We need to build the capacity of nutrition professionals

The links between education and nutrition are often thought of solely in terms of the first 1000 days of a child’s life, or school meals. When you think of education in its broader sense, however, you realize it is far more of a partner in a bid for better nutrition: not only because of the lessons we learn throughout life about how to eat well and sustainably, but also because of the role education plays in ensuring that nutrition professionals have the knowledge and skills to help societies move towards better diets. This can happen through higher education, through organizations, through training programmes for current nutrition professionals, and in communities.

The problem? There aren’t enough nutrition professionals to go around, and healthy diets are suffering.

In Learn to eat well, a report with the Research Consortium for School Health and Nutrition of the School Meals Coalition, we featured the findings of a review of nutrition policies in 159 countries that showed seemingly good news: 96% had trained nutritionists or dietitians and 87% mandated supervised practice in dietetic training.

Some countries have clocked on to the need for nutrition professionals to help societies move to more healthy and sustainable diets. In Japan, for instance, registered dietitians are credited for building a nation famous for healthy longevity. Bangladesh was recruiting nutrition officers for all its 64 districts. Cameroon is establishing a professional body of nutritionists in the public service, the National Nutrition Council.

But this does not mean there are enough trained nutrition professionals to go around. There are only 2.3 professionals per 100,000 people in 126 countries according to last estimates ranging from just 0.1 per 100,000 people in Nigeria to 42.6 per 100,000 in Portugal. In addition, even where there are nutrition professionals, they may not be adequately utilized, for example to help inform the quality of school meals, as a previous blog covered on this site.

Source: Download the recipe book: How to cook up nutrition education

The content of training programmes on nutrition is often inadequate. In 2016–17, for example, while almost all countries (90%) offered training in maternal and child nutrition for nutrition professionals, the pre-service training they received averaged out at less than 20 hours on critical topics such as malnutrition, breastfeeding counselling and complementary feeding counselling.

In 2022, only 14% of countries reported that the pre-service curriculum of medical doctors, nurses, midwives and other professionals adequately covered the topic of feeding infants and young children. Many countries, such as India and Sierra Leone, emphasize the need to train community health workers so that they can deliver nutrition interventions. They are critical because they are both community members and can have specialist nutrition knowledge. Studies show a clear link between community health worker home visits and increased early initiation of breastfeeding and exclusive breastfeeding, for instance. And yet they lack adequate investment and support.

Several countries aim to improve nutritional training for health professionals to meet nutrition goals. Cambodia is looking to update and standardize its national pre-service nutrition curriculum for all government health, public health and medical professionals. Egypt’s National Nutrition Institute is also aiming to embed life-course nutrition training into medical and nursing curricula, , with a focus on breastfeeding and child feeding. Indonesia aimed to have skilled nutritionists and midwives in 83% of primary healthcare facilities by 2024.

Training for farmers is also important for nutrition goals. In Odisha, India, a minimum level of education boosted the adoption of modern paddy varieties and raised farm productivity. In Viet Nam, training helped farmers’ ability to manage larger farms, enhancing rice output. Agricultural extension programmes help farmers improve farm productivity and practices. Farmer field schools in Kenya, Uganda and the United Republic of Tanzania raised household income by 61%, particularly benefiting those without formal education. A review of 65 studies of farmer field schools found positive impacts on critical thinking, experimentation and innovation.

There is no one-size–fits–all approach, however. Programmes may fail because farmers are reluctant to adopt new technologies and innovations. Understanding how farmers like to learn can make training programmes more effective. Some farmers express distrust towards science, and prefer receiving information from other farmers instead, for example. One project in Europe which linked farmers up with mentors, resulted in some 4,500 farmers in Germany, Ireland, Italy and the United Kingdom to adopt new technologies.

Networks are important not just for learning new skills, but for protecting old ones too. In Brazil, for example, a group of agronomists, forest engineers, farmer unions and farmers have joined together to help preserve traditional farming practices.

Working with farmers can also help make sure that the food going into school meal programmes is locally produced. This means creating effective links to local smallholder farmers, and traders to ensure that the food being grown is appropriate and predictable enough for the markets. In India, when the country decided to introduce locally produced and procured biofortified zinc wheat and iron pearl millet into school meals in six states, some 20,000 farmers who lived near schools needed to be trained to adopt, grow and market the grains and link them to school food procurement systems.

Often the training is needed to build farmers’ supplier capacity rather than to focus on the crops being grown. In Cambodia, for example, an evaluation of its home-grown school feeding programme found that many suppliers needed more training on procurement and pricing.

Education also plays a role in building research capacities in institutions on nutrition issues. Ethiopia’s bid to improve food safety and quality relies on strengthening its research capacities. Jordan’s national food security strategy lists the need to support agricultural research and knowledge development among its core objectives.

It’s never too late to #LearnToEatWell, whether you’re a toddler in your mother’s arms, a child in school, a student, an office-worker, farmer, researcher or nutrition professional. For as long as it is true that societies are eating unhealthy diets, it will also be true that education has a role to play in helping us learn how to improve our behaviour.