Demographics of Modified Delphi Study Participants
As summarised in Table 1, of the 115 experts invited to participate in the first Delphi round, 70 (60.9%) provided feedback. Of these, a higher percentage were females (55.7%) and the majority (44.3%) were in the 25-29 years age bracket. Academic-wise, most (45.7%) had attained training at the master's level of education and 5.7% had doctorate training. All the participants had work experience with the majority (57.1%) having worked for 5-9 years; followed by 22.9% with work experience of 1-4 years and 20% with experience of 10 and or more years. The majority of the participants (38.6%) worked in central Uganda; some (7.1%) worked outside Uganda. Participants worked with a range of employment agencies; the majority (57.1%) being employed by Non-government Organisations, followed by those in academia (15.7%); district local governments (8.6%), and health facilities (5.7%).
As further summarised in Table 1, of the 70 experts invited to contribute to the second Delphi round, 55 (78.6%) responded. The majority of those who responded were females (58.2%), most (47.3%) were in the 25-29 years age bracket, and over half (50.9%) had attained master's level training. Participants had demonstrated work experience with the majority (58.2%) having 5-9 years; 21.8% had 1-4 years; and 20% had an experience of 10 and or more years. The majority (38.2%) worked in central Uganda; followed by 23.6% who worked in western Uganda; and 20% who worked in northern Uganda. Employment-wise, participants worked with different employers; the majority (56.4%) were employed by Non-government Organisations, followed by those in academia (16.4%); district local governments (10.9%), and health facilities (5.5%).
Table 1: Delphi Participants Demographics
Characteristic
|
Category
|
Participants Invited for 1st Round (n=115)
|
1st Round Participants (n=70)
|
2nd Round Participants (n=55)
|
Gender
|
Male
|
53 (46.1%)
|
31 (44.3 %)
|
23 (41.8%)
|
Female
|
62 (53.9%)
|
39 (55.7 %)
|
32 (58.2%)
|
Age
|
25-29
|
51(44.3%)
|
31 (44.3 %)
|
26 (47.3%)
|
30-34
|
33 (28.7%)
|
19 (27.1 %)
|
16 (29.1%)
|
35-39
|
19 (16.5%)
|
12 (17.1 %)
|
6 (10.9%)
|
40-44
|
9 (7.8%)
|
8 (11.4 %)
|
7 (12.7%)
|
≥45
|
3 (2.6%)
|
-
|
-
|
Level of Training
|
Masters
|
51 (44.3%)
|
32 (45.7 %)
|
28 (50.9%)
|
Bachelors
|
46 (40%)
|
29 (41.4 %)
|
19 (34.5%)
|
Post graduate diploma/certificate
|
11 (9.6%)
|
5 (7.1 %)
|
5 (9.1%)
|
Doctorate
|
7 (6.1%)
|
4 (5.7 %)
|
3 (5.5%)
|
Years of Working Experience
|
1-4 years
|
31 (27%)
|
16 (22.9%)
|
12 (21.8%)
|
5-9 years
|
61 (53%)
|
40 (57.1%)
|
32 (58.2%)
|
≥10 years
|
23 (20%)
|
14 (20%)
|
11 (20%)
|
Region of Operation
|
Central Uganda
|
47 (40.9%)
|
27 (38.6 %)
|
21 (38.2%)
|
Northern Uganda
|
28 (24.3%)
|
14 (20 %)
|
11 (20%)
|
Western Uganda
|
21 (18.3%)
|
15 (21.4 %)
|
13 (23.6%)
|
Eastern Uganda
|
10 (8.7%)
|
9 (12.9 %)
|
7 (12.7%)
|
Outside Uganda
|
9 (7.8%)
|
5 (7.1 %)
|
3 (5.5%)
|
Category of present or most recent employer
|
Non-Government Organization
|
66 (57.4%)
|
40 (57.1%)
|
31(56.4%)
|
Health Facility
|
9 (7.8%)
|
4 (5.7%)
|
3 (5.5%)
|
Academia/Higher Education Institutions of Learning
|
15 (13%)
|
11 (15.7%)
|
9 (16.4%)
|
Government Ministry, Agency, or Department
|
7 (6.1%)
|
3 (4.3%)
|
2 (3.6%)
|
Donor/United Nations Agency
|
2 (1.7%)
|
-
|
-
|
Hotel and Catering Facility
|
4 (3.5%)
|
2 (2.9%)
|
-
|
Food Processing Industry
|
2 (1.7%)
|
1 (1.4%)
|
2 (3.6%)
|
District Local Government
|
7 (6.1%)
|
6 (8.6%)
|
6 (10.9%)
|
Consultancy/Research
|
3 (2.6%)
|
3 (4.3%)
|
2 (3.6%)
|
Consensus Development and Content Validation of the HN/HND CBE Model Framework
Developing consensus on the relevancy and suitability of the contents of the Draft 1 HN/HND competency-based education model framework (seven domains, 24 subdomains, and 190 competency statements) for being learned during undergraduate training in HN/HND was achieved in two modified Delphi rounds. In the analysis, 16 competency statements were excluded for being considered as duplicate, ambiguous, or broad and impractical to assess hence leaving 174 competency statements to constitute the final CBE framework as summarised in Table 2.
Table 2: Composition of the Validated HN/HND Competency-Based Education Model for Uganda
Domain
|
Subdomains
|
Number of Competency Statements
|
In Draft CBE Model
|
In Final CBE Model
|
Attained ≥ 80% Set Level of Consensus
|
Domain 1: Prevention and Management of Malnutrition in all its Forms
|
1.1 Nutrition Assessment
|
12
|
12
|
12
|
1.2 Nutrition Diagnosis
|
03
|
03
|
03
|
1.3 Designing Nutrition Interventions
|
23**
|
21
|
21
|
1.4 Monitoring and Evaluation of Nutrition Interventions
|
06
|
06
|
06
|
1.5 Emergency Nutrition
|
06
|
06
|
06
|
1.6 Technical Support and Capacity Development in the Management of Malnutrition
|
07
|
07
|
07
|
1.7 Interprofessional Collaboration in Management of Malnutrition
|
05
|
05
|
05
|
1.8 Water, Sanitation, and Hygiene
|
06
|
06
|
06
|
1.9 Procurement and Management of Nutrition Supplies
|
05
|
05
|
05
|
1.10 Data Management and Record-keeping
|
09*
|
08
|
08
|
Domain 2: Nutrition in the Lifecycle
|
None
|
19**
|
17
|
17
|
Domain 3: Food Security; Agriculture; and Livelihoods Promotion
|
3.1 Nutrition-sensitive Agriculture, Food Security, and Livelihoods Promotion
|
13*
|
12
|
12
|
3.2 Post-harvest Handling and Food Safety Management
|
03
|
03
|
02
|
Domain 4: Ethics and Professionalism in Nutrition and Dietetics
|
4.1 Knowledge of Codes of Ethics, Practice Guidelines, and Standard Operating Procedures
|
05**
|
03
|
03
|
4.2 Ethical Principles in Practice
|
05*
|
04
|
04
|
Domain 5: Research and Data Analysis
|
5.1 Planning & Data Collection
|
12***
|
09
|
09
|
5.2 Data Analysis, Report Writing, and Results Dissemination
|
09**
|
07
|
05
|
Domain 6: Policy; Advocacy; and Social and Behaviour Change Communication
|
6.1 Policy
|
03
|
03
|
00
|
6.2 Advocacy
|
07
|
07
|
01
|
6.3 Social and Behaviour Change Communication
|
09
|
09
|
09
|
Domain 7: Nutrition Leadership and Management:
|
7.1 Planning and Budgeting
|
04*
|
03
|
00
|
7.2 Human Resource Management
|
05
|
05
|
05
|
7.3 Multisectoral Stakeholder Engagement
|
05
|
05
|
03
|
7.4 Program/Project Implementation
|
03
|
03
|
02
|
7.5 Monitoring and Evaluation
|
06*
|
05
|
02
|
Total
|
24
|
190
|
174
|
153
|
HN/HND: Human Nutrition and Dietetics; CBE: Competency-Based Education; * One competency statement was dropped from each of the respective subdomains in the final analysis; ** Two competency statements were dropped from each of the respective subdomains in the final analysis; and *** Three competency statements were dropped from the subdomain in the final analysis
Upon completing the two modified Delphi rounds, all of the seven domains (100%); 22(91.7%) of the 24 subdomains; and 153(87.9%) of the 174 analysed competency statements attained the 80% set level of participant consensus in being evaluated as both relevant and suitable for training in HN/HND at the undergraduate level in Uganda. These assessed competencies were aggregated into a final CBE model framework considered suitable for undergraduate HN/HND training in Uganda as summarised in Table 3. In the final CBE model, all statements for which the 80% set level of participant consensus was attained in the first modified Delphi round for both levels of assessment are represented with an “X”; those for whom consensus was not attained in either round are represented with an “N”; those that attained consensus on one level of assessment in either round are represented with X1 and X2 depending on whether consensus was obtained in the first or second round respectively as summarised in the Final CBE model (Table 3).
