocol of
nutrition screening & assessment -management of severe
malnutrition ( PEM )- & recording forms & sheets.
Dr Azza Gohar (Egypt)
Described the NCD experience in Egypt related to the NNI and the
national task force for NCD. She explained the history &
structure of its formation and the activities done in the short
time since the establishment of the task force .Some of the
main activities were a national seminar (hosted by NNI) and
supported by the Minister of Health and Population -the short &
medium term training courses in nutrition (conducted by NNI ).
Also she demonstrated the website designed & hosted by NNI for
NCD in Egypt describing the services to be provided by the
website such as a database of HR working in nutrition with the
contact information & short CVs-the database of reports,
bulletins, publications, surveys conducted by national
nutritionists & nutrition organizations- scientific events
(national – regional – international) - training courses &
academic programs – links to useful nutrition sites, etc. She
also displayed the NCD brochure developed by the task force for
advocacy on NCD and representation of the national group .A copy
of the brochure was given to each Participant & Dr Azza offered
that the designed website & brochure could be used with
modification and adaptation by the regional group.
The 1st day ended by division of the participants into working
groups in preparation for the 2nd day according to the main
areas of concern chosen by the participants for the NCB
Working forms were distributed to participants to be filled and
given back to the organizing committee the next morning.
Day II, Thursday July 15, 2004
Sessions III (9:00 t0 13:30)
Separate Groups Sessions
The groups worked each into three sessions;
o
First Session:
Each group formulated the goals and objectives of the activity,
then followed by a presentation.
o
Second Session:
Each group identified strategies / actions and activities
needed, then followed by a presentation.
o
Third Session:
Each group documented the plan to implement the activity, and
then followed by presentations of all groups presenting their
findings.
General Discussions:
Discussions took place concerning the action plan of all groups
to finalize main action plans outcomes.
LUNCH BREAK
Session IV (14:30 to 17:30)
General Session
1) Planning for the structure / mechanism /organization of the
regional NCB work group
·
On this issue it was decided and agreed by all the participants
the importance of establishing the Middle East and North Africa
Nutrition Association “MENANA” which would be the main formal
structure / organization for monitoring the Regional Nutrition
Capacity Building activity initiative.
·
The constitution and bylaws would be prepared by Dr. Osman Galal,
IUNS Secretary General, and a draft sent to all members for
comments and approval. (Annex 8)
·
Under the auspices of this Association would come all the major
activities and standing committees to monitor activities of
the regional Nutrition Capacity Building Activities. Such as :
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The regional NCB website.
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The regional research committee which is a board
o
The regional training committee
o
The regional HR data base
o
The regional Nutrition research data base
o
The regional standards committee.
·
Members of this Association will be Nutrition Societies and
Nutrition Institutes/Centers from countries of the region.
·
The administration of the association and functions will be
governed by the laws.
2)
Goals & objectives of the regional group
·
Will be further defined within the constitution of the MENANA
together with roles & responsibility assignment.
3) Role of international organizations in regional NCB
Discussion was postponed till further meetings and establishment
of MENANA.
4) Planning for future meetings
·
Ms. Deena Al Asfor was requested to host the next Regional NCB
meeting in Sultanate of Oman (on behalf of GCC countries) in Dec
2005. She welcomed the idea after seeking approval of MOH Oman
·
It was agreed by all that Dr. Azza Gohar would continue her
functions as regional coordinator for the NCB group until
further decided.
·
It was decided that each participant should brief his / her
authorities upon return to inform, involve and gain support.
·
It was also agreed that each delegate should try to advocate for
NCB with the country MOH with the aim of announcing nutrition
as a priority in the health agenda in the upcoming Regional
meeting with WHO/EMRO for Regional Ministers of Health.
·
It was also suggested to design various logos and send them to
participants for selection of the regional NCB logo.
Closing:
·
The meeting was concluded the participants all expressed sincere
appreciation to the hosting & organizing institute NNI and
especially to Prof Dr. Hoda Hassan (Director of NNI), Dr. Azza
Gohar and the administration team for their hospitality and
organization of a fruitful and pleasant work shop.
·
The participants were all invited and transported to the dinner
site (Nile Maxim from 8.00 to 10.00) where they all enjoyed a
lovely oriental dinner on a mystical Nile night cruise with a
special Egyptian show of performers and oriental dancers.
Plan of Action
Summary of Groups Decisions
On the 1st day of the work shop the participants
agreed on the 5 main core areas or strategies that they would
work on .These core areas are:
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Nutrition Research |
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Nutrition Training |
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Nutrition Academic Education & Accreditation |
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Nutrition Advocacy Education communication |
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Nutrition Networking |
Participants worked as groups on each core area and the outcome
of working groups on the 2nd day were as follows:
1.
Nutrition Research
1.1 Goal:
to promote regional research capacity to support the role of
nutrition in prevention and treatment of diseases
1.2
Objectives:
·
Encourage and promote regional nutrition research
·
Update and adapt research methods on nutritional assessment
/anthropometry, dietary research, biomarkers and clinical
research
·
Apply predictive research and meta analysis for available
regional data
·
Identify regional nutrition risk factors.
