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The ENACT Project: Education for Effective Nutrition in Action

The Food and Agriculture Organization (FAO) of the United Nations is working to develop institutional and professional capacities in nutrition education in Africa through the Education for Effective Nutrition in Action (ENACT) project, funded by the German Ministry of Food, Agriculture and Consumer Protection (BMELV).

Why is Nutrition Education needed?
Nutrition education and communication (NE)

is increasingly recognized as an essential catalyst in the success of food and nutrition security interventions, ensuring that increased food production/income translates into improved nutrition status and improved diets. Several recent reviews and key documents support the role of nutrition education in agricultural/food and nutrition security interventions (1-5).

Although NE contributes to all the pillars of food and nutrition security, it is mainly concerned with whatever influences food consumption and dietary practices: food habits and food purchasing, food preparation, food safety and environmental conditions.

Many causes of poor nutrition are attitudes and practices that can be influenced by education: food taboos, long established dietary and snacking habits, agricultural production decisions, food distribution in the family, ideas about child feeding, misleading food advertising, ignorance of food hygiene, or negative attitudes to vegetables.

Nutrition education is also becoming critically necessary in countries affected by globalisation and urbanisation which are experiencing a dangerous dietary transition to cheap processed foods rich in sugar, fat and salt (4).

FAO nutrition education work in Malawi: improved food security and complementary feeding. Photo by I. Grifi, FAO

FAO nutrition education work in Malawi: improved food security and complementary feeding. Photo by I. Grifi, FAO

The need for nutrition education has been strongly reinforced by the concept of the Right to Food (6, 7). Parties to the International Covenant on Economic, Social and Cultural Rights are under an obligation to provide information and education on good diet, food safety, food-borne diseases, food labelling and processing, production and preparation; while in the school curriculum integrating agriculture, food safety, environment, nutrition and health education builds citizens’ capacity to achieve and maintain their own food security. Hence nutrition education is an essential vehicle for establishing food rights.

Box 1. What is Nutrition Education?
Nutrition Education has been defined as “any combination of educational strategies, accompanied by environmental supports, designed to facilitate the voluntary adoption of food choices and other food- and nutrition-related behaviours conducive to health and well-being; nutrition education is delivered through multiple venues and involves activities at the individual, community, and policy levels.” (13)This definition implies three essential components (14):

  1. an awareness-raising component to focus attention on nutrition and increase motivation to improve diets through effective education and communication strategies,
  2. an action component, where the goal is to facilitate people’s ability to take action to improve their diets, and
  3. an environmental component where nutrition educators work with policymakers at national and community levels to make healthy foods more accessible.

This may involve many activities that are not usually called nutrition education, such as promoting the production of micronutrient-rich foods, nutrition counselling for mothers, cooking demonstrations, health promotion, the production and dissemination of dietary guidelines, as well as ensuring that schools and workplaces offer healthier meals.

 

Background to the ENACT project: Needs assessment in Africa
In 2010, a needs assessment for professional training in nutrition education and communication was carried out in seven African countries (Botswana, Egypt, Ethiopia, Ghana, Malawi, Nigeria and Tanzania), including extensive interviews with over 100 experts (8). The needs analysis also included two literature reviews on (a) nutrition education needs in the literature (9) and (b) nutrition education training needs in the literature (10).

The findings showed that:

  • suitable approaches and relevant training were lacking or irregularly available in most sectors and settings,
  • the perceived need for capacity development and advocacy in this field was high, and
  • respondents saw an urgent need for developing and adopting a suite of professional training courses at undergraduate, postgraduate and extension levels.

ENACT project
The ENACT project was implemented in 2012 as a tailored response to this needs assessment. In collaboration with partners from national universities in several African countries, the ENACT project will produce, pre-test and disseminate a basic module at undergraduate level which will apply the best practices of professional training in dietary promotion, and will also be adaptable to local demand. The materials will be available for online, face-to-face or blended use, and will be piloted in all these formats in Africa. The module will be piloted face-to-face by the University of Botswana, Hawassa University in Ethiopia, University of Ghana, Michael Okpara University of Agriculture in Nigeria, Sokoine University of Agriculture in Tanzania and Makerere University Kampala in Uganda. Discussions are underway with the University of South Africa (UNISA), Kenyatta University in Kenya and the People’s Open Access Educational Initiative (People’s University) regarding the piloting of the online/blended versions of the course. The module will consist of 10 course units divided into three sections that cover the basics of nutrition education, designing and implementing a nutrition education intervention, and the institutional framework for nutrition education. In addition to input received from tutors in the partner universities, Dr. Paul Amuna from Greenwich University (UK) advises the ENACT team on curriculum development. An optional preliminary course in basic nutrition (the ABC-N course) for those who lack essential nutrition knowledge and a training-of-trainers course (the EAT course) are also being developed. It is hoped that the undergraduate module will be followed by a training course at Master’s level and a course for extension workers.