Assessment of Domains, Subdomains, and Respective Competency Statements
Domain One: Prevention and Management of Malnutrition in all its forms
This domain was comprised of ten subdomains; each had different competency statements (Table 3). Aggregately, the ratings of the domain, all its ten subdomains, and almost all the competency statements attained the 80% set level of participant consensus in the first Delphi round in consideration that they were both relevant for HN/HND graduates and suitable to be learned during undergraduate level training. Based on a review of the participants’ justifications for the given ratings, demonstrating competence in this domain was considered central for practicing nutrition and dietetics and that preservice training in this overall domain needed to advance with the level of training.. The subdomain on nutrition assessment was comprised of 12 competency statements all of which attained the 80% set level of participnt consensus in consideration that they were both relevant and suitable to be learned during the undergraduate level of HN/HND training (Table 3). Participants observed that demonstrating this competency was essential for the identification and management of malnutrition. As for some of the competencies under this subdomain, demonstrate knowledge on the nature, origin, progress, and causes of different forms of malnutrition was considered to be the foundation for practicing nutrition and dietetics; it was considered essential for HN/HND graduates to demonstrate knowledge and skills necessary using different nutrition assessment screening tools appropriate for different age groups, physical, physiological, and disease state. The need to demonstrate competency in undertaking clinical assessment was perceived to be sensitive but important for all levels of training. Demonstrating competency in undertaking dietary assessments was evaluated as essential given the consideration that effective diet therapy is a cornerstone for most nutrition interventions. In evaluating the need to demonstrate knowledge and skills in biochemical assessment, the ability to interpret the biochemical results rather than practical knowledge on how to undertake the actual tests was viewed to be more relevant for the HN/HND graduates. However, demonstrating competeny in conducting simple tests related to the measurement/assessment of blood glucose, haemoglobin, and body vital signs was emphasise. Participants considered demonstrating knowledge and skills in obtaining client and caretaker perceptions/opinions of the underlying health conditions key to enhancing client adherence to different interventions.
The subdomain on nutrition diagnosis comprised three competency statements; All attained the 80% set level of participant consensus in the first Delphi round in being evaluated as both relevant for HN/HND graduates and suitable to be learned at the undergraduate level. Demonstrating competency in this subdomain was evaluated as relevant and recommended for undergraduate training (Table 3) based on the views that it enables professionals to make the right judgments of the underlying nutrition conditions enabling professionals to develop the right interventions. As for some of the competencies under this subdomain, demonstrating knowledge on how to interpret results from different nutrition assessments was considered to require adequate practice and training undertaken at either the bachelor's or master’s level. The need for HN/HND graduates to demonstrate knowledge and skills required to work in collaboration with other health team members to make appropriate diagnoses based on assessment findings was considered essential due to the perception that interprofessional collaboration improves the quality of services, hastens patient recovery and overall intervention outcomes.
The subdomain on developing nutrition interventions comprised of 21 competency statements (Table 3). The 80% set level of respondent consensus was attained in the first Delphi round for the subdomain and for all the competency statements in consideration that these were relevant for all HN/HND graduates and suitable to be learned during undergraduate training. As for the evaluations of some competency statements under this subdomain; developing competence in designing nutrition interventions for different conditions was perceived as requiring adequate training and practice and hence considered suitable for individuals with a minimum of bachelor’s training in HN/HND. Demonstrating competency to work with interdisciplinary teams in managing clients across different health departments was considered beneficial for it results in better support for the client and promotes interprofessional collaboration between the nutritionist/dietitian and other health care workers. The need for HN/HND graduates to demonstrate competency in setting measurable and achievable short and long-term recovery goals for clients was emphasised and recommendations made that students needed to be provided more practical time during training to improve their mastery of dietetic skills. Demonstrating competency to communicate results of assessment, diagnosis, and intervention plans with clients was considered a basic requirement for all HN/HND graduates. Competency to design therapeutic diets tailored to particular diseases, health, and lifestyle needs was expected to be demonstrated by all bachelor’s and master’s level graduates. Respondents expressed divided opinions on whether HN/HND graduates needed to demonstrate competency in tube feeding and the insertion of feeding tubes. Those in support of this competency opined that having such competency was imperative to the practice of nutrition and dietetics; others felt that although demonstrating this competency was important, it could be handled interdisciplinary. It was also highlighted that HN/HND graduates did not have to perform medical procedures unless approved by relevant authorities. Demonstrating competency in offering tailored nutrition and dietetics guidance and counselling services to clients and their caretaker’s participants was recommended for all HN/HND graduates irrespective of the level of education. Similar observations were made when evaluating the need for HN/HND graduates to exhibit competency in prescribing exercise and lifestyle strategies meeting client conditions.
This subdomain on monitoring and evaluation of nutrition care interventions was comprised of six competency statements all of which attained the 80% set level of respondent consensus in the first Delphi round in being evaluated as both relevant to be demonstrated by HN/HND graduates and suitable for undergraduate training. For some of the evaluated competency statements, participants considered it essential for all HN/HND graduates to demonstrate knowledge of the different nutrition reference standards; expressed that all HN/HND graduates needed to demonstrate competency in assessing client progress on nutrition interventions irrespective of the level of training; and considered demonstrating competency in identifying and resolving the causes of default and relapse amongst clients as requiring adequate training and practice. The need for HN/HND graduates to demonstrate competency in reviewing client adherence to prescribed interventions, identifying challenges, and adjusting interventions as necessary was recommended for the bachelors and master’s degree holders given the observation that it's these graduates that mainly design and handle client interventions.. Demonstrating competency in communicating monitoring and evaluation assessments results with clients and their caretakers was considered essential for all nutrition care providers.
The subdomain on emergency nutrition consisted of six competency statements; all attained the 80% set level of participant consensus in the first Delphi round in consideration that they were both relevant and suitable for learning at the undergraduate level (Table 3). Participants emphasized that it was important for HN/HND graduates to understand the SPHERE humanitarian standards and further expressed that the levels of competency amongst HN/HND graduates could defer depending on the training received but bachelors and masters level graduates were in particular expected to exhibit this competency. As for the evaluation of some competency statements under this subdomain; participants emphasized that it was important for HN/HND graduates to understand the SPHERE humanitarian standards particularly the application of the recommended food security and nutrition minimum standards. Regarding training, an observation was made that master’s and bachelor’s level training needed to equip graduates with all aspects of nutrition management during emergencies while diploma level training could cater for some but not all areas of nutrition in emergencies. The need for HN/HND graduates to exhibit competency required for training fellow staff, volunteers, and peer counsellors on infant and young child feeding in an emergency was evaluated as relevant. Participants observed that it was necessary to integrate infant and young child feeding in an emergency (IYCF-E) in the HN/HND syllabi as this would make it easy for HN/HND graduates to transfer this knowledge to others. They also recommended for training in the monitoring of emergency activities to be done at all levels.
The subdomain on technical support and capacity development in the management of malnutrition was comprised of seven competency statements. In the evaluations, the subdomain and six of the seven competency statements obtained the 80% set level of participant consensus in the first Delphi round in consideration that they were both relevant for HN/HND professionals and suitable for learning at the undergraduate level in the first Delphi round. The exception was for competency statement 1.6.2 on the need for HN/HND graduates to demonstrate skills in using approved quality improvement (QI) tools to facilitate the sustainable delivery of quality and equitable nutrition services for which consensus on suitability for learning of the competency at the undergraduate level was attained in the first round but consensus on the relevancy of the statement for HN/HND graduates was obtained in the second round (Table 3). Going by the participants' justifications, this particular competency was considered important but mainly in programme monitoring and evaluation. In practice, it was recommended that QI be done by either the master's or bachelor’s degree holders given its perceived complexity in terms of assessment, analysis, evaluation, and engagement of multi-disciplinary health teams. Overall, the participants also viewed it necessary for HN/HND graduates to undertake post-graduate training and other professional growth and development measures through continuous professional development (CPD) initiatives to improve their competency in offering technical support and capacity development in the management of malnutrition.
The subdomain on interprofessional collaboration in the management of malnutrition was constituted of five competency statements all of which attained the 80% set level of participant consensus in consideration that they were both relevant for HN/HND graduates and suitable for learning at the undergraduate level (Table 3). Participants observed that HN/HND graduates work in collaboration with other teams; implementing nutrition interventions necessitates multisectoral and multistakeholder partnerships and that this was the norm being promoted; there was a need for graduates to adhere to the professional principles of ethics and practice and the codes of practice even when under multisectoral and multistakeholder partnerships; graduates needed to have effective communication skills; and that being able to identify and manage/resolve work-related conflicts was relevant for all graduates.
The WASH subdomain consisted of six competency statements all of which attained the 80% set level of participant consensus in the first Delphi round in consideration that they were relevant for HN/HND graduates and suitable for learning during undergraduate training (Table 3). Evaluations were based on participants’ observations that WASH: affects nutrition and health outcomes; is a key component of nutrition and health; is integrated with many nutrition programmes; is important in promoting community nutrition and that HN/HND graduates needed to understand protocols of infection control used in health facilities.
The subdomain on procurement and management of nutrition supplies was comprised of five competency statements. All attained the 80% set level of participant consensus in the first Delphi round in consideration that they were relevant and suitable for being learned during undergraduate level training (Table 3). From the narratives, some participants felt that competency in procurement and management of nutrition supplies was not a necessity for HN/HND graduates as organisations usually employ staff specialised in this field. Nonetheless, demonstrating competency necessary for maintaining coordination with different stakeholders; upholding hygiene and safety of nutrition food and therapeutic supplies; undertaking accountability of received nutrition supplies; and general ability to plan and make forecasts of needed nutrition supplies were considered key.
The subdomain of nutrition data management and record-keeping consisted of eight competency statements. All attained the 80% set level of participant consensus in the first Delphi round in consideration that they are relevant for HN/HND graduates and suitable for learning at the undergraduate level (Table 3). From the narratives, it was observed that graduates of all levels needed to be grounded in data management as data is needed at all stages of nutrition care and support; appropriate documentation of nutrition records using different medical styles was low amongst the graduates hence recommended since all graduates do documentation at some stage; it was important for all nutrition care providers to have skills in the use of the Health Management Information System (HMIS); and that mentoring was crucial for health systems strengthening.