·
Standardize and validate regional research methods.
·
Monitoring public health nutrition.
1.3 Action:
·
Formation of regional research committee / society
·
Establish regional review board for research
·
Establish & build nutrition research data base & network
·
Establish an award system for nutrition research
·
Mapping research centers in the region and establish
coordination system among them.
·
Compile & utilize available disease registries & data for
research.
·
Establish mechanism for identification of major causes of
public health problems
·
Establish fund raising system & activities for regional
nutrition research.
2.
Nutrition
Training:-
2.1 Goal:
to strength regional training capacity and regional
constellations / organizations with trained professionals in
nutrition.
2.2
Objectives:-
·
To identify & map regional training facilities/ centers/
institutes.
·
To assess capabilities & quality of these centers (curriculum –
HR – facilities – equipment).
·
To assess regional training needs is nutrition.
·
To form a regional training council / committee to over look &
coordinate regional training activities.
2.3 Actions:-
·
Formation of regional training council / committee.
·
Identification of training focal points in each country.
·
Develop tools for mapping / training centers.
·
Develop tools for training needs assessment.
·
Survey /determine regional training needs.
·
Mapping & assessment of available regional training facilities
·
Designing developing & disseminating regionally driven training
modules / kits.
·
Establish a mechanism for developing & strengthening regional
training centers (infrastructure- materials & HR).
3.
Nutrition Academic
Education & Accreditation.:-
3.1 Goal:
to enhances regional academic capacity in nutrition through
defining and standardizing training requirements for regional
accreditation of nutritionists/dieticians.
3.2
Objectives:-
·
Define regional academic requirements for
nutritionists/dietitians.
·
Develop a structured regional program in nutrition / dietetics
·
Establish a regional accreditation board & registration of
qualified nutritionist / dietitian
·
Mapping of regional institution capacity to assess & identify
those satisfying accreditation requirements
·
Establish mechanisms & systems through which only accredited
nutritionists/ dieticians would be allowed to practice in
regional health care facilities.
3.3
Actions:-
·
Formation of regional accreditation board
·
Definition dissemination of accreditation requirements &
criteria , through adoption & adaptation of internationally
recognized nutrition / dietetic associations with possible
introduction of emerging disciplines
·
Mapping of regional institutional capacity to identify those
satisfying accreditation requirements & preparing a list
·
Initiating measures to support institutions satisfying
requirements and encourage institutions not satisfying
requirements to become accredited
·
Persuade countries through advocacy to adopt policies of
recruiting only accredited nutritionists in health care
facilities
·
Develop and implement a structured regional training program &
training modules in nutrition & dietetics including the minimal
requirements qualifying for regional accreditation
·
Mapping of all regional Academic Institutions which teach
nutrition
·
Assessment of nutrition curricula gaps of Academic
Institutions
3.
Nutrition Advocacy, Communication & Education
4.1 Goal: -
To promote regional nutrition Advocacy, Communication &
Education.
4.2 Objective:-
·
To increase nutrition awareness and capacity at all levels of
the community
·
To persuade policy /decision makers to make
nutrition an agenda priority for health welfare & development of
population
·
To enhance & activate & incorporate nutrition policies
·
To increase government allocation of resources in nutrition
·
To increase sustainability of national nutrition programs
through government commitments.
·
To include nutrition capacity development in country development
plans
·
To develop & disseminate regional nutrition education materials
·
To develop advocacy & marketing strategy for regional NCD
4.3 Actions
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To prepare and translate technical & scientific
nutrition data & information into terms / information &
arguments simply understood by non -nutrition experts for
advocacy with focus on relevance to development indicators
o
To calculate estimations of cost/ benefit & effectiveness of
nutrition programs for advocacy ( using recent software programs
eg profiles)
o
To conduct workshops- seminars – conferences to raise public
awareness
o
To conduct activities involving multi- sectors to enhance
collaboration & increases awareness at policy maker levels
o
To develop materials & presentations that can be used for
regional nutrition advocacy
o
To develop materials for effective public nutrition education
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To develop capacity of regional HR in nutrition communication &
advocacy.
o
To develop, produce & distribute appropriate regional material
eg (brochures – pamphlets - posters – leaflets – flyers – videos
– audiovisuals
o
To integrate nutrition messages into available communication
programs, services & products
5.
Regional Nutrition
Networking
5.1 Goal: -
enhance & strengthen regional inter- country collaboration &
cooperation for NCB.
5.2 Objectives:-
·
Strengthen intra & inter country collaboration in nutrition in
the field of research, training, academic education - advocacy
·
Enhance communication & cooperation channels among nutritionists
in the region.
·
To establish a structure / organization / body to coordinate
regional nutrition activities
5.3 Action:-
·
To establish a Regional Nutrition Association to act as the
governing body for regional nutrition capacity development
initiative activities.
·
To develop a constitution for the Association.
·
To adjust the constitution by member countries.
·
To name the association MENANA (Middle East & North Africa
Nutrition Association).
·
The MENANA would supervise & oversee standing committees in each
of the core areas selected by the participants such as
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Establish a regional information system \ data base-
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Regional NCB website
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Accreditation committee
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Research committee
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Training committee /Council |