Nutrition education needs and capacity analysis package
As a first step towards improving country capacity for nutrition education it is important to assess the existing situation. The tools used in the FAO seven-country survey have been revised and adapted, so that they can now be used by any organization interested in assessing existing country capacity for nutrition education (11). The findings of such a survey can be a useful base for developing NE interventions or for advocating for better policies in this field. The tools are available free.

Participants at the ENACT Ghana workshop. Photo by C. Alvarez, FAO

Participants at the ENACT Ghana workshop. Photo by C. Alvarez, FAO

Curriculum development workshop for professional training in Nutrition Education
The first stage of the ENACT project culminated in a workshop held in Ghana in July 2012, where experts from 15 countries participated. The purpose of the workshop was to meet project partners in Africa and discuss the preparation and piloting of learning materials (12).

 

 

What’s next?
A pre-piloting workshop will be held in April 2013 in Uganda. The ENACT module will be piloted later this year by the selected universities in order to ensure that the course is relevant to addressing food and nutrition problems in the piloting countries, effective in raising technical competency of students in nutrition education and contributes to the further development of the final ENACT course, in a form that is demonstrably suitable to the context of African universities.

For more information on FAO’s work on Nutrition Education, see http://www.fao.org/ag/humannutrition/nutritioneducation/en/

For further information and inquiries on the ENACT project, please contact the ENACT team:
Ellen Muehlhoff (Senior Officer/Team Leader, Nutrition Education and Consumer Awareness Group), Jane Sherman, Anthony Jennings, Cristina Alvarez, Ramani Wijesinha-Bettoni and BeeGeok Cham
Nutrition Education and Consumer Awareness Group, Nutrition Division, Food and Agriculture Organization of the United Nations
Email: ENACT@fao.org

 

References



1. Girard AW, Self JL, McAuliffe C, Olude O. 2012. The Effects of Household Food Production Strategies on the Health and Nutrition Outcomes of Women and Young Children: A Systematic Review. Paediatr Perinat Epidemiol. 26, Suppl 1:205-22. doi: 10.1111/j.1365-3016.2012.01282.x.Suppl.1, 205-222.

2. IFPRI 2011. Gender: A Key Dimension Linking Agricultural Programs to Improved Nutrition and Health. Written by Ruth Meinzen-Dick, Julia Behrman, Purnima Menon, and Agnes Quisumbing. International Food Policy Research Institute. 2020 Conference Brief 9. Available online.

3. Leroy, J.L. and Frongillo, E.A. (2007) Can interventions to promote animal production ameliorate undernutrition? Journal of Nutrition 137, 2311–2316. Available online.

4. UNSCN report 2010. World Nutrition Situation. Sixth report on the world nutrition situation by the United Nations System Standing Committee on Nutrition (UNSCN). Available online.

5. World Bank 2007: From Agriculture to Nutrition: Pathways, Synergies and Outcomes. The International Bank for Reconstruction and Development / The World Bank. Available online.

6. Right to Food Brief No. 6. Education and awareness-raising. Available online.

7. UN Committee on Economic, Social and Cultural Rights (CESCR), General Comment No. 12: The Right to Adequate Food (Art. 11 of the Covenant), 12 May 1999. Available online.

8. FAO, 2011a. The Need for Professional Training in Nutrition Education and Communication. Report on seven case studies carried out in Botswana, Egypt, Ethiopia, Ghana, Malawi, Nigeria, and Tanzania. Available online.

9. FAO, 2011b. NEAC Needs in the Literature. Written by Sherman, J. Available online.

10. FAO, 2011c. NEAC training needs in the literature. Written by Sherman, J. Available online.

11. FAO, 2012a. Nutrition Education Needs and Capacity Analysis Package. FAO, October 2012. Available online.

12. FAO, 2012 b. ENACT workshop, Aburi (Ghana), 16-20 July 2012: Final Report. FAO, 2012. Available online.

13. Contento, I.R. 2007. Nutrition Education: Linking theory, research, and practice. Sudbury, MA: Jones & Bartlett. 2007.

14. Contento, I.R. 2008. Nutrition Education: Linking theory, research, and practice. Asia Pac. J.Clin. Nutr. 17 (1), 176-179.

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