Domain Two: Nutrition in the Lifecycle
A total of 17 competency statements were assessed under this domain. All attained the 80% set level of participant consensus in the first Delphi round in consideration that they were relevant to be demonstrated by HN/HND graduates and suitable for undergraduate training in these fields (Table 3). Participants observed that: training in this domain needed to be made compulsory for all HN/HND trainees given the domain’s focus on health promotion especially during the first 1000 days of an individual’s life; nutrition assessment, counselling, and support (NACS) was applicable at all the different levels of nutrition service delivery; demonstrating competency in management of malnutrition for different age groups was vital for all providers of nutrition case services; it was essential for all HN/HND graduates to demonstrate competency in growth monitoring and promotion (GMP) as this was mandatory for all children; care is an important aspect affecting nutrition and health outcomes; it was essential for all HN/HND graduates to undertake Infant and Young Child Feeding (IYCF) in different contexts including Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome (HIV/AIDs) and also know about the IYCF policies; all HN/HND graduates needed to demonstrate competency in lactation management so as to be able to support mothers with breastfeeding challenges; demonstrating competency in use of different community approaches/models to promote Maternal, Infant, Young Child and Adolescent Nutrition (MIYCAN) was important for all HN/HND graduates; it was important for HN/HND graduates to demonstrate competency in designing and using appropriate information, education communication (IEC) materials; HN/HND graduates besides understanding the Baby-friendly Hospital Initiative (BFHI) needed to be able to promote the same in health facilities; HN/HND graduates needed to know the WHO International Code of Marketing of Breastmilk Substitutes; it was important for graduates to know MIYCAN policies and existent guidelines and that these needed to be used as reference ‘guidelines’ for practice; nutrition and dietetics care providers had to work in teams with other professionals as working in collaboration helped to fill identified ‘system’ gaps; and that coordination of nutrition programmes and activities was an important area requiring support at the district level and that nutrition and dietetics graduates needed to learn/master skills in coordination. Caution was however raised that learning of the different competencies needed to be tailored for different levels of training. Also observed was that competency in public health interventions such as food fortification, iodization, bio-fortification, and their application could be made a specialty for masters level training.
Domain Three: Food Security, Food Safety, Agriculture, and Livelihoods Promotion
This domain was comprised of two subdomains (1) nutrition-sensitive agriculture; food security; and livelihoods promotion and (2) post-harvest handling and food safety management. The ratings for the overall domain attained the 80% set level of participant consensus in consideration they were relevant for HN/HND graduates and suitable for learning at the undergraduate level. The subdomain on nutrition-sensitive agriculture; food security; and livelihoods promotion consisted of 12 competency statements; the ratings for the subdomain and ten of its competency statements were above the 80% set level of participant consensus in the first Delphi round for both relevancy and recommendation that learning of the same occurs during the undergraduate level of training (Table 3). As for the two competency statements (3.1.6 and 3.1.10) for which the 80% set level of participant consensus was not attained, participants noted that although demonstrating competency in analysing the influence of existing national laws, regulations, policies, and sectoral plans on food security and livelihoods was relevant for HN/HND graduates; one requires critical thinking and advanced skills to be able to influence decision making. As such demonstrating this competency was viewed as better suited for the master’s level graduates. Observations were also made that projects with a strong basis in animal production usually employ either veterinary offices or agronomists; hence HN/HND graduates only needed basic training in livestock production for purposes of promoting the same as a livelihood strategy hence did not evaluate demonstrating this competency relevant for HN/HND graduates.
The second subdomain on post-harvest handling and food safety management was comprised of three competency statements. The ratings for this subdomain and two of the competency statements i.e. (1) demonstrating knowledge of post-harvest handling and skills to control food losses along the food value chain using modern and local/traditionally effective techniques and (2) demonstrating knowledge and skills to apply the CODEX general principles of food hygiene and food safety management attained the 80% set level of participant consensus in the first Delphi round in consideration that they were relevant and suitable to be learned at the undergraduate level (Table 3). In their evaluation, participants observed that demonstrating these competencies empowers graduates to reduce food intoxication and wastage hence contributing to the prevention of malnutrition and other diseases and to promote post-harvest handling in communities. The need for HN/HND graduates to demonstrate competency in the application of the Hazard Analysis and Critical Control Point (HACCP) principles was not evaluated as relevant for HN/HND graduates in both Delphi rounds but consensus that training in the same occurs during undergraduate training was attained. The participants' evaluations were based on observations that skills in HACCP were best suited to food science and technology professionals and the views that nutritionists/dietitians need competency in HACCP to ensure that quality food reaches the final consumers. Demonstrating competency in the application of the CODEX general principles of food hygiene and food safety management was evaluated as relevant in the first Delphi round; learning of the same was recommended for undergraduate training. Observations were made that poor food hygiene was responsible for foodborne related illnesses hence making it essential for all HN/HND graduates to understand and apply the CODEX principles of food hygiene and food safety management.
Domain Four: Ethics and Professionalism in Nutrition and Dietetics
The domain on ethics and professionalism in nutrition and dietetics contained two subdomains; 1) knowledge of codes of ethics, practice, guidelines, and standard operating procedures and 2) ethical principles in practice. Overall, the ratings for the domain, the subdomains, and all the competency statements under the respective subdomains attained the 80% set level of participant consensus in the first Delphi round in consideration that they were relevant to be demonstrated by the HN/HND graduates and that learning of the same was appropriate for the undergraduate level of HN/HND training (Table 3). In evaluating the overall domain, participants observed that all HN/HND graduates needed to understand the professional code of ethics, practice guidelines, and standard operating procedures irrespective of their level of training as this supports knowing professional limits and boundaries. Participants also considered it relevant for HN/HND trainees to be oriented on the different codes of ethics, practice guidelines, and standard operating procedures of different professionals and organizations
Three competency statements were evaluated under the subdomain of knowledge of codes of ethics, practice, guidelines, and standard operating procedure and all attained the 80% set level of participant consensus in the first Delphi round for both relevancy and suitability for undergraduate training (Table 3). In the justifications, participants observed that many HN/HND graduates were not aware of the national code of ethics and practice guidelines in nutrition and dietetics partly because these did not exist; employees were expected to adhere to existent organizational laws and regulations but also observe professional limits; and that demonstrating competency in identifying and resolving work-related conflicts was necessary for HN/HND graduates as it supports team building and leadership. Relatedly, three competency statements were also evaluated under the subdomain on ethical principles in practice and the 80% set level of consensus was attained for both evaluations of relevancy and suitability of learning the competencies at the undergraduate level. In the evaluations, participants observed that competency in engaging clients/caretakers in making informed decisions was vital in counselling and promoting quality service delivery and good work conduct; demonstrating competency in upholding client privacy and confidentiality and maintaining professional-client boundaries were important for all HN/HND practitioners given the need to promote client-service provider relationships; and upholding human rights principles was relevant for graduates irrespective of the level of training.
Domain Five: Research and Data Analysis
This domain was comprised of two subdomains; (1) planning and data collection and (2) data analysis, report writing, and results dissemination. In evaluating the domain, participants observed that it was important for all the HN/HND graduates to demonstrate competency in research and data analysis but cautioned that training content needed to differ according to the level of training. The subdomain on planning and data collection and all its nine competency statements attained the 80% set level of participant consensus in the first Delphi round in consideration that they were both relevant for HN/HND graduates and suitable for being learned at the undergraduate level (Table 3). In the evaluations, participants expressed the need to ensure that training equipped all HN/HND graduates with the knowledge skills, and abilities to: understand both quantitative and qualitative research methods and designs; design nutrition and health-related data collection tools; understand and use different nutrition indicators; write research proposals; publish research findings; use different databases and search engines to access information on health and nutrition; work with different stakeholders in planning and undertaking research; understand and adhere to established research guidelines and ethical principles; and to be ambitious and self-motivated in identifying research opportunities. In all, it was also noted that comprehending research was challenging for diploma holders given the limited timeframe of diploma training.
The subdomain on data analysis, report writing, and results dissemination consisted of seven competency statements. All were evaluated as relevant for HN/HND graduates with the 80% set level of participant consensus on the same attained in the first Delphi round. However, only five of the competency statements attained the 80% set level of participant consensus in the first Delphi round in being recommended for undergraduate HN/HND training. The consensus was still not attained for the remaining two competency statements even after being re-evaluated in the second Delphi round (Table 3). From the justifications, participants observed that research, report writing, and information dissemination were vital for all HN/HND professionals but the depth of training needed to differ for different levels. Although the need for HN/HND graduates to demonstrate competency in using appropriate statistical tests was evaluated relevant, consensus as to whether undergraduates should demonstrate this competency was not attained based on the reasoning that it required one to have higher-level knowledge and skills which are better attained through masters’ level training. A similar observation was made for the need to demonstrate competency in planning and hosting seminars, workshops, and conferences as well as the ability to share nutrition research in different fora. Participants also highlighted most of the skills under this subdomain were required to be learned during the master's level training as master’s degree graduates tend to be employed in positions that require these skills.
Domain Six: Policy, Advocacy, and Social and Behaviour Change Communication
This domain was comprised of three subdomains: (1) policy; (2) advocacy; and (3) social and behaviour change communication (SBCC) and was in general evaluated both relevant for HN/HND graduates and suitable for learning during undergraduate training. Participants generally observed that promoting policy, advocacy, and SBCC was required of all HN/HND graduates irrespective of their level of training. Also observed was that training in this competency domain needed to be phased with advanced content learned at the master’s level. The policy subdomain consisted of three competency statements each of which attained the 80% set level of participant consensus in the first Delphi round in being evaluated as relevant to be demonstrated by HN/HND graduates. However, the 80% set level of participant consensus was not attained for the subdomain and its competency statements in either Delphi rounds in regards to recommending their learning at the undergraduate level (Table 3). As per the participants' observations, training in policy was considered better suited for the master's level graduates as they engage more in policy-related activities than the bachelor’s level graduates. Some participants however observed that it was important for all HN/HND graduates to be actively involved in at least one or all the stages of the policy cycle irrespective of their level of training.
