Stakeholders’ perceptions of the nutrition and dietetics needs and the requisite professional competencies in Uganda: a cross-sectional mixed methods study

Abstract

Background Effective implementation of nutrition and dietetics interventions necessitates professionals in these fields to possess the requisite competencies for health systems performance. This study explored the stakeholders’ perceptions of the community nutrition and dietetics needs, the nature of work done by graduates of the Bachelor’s degree in Human Nutrition/Human Nutrition and Dietetics (HN/HND), and the competencies required of Nutrition and Dietetics professionals in Uganda. Methods A cross-sectional mixed methods design was used. Respondents included 132 graduates of the Bachelor’s degrees in HN/HND obtained from the Makerere and Kyambogo Universities in 2005–2016; 14 academic staff that train HN/HND in the two universities; and 11 HN/HND work/internship supervisors. Data from the graduates was collected through an email-based survey; data from other participants was through face to face interviews using researcher administered questionnaires. Results Most HN/HND respondents (84.8%) obtained their Bachelor’s degrees from Kyambogo University; 61.4% graduated in 2013–2016. Most (64.3%) academic staff respondents were females and the majority (57.1%) had doctorate training. All stakeholders viewed communities as facing a variety of nutrition and dietetics challenges cutting across different Sustainable Development Goals. The nutrition and dietetics interventions requested for, provided, and considered a priority for communities were both nutrition-specific and nutrition-sensitive. Work done by HN/HND graduates encompassed seven main competency domains; the dominant being organizational leadership and management; management of nutrition-related disease conditions; nutrition and health promotion; research; and advocacy, communication, and awareness creation. Conclusions This study shows that nutrition and dietetics challenges in Uganda are multiple and multifaceted; HN/HND graduates are employed in different sectors, provide nutrition-specific and sensitive services in a multisectoral environment, and are expected to possess a variety of knowledge and skills. However, graduates have knowledge and skills gaps in some of the areas they are expected to exhibit competency. We recommend using these findings as a basis for obtaining stakeholder consensus on the key competencies that should be exhibited by all HN/HND graduates in Uganda; developing a HN/HND competency-based education model and a national HN/HND training and practice standard; and undertaking further research to understand the quality and relevancy of HN/HND curricula to Uganda’s job market requirements.

Development and Validation of a Competency-Based Education Model Suitable for Undergraduate Human Nutrition and Dietetics Training in Uganda: A Modified Delphi Process

“…The rst stage was a participatory face-to-face stakeholder workshop to propose competency domains for the draft CBE model. Proceedings at this stage were a continuation of the stakeholder needs assessment results validation workshop as detailed in our earlier publication [14].…”

“…The process leading to the development and content validation of the CBE model was undertaken in two main phases of (1) competency needs assessment and (2) model development and content validation as summarised in Figure 1. Findings of the competency needs assessment phase are as per our earlier publication [14] and formed the basis for the model development and content validation phase-a focus of the current publication.…”

“…Prior to undertaking the rst modi ed Delphi round, an invitation letter and a consent form detailling the process for the Delphi rounds were sent to all stakeholders that participated in the competency needs assessment phase of the study (i.e. 132 graduates, 14 academic Staff, and the 11 employers/internship supervisors) and all the 31 participants of the stakeholder needs assessment results validation workshop as described in our earlier publication [14]. Invitees interested in participating in the study were requested to provide their demographic information and area of expertise in nutrition and dietetics.…”

“…The CBE model framework as developed envisions the need for HN/HND undergraduates trained in Uganda to demonstrate competency in emergency nutrition and contains six competency assessed statements to this effect. It is equally important to note that many HN/HND graduates in Uganda are employed by Non-governmental organizations (NGOs) offering humanitarian services [14] The fact that Uganda is one of the countries the highest numbers of refugees globally [54] also presents numerous opportunities for HN/HND graduates to work in the humanitarian/emergency sector. Graduates However need to be equipped with the requisite for emergency nutrition as well as to understand recommended SPHERE standards on food security and nutrition [55] during pre-service training to ably perform in the humanitarian sector.…”

“…According to the WHO guidelines for drinking-water quality, "Water is essential to sustain life, and a satisfactory (adequate, safe, and accessible) supply must be available to all" [64, p.1] . WASH is a critical component in nutrition programming and was one of the services found to be demanded by community members in the competency needs assessment study phase [14] . Another study undertaken in Uganda [65] found that households with insufficient access to WASH facilities faced higher food insecurity compared to those that had such access.…”