The second subdomain consisted of seven competency statements; all of which attained the 80% set level of participant consensus in the first Delphi round in being evaluated as relevant for HN/HND graduates. However, only one of these; competency statement 6.2.5 on the need for HN/HND graduates to demonstrate knowledge and skills in the use of different advocacy tactics, attained the 80% set level of participant consensus in being recommended as suitable for learning at the undergraduate level (Table 3). In the justifications, participants observed that demonstrating competency in undertaking evidence-based policy and budget advocacy was relevant for HN/HND graduates but training in the same was not suited for undergraduate training as prior understanding of existent policy gaps, expertise, and experience working with decision-makers was needed. Demonstrating competency in planning and managing advocacy events was considered to require divergent skills, some of which develop with experience and exposure. The need for HN/HND graduates to demonstrate competency in using different techniques to undertake advocacy was evaluated as relevant but some participants considered it to require having advanced knowledge and capabilities to deal with different stakeholders; a competency more suited for master’s graduates. Demonstrating competency in undertaking national and local level nutrition advocacy targeting different decision-makers was also considered relevant for HN/HND graduates but not recommended for undergraduate training as mastering this competency was considered more suitable for the master’s level graduates who are usually more likely to be employed in positions requiring such skills. Some participants also expressed that advocacy occurs at all levels hence HN/HND graduates needed to be able to monitor and evaluate the impact of advocacy initiatives irrespective of the level of training.
Subdomain three on social and behaviour change communication consisted of nine competency statements. The ratings for relevance and suitability of the subdomain and its respective competency statements for undergraduate training attained the 80% set level of participant consensus in the first Delphi round (Table 3). Based on the narratives, participants observed that behaviour change is a key element of nutrition programs and that having such a competency promoted easier acceptance of interventions by the community. As for the competency statements under this domain, observations were made that: it was essential for professionals to ably analyse the health and nutrition behaviours of communities in which they operate to ably design solutions meeting the community needs; identify and address the undesirable/un-intended culture/religious beliefs, practices, and food taboos existing in communities; nutrition interventions thrive on SBCC hence the need for all HN/HND graduates to demonstrate competency in using/applying different theories of behaviour change; developing and using appropriate IEC materials played a big role in promoting behaviour change; and that adherence to the ethical and ‘do no harm’ principles in SBCC programming was essential for promoting SBCC.
Domain Seven: Nutrition Leadership and Management
The leadership and management domain was comprised of five subdomains: planning and budgeting; human resources management; multisectoral and multistakeholder engagement; program/project implementation; and monitoring and evaluation. The 80% set level of participant consensus was attained in the first Delphi round in evaluating the domain, its subdomains, and all their respective competency statements as being relevant for HN/HND graduates but was variably attained in recommending their training at the undergraduate level (Table 3). The subdomain on planning and budgeting was comprised of three competency statements. All attained the 80% set level of participant consensus in being evaluated relevant for HN/HND graduates; however, none of these attained the 80% set level of participant consensus in being recommended to be learned during undergraduate level training (Table 3). From the given justifications, participants observed that demonstrating competency in planning and budgeting was more important for HN/HND graduates working as project managers, assistants, and field nutrition coordinators who usually need to have master’s level training. As for the competency statements under this subdomain, demonstrating competency in developing nutrition program/project proposals, work plans, and budgets was considered relevant but not recommended for learning at the undergraduate level in both Delphi rounds. Resource mobilization was observed to be a main reserve for the programme directors who usually hold higher academic credentials above undergraduate level training. Nutrition program/project budget tracking was observed as being done by HN/HND graduates employed in project managerial positions but is mainly a function of the finance department and related professionals not nutrition/dietetics professionals. On this basis, it was recommended that HN/HND graduates interested in improving their competency in budgeting and budget tracking could undertake additional training probably at a post-graduate level and or through formal continuous professional development (CPD) programs to improve their competence in this area.
The subdomain on human resource management was comprised of five competency statements all of which attained the 80% set level of participant consensus in the first Delphi round in consideration that they were both relevant for HN/HND graduates and suitable for learning at the undergraduate level (Table 3). Some of the participants observed that demonstrating competency in human resource management ensures that graduates can undertake tasks related to the selection, training, and coaching of fellow staff. Some participants however observed that human resource management was not a core mandate of HN/HND graduates. In evaluating the competency statements under this subdomain; the need to demonstrate knowledge of leadership and management principles was considered to be required by all graduates as any graduate can take up leadership roles irrespective of the level of training. Demonstrating competency in staff recruitment was considered relevant on the basis that employed graduates were in one way or another expected to contribute in carrying out this function. The need for HN/HND graduates to demonstrate competency in supportive supervision was evaluated as relevant but participants observed that prior expertise in project implementation was needed. Relatedly, demonstrating competency in setting up organisational supportive supervision systems was evaluated as relevant but more so for graduates employed in managerial positions. Demonstrating competency in organising, coordinating, and contributing to training and mentorship of program/project staff was also evaluated as necessary especially for people in managerial positions and field nutrition coordinators.
The subdomain on multisectoral and multistakeholder engagement had five competency statements. All attained the 80% set level of participant consensus in being evaluated as relevant to be demonstrated by HN/HND graduates but only three of these (i.e. 7.3.2, 7.3.3) were recommended for learning at the undergraduate level (Table 3). Participants observed that demonstrating competency in engaging in multisectoral and multistakeholder partnerships was relevant for all HN/HND graduates given that implementation of nutrition and dietetics services involves interplay of different stakeholders. For the underlying competency statements, participants viewed the need for HN/HND graduates to demonstrate competency in stakeholder mapping as mainly being a function of leadership and management hence core for graduates in managerial positions who were usually master’s level graduates. Participants observed that different nutrition interventions were being implemented through partnerships; HN/HND graduates hence need to demonstrate competency required for working in multisectoral and multistakeholder nutrition partnerships. The need for HN/HND graduates to demonstrate competency in identifying and managing conflicts of interest that arise in multisectoral and multistakeholder partnerships was evaluated relevant and recommended for undergraduate training on the basis that conflicts of interest were inevitable at the workplace. Demonstrating knowledge on the composition, governance and functionality of multisectoral coordination committees at different levels was evaluated to be relevant for HN/HND graduates given that nutrition interventions were being implemented multisectorally. Despite recognising that HN/HND graduates generally needed to understand governance structures in the multisectoral approach, consensus was not attained in recommending the learning/orientation of graduates on this competency during undergraduate level training. The master’s level graduates were observed to benefit more from this competency as they are usually employed in positions that need such knowledge and skills. The need to demonstrate competency required for supporting nutrition coordination committees in the development of multisectoral nutrition action plans was evaluated as relevant for HN/HND graduates and learning of this competency was recommended to occur during undergraduate training. However, some participants also observed that demonstrating this competency was technical, required experience and maturity which undergraduates usually lacked. Some participants also observed that this competency could be learned through experience and exposure hence did not require formal training. In general, although not all the competency statements assessed under this subdomain were recommended for undergraduate training; the Delphi assessment results supported findings of the competency needs assessment phase where the graduates indicated being employed in different sectors and providing a range of nutrition-specific and nutrition-sensitive services in a multistakeholder environment that required them to have competency in multisectoral and multistakeholder partnerships.
The subdomain on program/project implementation was constituted of three competency statements. All attained the 80% set level of participant consensus in the first Delphi round in being evaluated as relevant for HN/HND graduates but only two of the competency statements (7.4.1 and 7.4.2) attained the set level of participant consensus in being recommended for learning at the undergraduate level even after the second Delphi round (Table 3). In evaluating this subdomain, participants observed that HN/HND graduates, more so those working as program managers needed to demonstrate competency in program/project implementation and that it was important for graduates to undertake specialised management training after their bachelor's or master’s level training. The need for HN/HND graduates to demonstrate competency in implementing programs/projects in line with agreed-upon protocols and in planning and leading organisation committee meetings were evaluated as relevant and learning of the same recommended during undergraduate training. On the other hand, demonstrating competency in analysing technical program/project reports and following up on the implementation of recommendations in particular considered to be mainly relevant for higher-level positions and graduates engaged in nutrition programming.
The subdomain on monitoring and evaluation (M&E) consisted of five competency statements; all were evaluated as relevant having attained the 80% set level of participant consensus but only two (competency statements 7.5.4 and 7.5.5) were recommended for learning at the undergraduate level (Table 3). Participants observed that learning and demonstrating competency in M&E at the undergraduate level reduced the requirements for the graduates to study the same afterward. Further noted was that evaluation of nutrition programs was on many occasions left to M&E specialists yet these have limited understanding of nutrition and sometimes provide misleading information. As for the five competency statements under this subdomain, participants highlighted that competency in undertaking monitoring and evaluation of program/project activities was mainly needed by HN/HND graduates working as project managers and that if at all training was to be done at the undergraduate level, it needed to be basic. Also noted was that organisations usually employed M&E specialists who had specific training in this area. The need for HN//HND graduates to demonstrate competency on the use of the Organization for Economic Cooperation and Development/Development Assistance Committee (OECD/DAC) principles (i.e. relevance, effectiveness, efficiency, impact, and sustainability) in program/project evaluation was evaluated as relevant but consensus on recommending the learning of this competency at the undergraduate level was not attained as this competency was considered best suitable for the M&E experts and graduates employed in managerial positions most of which require master’s level training. Demonstrating competency in analysing program/project monitoring and evaluation data was evaluated as relevant but consensus on recommending the training in this competency at the undergraduate level was not attained in both Delphi rounds. Some participants however felt it was relevant for training in this competency to be undertaken at both the undergraduate and the master’s level. The need for HN/HND graduates to demonstrate competency in preparing and presenting timely reports on program/project outcomes, activities, processes, and lessons learned to different stakeholders was evaluated as relevant and also recommended for undergraduate training. In evaluating this competency, participants observed that reporting of program/project activities was poor amongst many HN/HND graduates and needed to be improved. Demonstrating competency in undertaking quality improvement (QI) of program/project performance was evaluated as relevant and recommended for undergraduate training. It was also observed that QI needed to be learned as part of the CPD courses in HN/HND.
Table 3: Competency-Based Education Model Framework for Training of Human Nutrition/Human Nutrition and Dietetics at the Undergraduate Level in Uganda as Developed in this Study
Competency domains, subdomains, and competencies required for the practice of Human Nutrition/Human Nutrition and Dietetics in Uganda
|
Relevancy to HN/HND Practice
|
Suitability for Undergraduate HN/HND Training
|
|
|
Domain 1: Prevention and management of malnutrition in all its forms: Demonstrates knowledge and skills to prevent and manage undernutrition, vitamin and mineral deficiencies, overweight, obesity, and resulting diet-related non-communicable diseases
|
X
|
X
|
|
1.1 Nutrition Assessment: Demonstrates knowledge and skills in the use of different methods of nutrition screening and assessment to evaluate nutrition status at the individual/household and community level
|
X
|
X
|
|
1.1.1 Demonstrates knowledge of the nature, origin, progress, and causes of undernutrition, vitamin and mineral deficiencies, overweight, obesity, non-communicable diseases (e.g. diabetes, cancer, cardiovascular diseases) and other disease conditions whose management requires nutrition therapy (e.g. lower and upper gastrointestinal tract disorders; liver disorders; food allergies and intolerances; conditions arising from different nutrient deficiencies; pulmonary diseases; renal disorders; metabolic complications, stress, burns, and trauma; rheumatic diseases; neurologic disorders; psychiatric conditions; genetic metabolic disorders; HIV/AIDs; and developmental related disabilities)
|
X
|
X
|
|
1.1.2 Demonstrates knowledge and skills to perform triage (identify clients in need of immediate attention by service providers)
|
X
|
X
|
|
1.1.3 Demonstrates knowledge and skills to undertake client clerking and using the emerging information to clearly and correctly fill and update the nutrition register
|
X
|
X
|
|
1.1.4 Demonstrates knowledge and skills to identify & use different nutrition assessment screening tools appropriate for different age groups, physical, physiological, and disease statuses
|
X
|
X
|
|
1.1.5 Demonstrates knowledge and skills to perform clinical assessments relevant for the identification of undernutrition; vitamin and mineral deficiencies or excesses; diet-related non-communicable diseases; and disease conditions whose management requires nutrition therapy
|
X
|
X
|
|
1.1.6 Demonstrates knowledge and skills to perform dietary intake assessments using objective and subjective techniques
|
X
|
X
|
|
1.1.7Demonstrates knowledge on the use of different nutrition biochemical tests
|
X
|
X
|
|
1.1.8 Demonstrates ability to perform certain tests e.g. glucose, haemoglobin, vital signs (blood pressure, pulse/heart rate, body temperature, and respiration rate)
|
X
|
X
|
|
1.1.9 Demonstrates knowledge and skills necessary for obtaining client history data as relates to medical treatment, disease, socio-economic status, culture/religious factors, psychological, and physical status
|
X
|
X
|
|
X: All statements for which the 80% set level of participant consensus was attained for both levels of assessment (i.e. relevancy and suitability for undergraduate training) in the first modified Delphi round; N: Statements for which the 80% set level of participant consensus was not attained in either round; X1 :Statements for which the 80% set level of participant consensus was attained on only one of the levels of assessment in the first round; X2: Statements for which the 80% set level of participant consensus was attained for only one of the levels of assessment but in the second round
Table 3 Continued: Competency-Based Education Model Framework for Training of Human Nutrition/Human Nutrition and Dietetics at the Undergraduate Level in Uganda as Developed in this Study
ese
Competency domains, subdomains, and competencies required for the practice of Human Nutrition/Human Nutrition and Dietetics in Uganda
|
Relevancy to HN/HND Practice
|
Suitability for Undergraduate HN/HND Training
|
|
|
1.1.10 Demonstrates knowledge and skills to obtain perceptions/opinions from the client or client’s caretakers on the underlying health condition
|
X
|
X
|
|
1.1.11 Demonstrates skills necessary for undertaking community screening, identifying, and referring malnourished individuals for health services
|
X
|
X
|
|
1.1.12 Demonstrates knowledge and skills to work with other health team members to plan, conduct, and supervise home visits for active case finding of malnourished individuals
|
X
|
X
|
|
1.2 Nutrition Diagnosis: Uses client assessment data and his/her understanding of nutrition and dietetics to identify underlying problems that can be addressed through diet and nutrition-related interventions
|
X
|
X
|
|
1.2.1 Demonstrates knowledge on how to interpret results from different nutrition assessments concerning different disease causal pathways, signs, and symptoms
|
X
|
X
|
|
1.2.2 Demonstrates knowledge and skills to use assessment findings to identify the form of malnutrition; and or diet-related non-communicable or communicable disease affecting the client
|
X
|
X
|
|
1.2.3 Demonstrates knowledge and skills required to work in collaboration with other health team members to make appropriate diagnoses based on assessment findings.
|
X
|
X
|
|
1.3 Designing Nutrition Interventions: Demonstrates knowledge and skills to implement relevant diet and nutrition-related interventions depending on the disease condition, the severity of symptoms, availability of supplies, and other prevailing socio-economic and environmental conditions
|
X
|
X
|
|
1.3.1 Demonstrates knowledge and skills required to work with an interdisciplinary health team in the management of clients across the different health departments with special emphasis on paediatrics, maternity intensive care unit, dysphagia clinics, HIV/AIDS, cardiovascular unit, burn units, cancer, emergency units, chronic disease treatment units, dentistry, diabetes mellitus, obesity, hypertension, infectious diseases such as malaria, and neurologic disorder management clinics
|
X
|
X
|
|
1.3.2 Demonstrates knowledge and skills to design and implement nutrition and dietetic care intervention plans through collaboration with the client, his/her caretakers, and an interdisciplinary health care team
|
X
|
X
|
|
1.3.3 Demonstrates knowledge and skills to set measurable and achievable short and long-term recovery goals for the client based on assessment and diagnosis results
|
X
|
X
|
|
1.3.4 Demonstrates knowledge and skills to communicate results of assessment, diagnosis, and intervention plans with the client and /or, depending on prevailing circumstances, with the client's caretakers
|
X
|
X
|
|
X: All statements for which the 80% set level of participant consensus was attained for both levels of assessment (i.e. relevancy and suitability for undergraduate training) in the first modified Delphi round; N: Statements for which the 80% set level of participant consensus was not attained in either round; X1 :Statements for which the 80% set level of participant consensus was attained on only one of the levels of assessment in the first round; X2: Statements for which the 80% set level of participant consensus was attained for only one of the levels of assessment but in the second round
Table 3 Continued: Competency-Based Education Model Framework for Training of Human Nutrition/Human Nutrition and Dietetics at the Undergraduate Level in Uganda as Developed in this Study
ese
Competency domains, subdomains, and competencies required for the practice of Human Nutrition/Human Nutrition and Dietetics in Uganda
|
Relevancy to HN/HND Practice
|
Suitability for Undergraduate HN/HND Training
|
|
|
1.3.5 Demonstrates knowledge of determining client nutrition requirements upon interpretation of nutrition assessment results
|
X
|
X
|
|
1.3.6 Demonstrates knowledge and skills to design therapeutic diets tailored to particular diseases, health, and lifestyle needs
|
X
|
X
|
|
1.3.7 Demonstrates knowledge of tube feeding and skills to insert feeding tubes appropriate for different disease conditions
|
X
|
X
|
|
1.3.8 Demonstrates knowledge and skills to administer and monitor enteral therapeutic feeding depending on the client’s disease condition
|
X
|
X
|
|
1.3.9 Demonstrates knowledge and skills to administer and monitor parenteral feeding as required for different conditions
|
X
|
X
|
|
1.3.10 Demonstrates knowledge and skills to offer tailored nutrition and dietetics guidance and counselling services to clients and their caretakers
|
X
|
X
|
|
1.3.11 Demonstrates skills to sensitize clients and their guardians on the role of care for improved nutrition outcomes
|
X
|
X
|
|
1.3.12 Demonstrates knowledge and skills to support clients in managing specific nutrient-drug interactions for optimum drug efficacy
|
X
|
X
|
|
1.3.13 Demonstrates knowledge and skills to offer individualized guidance on the use of vitamin and mineral supplements to address different nutrient deficiencies
|
X
|
X
|
|
1.3.14 Demonstrates knowledge and skills to design meal plans for clients to meet therapeutic/supplementary purposes
|
X
|
X
|
|
1.3.15 Demonstrates knowledge and skills to prescribe exercise and lifestyle strategies that suit the client conditions
|
X
|
X
|
|
1.3.16 Demonstrates knowledge and skills to perform cooking demonstrations to clients and caretakers
|
X
|
X
|
|
1.3.17 Demonstrates knowledge and skills to plan for and conduct community nutrition outreaches
|
X
|
X
|
|
1.3.18 Demonstrates knowledge and skills to manage clients under the different phases of management of acute malnutrition (ITC, OTC, SFP, community outreach)
|
X
|
X
|
|
1.3.19 Demonstrates knowledge and skills to manage other cases of malnutrition amongst clients both within the hospital and in the community
|
X
|
X
|
|
1.3.20 Demonstrates knowledge of referral processes and their use in ensuring that clients receive other health care interventions beyond the realm/scope of nutrition and dietetics
|
X
|
X
|
|
X: All statements for which the 80% set level of participant consensus was attained for both levels of assessment (i.e. relevancy and suitability for undergraduate training) in the first modified Delphi round; N: Statements for which the 80% set level of participant consensus was not attained in either round; X1 :Statements for which the 80% set level of participant consensus was attained on only one of the levels of assessment in the first round; X2: Statements for which the 80% set level of participant consensus was attained for only one of the levels of assessment but in the second round
Table 3 Continued: Competency-Based Education Model Framework for Training of Human Nutrition/Human Nutrition and Dietetics at the Undergraduate Level in Uganda as Developed in this Study
ese
Competency domains, subdomains, and competencies required for the practice of Human Nutrition/Human Nutrition and Dietetics in Uganda
|
Relevancy to HN/HND Practice
|
Suitability for Undergraduate HN/HND Training
|
|
|
1.3.21 Demonstrates knowledge and adheres to established national and international guidelines and institutional protocols for nutrition assessment, classification, and management (e.g. IMAM guidelines, IYCF guidelines, Diet-related NCD guidelines)
|
X
|
X
|
|
1.4 Monitoring and Evaluation of Nutrition Interventions: Demonstrates knowledge and skills to monitor and evaluate client progress through the applied nutrition interventions and set goals
|
X
|
X
|
|
1.4.1 Demonstrates knowledge of different reference in nutrition care standards (e.g. WHO Growth Standards, Admission and Discharge Criteria)
|
X
|
X
|
|
1.4.2 Demonstrates knowledge and skills to assess client progress on interventions based on review of client medical records vis-à-vis the set goals/desired outcomes
|
X
|
X
|
|
1.4.3 Demonstrates knowledge and skills to identify and resolve the causes default and relapse amongst clients admitted to nutrition rehabilitation programs
|
X
|
X
|
|
1.4.4 Demonstrates knowledge and skills to review client adherence to prescribed interventions, identify client challenges, and adjust interventions as may be required
|
X
|
X
|
|
1.4.5 Demonstrates knowledge and skills to communicate with clients/caretakers the results of the monitoring and evaluation using easy to understand but standard terminology
|
X
|
X
|
|
1.4.6 Demonstrates knowledge and skills to compile, analyse, and utilize knowledge nutrition therapy to improve both the client and program outcomes.
|
X
|
X
|
|
1.5 Emergency Nutrition: Demonstrates knowledge of and skills to offer nutrition services in differing emergency contexts
|
X
|
X
|
|
1.5.1 Demonstrates a general understanding and application of the recommended minimum standards in humanitarian response with emphasis on food security and nutrition as stipulated in the SPHERE handbook and as updated from time to time
|
X
|
X
|
|
1.5.2 Demonstrates knowledge and skills to support the functionality of ITC, OTC, IYCFE-services in emergency and refugee settings
|
X
|
X
|
|
1.5.3 Demonstrates technical knowhow on how to plan and conduct mass screenings in refugee settlements and emergency contexts
|
X
|
X
|
|
1.5.4 Demonstrates knowledge and skills to train nutrition staff, volunteers, and peer counsellors on IYCF-E
|
X
|
X
|
|
X: All statements for which the 80% set level of participant consensus was attained for both levels of assessment (i.e. relevancy and suitability for undergraduate training) in the first modified Delphi round; N: Statements for which the 80% set level of participant consensus was not attained in either round; X1 :Statements for which the 80% set level of participant consensus was attained on only one of the levels of assessment in the first round; X2: Statements for which the 80% set level of participant consensus was attained for only one of the levels of assessment but in the second round
Table 3 Continued: Competency-Based Education Model Framework for Training of Human Nutrition/Human Nutrition and Dietetics at the Undergraduate Level in Uganda as Developed in this Study
ese
Competency domains, subdomains, and competencies required for the practice of Human Nutrition/Human Nutrition and Dietetics in Uganda
|
Relevancy to HN/HND Practice
|
Suitability for Undergraduate HN/HND Training
|
|
|
1.5.5 Demonstrates knowledge and skills to undertake monitoring of emergency activities (Food Distribution, growth monitoring and promotion, childhood nutrition, micronutrient supplementation, and IYCF-E) in refugee settlements and emergency contexts
|
X
|
X
|
|
1.5.6 Demonstrates knowledge and skills to develop and maintain humanitarian working relations with all concerned stakeholders
|
X
|
X
|
|
1.6 Technical support and capacity development in the management of malnutrition: Uses his/her expertise in nutrition and dietetics to offer technical support and capacity development as may be required by different stakeholders or fellow professionals and health team members
|
X
|
X
|
|
1.6.1 Demonstrates knowledge of different approaches applied in undertaking Quality Improvement (QI)
|
X
|
X
|
|
1.6.2 Demonstrates skills in using approved QI tools to facilitate the sustainable delivery of quality and equitable nutrition services
|
X2
|
X1
|
|
1.6.3 Demonstrates knowledge and skills to plan and conduct on-job mentorship for fellow professionals, other health staff, and Village Health Team members on various nutrition packages used in the country
|
X
|
X
|
|
1.6.4 Demonstrates knowledge and skills necessary for supervising nutrition staff and other health cadres offering nutrition services.
|
X
|
X
|
|
1.6.5 Demonstrates teamwork skills necessary for undertaking support supervision of health facilities offering nutrition services
|
X
|
X
|
|
1.6.6 Demonstrates knowledge and skills to support project needs assessment, monitoring, and evaluation to improve the provision of nutrition and dietetics services
|
X
|
X
|
|
1.6.7 Demonstrates ability to undertake personal initiative towards professional growth and development
|
X
|
X
|
|
1.7 Interprofessional collaboration in management of malnutrition: Demonstrates knowledge and skills necessary to collaborate and work with an interdisciplinary team in the management of malnutrition
|
X
|
X
|
|
1.7.1 Demonstrates knowledge and respect for the core values and responsibilities of his/her profession and those of other fellow health professionals
|
X
|
X
|
|
1.7.2 Demonstrates knowledge of ethical principles in interprofessional training and practice
|
X
|
X
|
|
1.7.3 Demonstrates teamwork and collaborative skills required to work with other health professionals for the effective delivery of health and nutrition-related services
|
X
|
X
|
|
1.7.4 Demonstrates effective verbal and non-verbal communication skills required for interprofessional collaboration
|
X
|
X
|
|
X: All statements for which the 80% set level of participant consensus was attained for both levels of assessment (i.e. relevancy and suitability for undergraduate training) in the first modified Delphi round; N: Statements for which the 80% set level of participant consensus was not attained in either round; X1 :Statements for which the 80% set level of participant consensus was attained on only one of the levels of assessment in the first round; X2: Statements for which the 80% set level of participant consensus was attained for only one of the levels of assessment but in the second round
Table 3 Continued: Competency-Based Education Model Framework for Training of Human Nutrition/Human Nutrition and Dietetics at the Undergraduate Level in Uganda as Developed in this Study
ese
Competency domains, subdomains, and competencies required for the practice of Human Nutrition/Human Nutrition and Dietetics in Uganda
|
Relevancy to HN/HND Practice
|
Suitability for Undergraduate HN/HND Training
|
|
|
1.7.5 Demonstrates knowledge and skills to identify and manage ethical dilemmas and related conflicts that may arise due to interprofessional collaborations
|
X
|
X
|
|
1.8 Water, Sanitation, and Hygiene (WASH): Demonstrates knowledge and skills required for promoting WASH at individual, household, community and facility level
|
X
|
X
|
|
1.8.1 Demonstrates knowledge of the linkage between WASH and Nutrition
|
X
|
X
|
|
1.8.2 Demonstrates knowledge and skills to promote adherence to safe water chain practices (water collection, handling, transportation, storage, treatment, and consumption)
|
X
|
X
|
|
1.8.3 Demonstrates knowledge of the different types of sanitation facilities (e.g. latrines or toilets, waste/garbage disposal) and skills to promote their use at different levels
|
X
|
X
|
|
1.8.4 Demonstrates knowledge and skills required for the promotion of individual and domestic hygiene practices
|
X
|
X
|
|
1.8.5 Demonstrates knowledge and skills relevant for ensuring infection control in health facilities
|
X
|
X
|
|
1.8.6 Demonstrates knowledge and skills required to integrate/align WASH in nutrition programming
|
X
|
X
|
|
1.9 Procurement and Management of Nutrition Supplies: Demonstrates knowledge and skills of the different processes necessary for procurement, storage, distribution, and disposal of nutrition-related supplies and/or equipment
|
X
|
X
|
|
1.9.1 Demonstrates knowledge and skills necessary for liaising with different stakeholder’s including the UN agencies and donors for the effective provision of nutrition supplies and equipment
|
X
|
X
|
|
1.9.2 Demonstrates knowledge of food safety and hygiene as applicable to nutrition supplies
|
X
|
X
|
|
1.9.3 Demonstrates skills necessary for maintaining high hygienic standards of hospital/institutional food storage facilities following recommended guidelines
|
X
|
X
|
|
1.9.4 Demonstrates knowledge and skills for effective management of nutrition commodities through forecasting, requisition, stocking, and utilization
|
X
|
X
|
|
1.9.5 Demonstrates skills in purchasing and stocking of therapeutic feeds and other related food supplies
|
X
|
X
|
|
1.10 Data management and record keeping: Demonstrates knowledge and skills for the efficient collection, analysis/processing, dissemination, use, and storage of data as relates to the provided nutrition, dietetics, and related health services
|
X
|
X
|
|
1.10.1 Demonstrates knowledge and skills on the use of different formats of patient and healthcare information systems (non-digital or digital e.g., the electronic medical record and electronic health record systems)
|
X
|
X
|
|
X: All statements for which the 80% set level of participant consensus was attained for both levels of assessment (i.e. relevancy and suitability for undergraduate training) in the first modified Delphi round; N: Statements for which the 80% set level of participant consensus was not attained in either round; X1 :Statements for which the 80% set level of participant consensus was attained on only one of the levels of assessment in the first round; X2: Statements for which the 80% set level of participant consensus was attained for only one of the levels of assessment but in the second round
Table 3 Continued: Competency-Based Education Model Framework for Training of Human Nutrition/Human Nutrition and Dietetics at the Undergraduate Level in Uganda as Developed in this Study
ese
Competency domains, subdomains, and competencies required for the practice of Human Nutrition/Human Nutrition and Dietetics in Uganda
|
Relevancy to HN/HND Practice
|
Suitability for Undergraduate HN/HND Training
|
|
|
1.10.2 Demonstrates knowledge and skills of using the different client/medical records documentation styles (e.g. ADIME: Assessment, Diagnosis, Intervention, Monitoring, and Evaluation; DAP: Diagnosis, Assessment, Plan; PES: Problem, Aetiology, Signs, and symptoms; SOAP: Subjective, Objective, Assessment, Plan)
|
X
|
X
|
|
1.10.3 Demonstrates knowledge in the use of the Health Management Information System (HMIS) as relates to the collection, processing, storage, retrieval, and dissemination of nutrition and related health information for decision making, planning, monitoring, and evaluation
|
X
|
X
|
|
1.10.4 Demonstrates knowledge and skills in using up-to-date HMIS tools (e.g. HMIS form 076, Order Form: HMIS Form 085; Daily dispensing log: HMIS Form 016; Requisition and issue voucher: HMIS Form 017; Stock card: HMIS Form 015) to capture quality HMIS data
|
X
|
X
|
|
1.10.5 Demonstrates knowledge and skills to train fellow cadres on the use of HMIS tools to capture nutrition services related data
|
X
|
X
|
|
1.10.6 Demonstrates knowledge and skills to analyse, present, and discuss HMIS nutrition data with different stakeholders for advocacy, decision making, and planning
|
X
|
X
|
|
1.10.7 Demonstrates knowledge and skills to compile and share monitoring and evaluation reports on the provided services following established organizational guidelines
|
X
|
X
|
|
1.10.8 Demonstrates knowledge and skills necessary for proper filing client/medical records and other organizational documents
|
X
|
X
|
|
Domain 2: Nutrition in the Lifecycle: Demonstrates knowledge and skills relevant for the promotion of optimal nutrition across the different stages of the human lifecycle: pregnancy and lactation, infancy, childhood, adolescence, adult years, and the elderly
|
X
|
X
|
|
2.1 Demonstrates knowledge of the nutrition requirements through the different phases of the human lifecycle
|
X
|
X
|
|
2.2 Demonstrate skills to undertake nutrition assessment, counselling, and support (NACS) in the context of MIYCAN, adults, and elderly nutrition
|
X
|
X
|
|
2.3 Demonstrates knowledge and skills to identify and manage cases of malnutrition among infants, young children, adolescents, pregnant and lactating women, adults, and the elderly
|
X
|
X
|
|
2.4 Demonstrates knowledge and skills to undertake Growth Monitoring and Promotion (GMP) activities.
|
X
|
X
|
|
2.5 Demonstrates knowledge of the role of care in nutrition and the skills necessary for its provision across the lifecycle
|
X
|
X
|
|
X: All statements for which the 80% set level of participant consensus was attained for both levels of assessment (i.e. relevancy and suitability for undergraduate training) in the first modified Delphi round; N: Statements for which the 80% set level of participant consensus was not attained in either round; X1 :Statements for which the 80% set level of participant consensus was attained on only one of the levels of assessment in the first round; X2: Statements for which the 80% set level of participant consensus was attained for only one of the levels of assessment but in the second round
Table 3 Continued: Competency-Based Education Model Framework for Training of Human Nutrition/Human Nutrition and Dietetics at the Undergraduate Level in Uganda as Developed in this Study
ese
Competency domains, subdomains, and competencies required for the practice of Human Nutrition/Human Nutrition and Dietetics in Uganda
|
Relevancy to HN/HND Practice
|
Suitability for Undergraduate HN/HND Training
|
|
|
2.6 Demonstrates knowledge and skills on infant and young child feeding as per the national guidelines (feeding infants and young children under normal circumstances; those exposed to HIV; in emergencies; and in other exceptionally difficult circumstances)
|
X
|
X
|
|
2.7 Demonstrates knowledge and skills to support clinical lactation management for the mother-infant pair
|
X
|
X
|
|
2.8 Demonstrates skills to guide and counsel HIV infected mothers on feeding recommendations for both the mothers and infants in the HIV/AIDS context
|
X
|
X
|
|
2.9 Demonstrates knowledge of different community approaches/models (e.g. community support groups, mother care support groups, Positive Deviance/Hearth approach) used to promote optimal MIYCAN; adult and geriatric nutrition
|
X
|
X
|
|
2.10 Demonstrates skills to plan and undertake community outreaches on issues relevant to promoting optimal MIYCAN; adult and geriatric nutrition
|
X
|
X
|
|
2.11 Demonstrates knowledge of public health interventions such as food fortification, iodization, bio-fortification, and their application
|
X
|
X
|
|
2.12 Demonstrates knowledge and skills to design and use appropriate and consistent Information, Education and Communication (IEC) materials for promoting optimal MIYCAN; adult; and geriatric nutrition
|
X
|
X
|
|
2.13 Demonstrates knowledge of the Baby-Friendly Hospital Initiative (BFHI) and skills necessary for supporting facilities to obtain BFHI status
|
X
|
X
|
|
2.14 Demonstrates knowledge of the WHO International Code of Marketing Breast milk Substitutes
|
X
|
X
|
|
2.15 Demonstrates knowledge of existing national policies, guidelines, and protocols that support the promotion of MIYCAN; adult and geriatric nutrition (e.g. National Health Policy, National Policy Guidelines and Service Standards for Reproductive Health Services, National Anaemia Policy, BFHI guidelines, Integrated Management of Childhood Illnesses guidelines, Food Fortification guidelines)
|
X
|
X
|
|
2.16 Demonstrates knowledge and skills to work inter-professionally and in collaboration with other key stakeholders to promote MIYCAN; adult and geriatric nutrition
|
X
|
X
|
|
2.17 Demonstrates knowledge and skills to provide technical support and guidance to district leadership on strategies to promote optimal MIYCAN; adult and geriatric nutrition
|
X
|
X
|
|
Domain 3: Food Security; Agriculture; and Livelihoods Promotion: Demonstrates knowledge and skills of implementing food security and safety; agriculture; and livelihoods interventions
|
X
|
X
|
|
X: All statements for which the 80% set level of participant consensus was attained for both levels of assessment (i.e. relevancy and suitability for undergraduate training) in the first modified Delphi round; N: Statements for which the 80% set level of participant consensus was not attained in either round; X1 :Statements for which the 80% set level of participant consensus was attained on only one of the levels of assessment in the first round; X2: Statements for which the 80% set level of participant consensus was attained for only one of the levels of assessment but in the second round
Table 3 Continued: Competency-Based Education Model Framework for Training of Human Nutrition/Human Nutrition and Dietetics at the Undergraduate Level in Uganda as Developed in this Study
ese
Competency domains, subdomains, and competencies required for the practice of Human Nutrition/Human Nutrition and Dietetics in Uganda
|
Relevancy to HN/HND Practice
|
Suitability for Undergraduate HN/HND Training
|
|
|
3.1 Nutrition-sensitive Agriculture, Food Security, and Livelihoods Promotion: Demonstrates knowledge and skills to design and implement nutrition-sensitive agriculture, food security, and livelihoods interventions in different contexts
|
X
|
X
|
|
3.1.1 Demonstrates knowledge of the concept of food and nutrition security and the cross-cutting issues between food and nutrition security and gender; climate change; HIV/AIDs; conflicts, crises, and natural disasters, political stability/instability; poverty; and sustainable livelihoods
|
X
|
X
|
|
3.1.2 Demonstrates knowledge of the different instruments for preventing and managing food crises (Food aid, Food security reserves, Food security funds, Crisis management plans, Early warning, and market information systems)
|
X
|
X
|
|
3.1.3 Demonstrates knowledge of the concept of livelihoods promotion, related strategies, and activities
|
X
|
X
|
|
3.1.4 Demonstrates knowledge of indicators of food and nutrition security at different levels (micro, meso, and macro)
|
X
|
X
|
|
3.1.5 Demonstrates knowledge and skills necessary for implementing integrated nutrition, food security, and livelihoods projects
|
X
|
X
|
|
3.1.6 Demonstrates knowledge and skills to analyse the influence of existing national laws, regulations, policies, and sectoral plans on food security and livelihoods
|
X1
|
N
|
|
3.1.7 Demonstrates knowledge and skills necessary for implementing good agricultural practices (GAPs) in crop production
|
X
|
X
|
|
3.1.8 Demonstrates knowledge of climate-smart approaches and skills necessary for their application in the agriculture value chain
|
X
|
X
|
|
3.1.9 Demonstrates knowledge and skills to select and implement nutrition-sensitive agriculture interventions (e.g. establishing home gardens, cultivation of fruits and vegetables, household domestication of small livestock)
|
X
|
X
|
|
3.1.10 Demonstrates knowledge and skills of livestock production
|
N
|
X1
|
|
3.1.11 Demonstrates knowledge and skills necessary for implementing community and school feeding projects
|
X
|
X
|
|
3.1.12 Demonstrates knowledge and skills of designing and implementing assessments for food security, agriculture, and livelihoods at different levels
|
X
|
X
|
|
3.2 Post-harvest handling and food safety management: Demonstrates knowledge and skills to promote food safety across the food value chain
|
X
|
X
|
|
3.2.1 Demonstrates knowledge of post-harvest handling and skills to control food losses (in terms of quantity and quality) along the food value chain using modern and local/traditionally effective techniques
|
X
|
X
|
|
X: All statements for which the 80% set level of participant consensus was attained for both levels of assessment (i.e. relevancy and suitability for undergraduate training) in the first modified Delphi round; N: Statements for which the 80% set level of participant consensus was not attained in either round; X1 :Statements for which the 80% set level of participant consensus was attained on only one of the levels of assessment in the first round; X2: Statements for which the 80% set level of participant consensus was attained for only one of the levels of assessment but in the second round
Table 3 Continued: Competency-Based Education Model Framework for Training of Human Nutrition/Human Nutrition and Dietetics at the Undergraduate Level in Uganda as Developed in this Study
ese
Competency domains, subdomains, and competencies required for the practice of Human Nutrition/Human Nutrition and Dietetics in Uganda
|
Relevancy to HN/HND Practice
|
Suitability for Undergraduate HN/HND Training
|
|
|
3.2.2 Demonstrates knowledge and skills to apply the principles of Hazard Analysis and Critical Control Point (HACCP) in the food industry
|
N
|
X1
|
|
3.2.3 Demonstrates knowledge and skills to apply the CODEX general principles of food hygiene and food safety management
|
X
|
X
|
|
Domain 4: Ethics and professionalism in Nutrition and Dietetics: Demonstrates ethics and professionalism in the practice of nutrition and dietetics
|
X
|
X
|
|
4.1 Knowledge of Codes of Ethics, Practice Guidelines, and Standard Operating Procedures: Demonstrates knowledge of the existing professional codes of ethics, practice guidelines, and standard operating procedures in the practice of nutrition and dietetics
|
X
|
X
|
|
4.1.1 Demonstrates knowledge of the existing national codes of ethics, practice guidelines, and standard operating procedures (e.g. Code of Conduct and Ethics for the Uganda Public Service and the Code of Conduct and Ethics for Health Workers)
|
X
|
X
|
|
4.1.2 Demonstrate knowledge and skills necessary to recognise and work within the boundaries of organisational laws, regulations, guidelines, protocols, and standard operating procedures
|
X
|
X
|
|
4.1.3 Demonstrates knowledge and skills to identify and resolve work-related conflicts
|
X
|
X
|
|
4.2 Ethical principles in practice: Demonstrates skills necessary for upholding professionalism, confidentiality, transparency, integrity, and accountability in delivering professional related services
|
X
|
X
|
|
4.2.1 Demonstrates skills necessary for engaging clients/caretakers in making informed decisions as relates to the interventions to be undertaken
|
X
|
X
|
|
4.2.2 Demonstrates knowledge and skills necessary for upholding client privacy and confidentiality
|
X
|
X
|
|
4.2.3 Demonstrates knowledge and skills necessary to maintain professional-client boundaries
|
X
|
X
|
|
4.2.4 Demonstrates skills necessary for upholding human rights principles (Universality and Inalienability; Indivisibility; Interdependence and Interrelatedness; Equality and Non-discrimination; Participation and Inclusion; and Accountability and Rule of Law) in dealing with clients
|
X
|
X
|
|
Domain 5: Research and Data Analysis: Demonstrates knowledge and skills necessary to coordinate nutrition and health-related research processes from planning, data collection, analysis, report writing, and dissemination of findings
|
X
|
X
|
|
X: All statements for which the 80% set level of participant consensus was attained for both levels of assessment (i.e. relevancy and suitability for undergraduate training) in the first modified Delphi round; N: Statements for which the 80% set level of participant consensus was not attained in either round; X1 :Statements for which the 80% set level of participant consensus was attained on only one of the levels of assessment in the first round; X2: Statements for which the 80% set level of participant consensus was attained for only one of the levels of assessment but in the second round
Table 3 Continued: Competency-Based Education Model Framework for Training of Human Nutrition/Human Nutrition and Dietetics at the Undergraduate Level in Uganda as Developed in this Study
ese
Competency domains, subdomains, and competencies required for the practice of Human Nutrition/Human Nutrition and Dietetics in Uganda
|
Relevancy to HN/HND Practice
|
Suitability for Undergraduate HN/HND Training
|
|
|
5.1 Planning & Data Collection: Demonstrates knowledge and skills required for developing research plans and data collection
|
X
|
X
|
|
5.1.1 Demonstrates knowledge and skills on the application of different research designs
|
X
|
X
|
|
5.1.2 Demonstrates knowledge and skills on the use of different quantitative and qualitative data collection methods and techniques
|
X
|
X
|
|
5.1.3 Demonstrates knowledge and skills required to design appropriate nutrition and health-related data collection tools
|
X
|
X
|
|
5.1.4 Demonstrates knowledge and skills on the use of different nutrition indicators (nutrition status indicators, indicators for assessing the causes of malnutrition (e.g. food insecurity indicators; care and caring practices; and environmental hygiene and access to the health services), indicators for monitoring and evaluating the performance of nutrition programmes/projects, and related indicators as applied in demographic and health survey studies) in research
|
X
|
X
|
|
5.1.5 Demonstrates knowledge and skills to design articulate research proposals
|
X
|
X
|
|
5.1.6 Demonstrates knowledge of different academic databases and search engines and their use in identifying relevant nutrition and health-related research
|
X
|
X
|
|
5.1.7 Demonstrates knowledge and skills to work with interdisciplinary teams to plan and undertake research at the community, district, regional, and or national level
|
X
|
X
|
|
5.1.8 Demonstrates knowledge of ethical principles in research and adheres to the established research guidelines by the Uganda National Council of Science and Technology
|
X
|
X
|
|
5.1.9 Demonstrates knowledge and skills to identify research opportunities relevant to professional practice
|
X
|
X
|
|
5.2 Data Analysis, Report Writing, and Results Dissemination: Demonstrates knowledge and skills to ably undertake data analysis, report writing, and results dissemination
|
X
|
X
|
|
5.2.1 Demonstrates knowledge and skills on the application of appropriate statistical tests (both parametric and non-parametric)
|
X1
|
N
|
|
5.2.2 Demonstrates knowledge and skills on the use of different software programs (e.g. NutriSurvey, ENA for SMART, WHO Anthro, WHO AnthroPlus, EPI/ENA, EPiInfo, SPSS, STATA, ATLAS.ti, and NVivo) applied in the analysis of nutrition-related data
|
X
|
X
|
|
5.2.3 Demonstrates knowledge and skills on the use of the Health Management Information Systems to support data analysis and reporting
|
X
|
X
|
|
X: All statements for which the 80% set level of participant consensus was attained for both levels of assessment (i.e. relevancy and suitability for undergraduate training) in the first modified Delphi round; N: Statements for which the 80% set level of participant consensus was not attained in either round; X1 :Statements for which the 80% set level of participant consensus was attained on only one of the levels of assessment in the first round; X2: Statements for which the 80% set level of participant consensus was attained for only one of the levels of assessment but in the second round
Table 3 Continued: Competency-Based Education Model Framework for Training of Human Nutrition/Human Nutrition and Dietetics at the Undergraduate Level in Uganda as Developed in this Study
ese
Competency domains, subdomains, and competencies required for the practice of Human Nutrition/Human Nutrition and Dietetics in Uganda
|
Relevancy to HN/HND Practice
|
Suitability for Undergraduate HN/HND Training
|
|
|
5.2.4 Demonstrates knowledge and skills to consolidate research findings into articulate reports
|
X
|
X
|
|
5.2.5 Demonstrates knowledge and skills required to write technical research reports
|
X
|
X
|
|
5.2.6 Demonstrates knowledge and skills of planning and hosting seminars, workshops, and conferences as well as sharing nutrition research with all relevant stakeholders using different fora
|
X1
|
N
|
|
5.2.7 Demonstrates ability to undertake personal capacity development initiatives in advanced research in nutrition, health, and other relevant disciplines
|
X
|
X
|
|
Domain 6: Policy; Advocacy; Social and Behaviour Change Communication (SBCC): Demonstrates knowledge and skills to contribute to policy, advocacy, and SBCC relevant to nutrition
|
X
|
X
|
|
6.1 Policy: Demonstrates knowledge and skills to contribute to the different stages of the policy cycle (Formulation, Implementation, and Evaluation)
|
X1
|
N
|
|
6.1.1 Demonstrates knowledge of the different national policies; laws; regulations; and sectoral policies and plans relevant to nutrition
|
X1
|
N
|
|
6.1.2 Demonstrates knowledge and skills to contribute to the formulation of nutrition policies and guidelines
|
X1
|
N
|
|
6.1.3 Demonstrates knowledge and skills to contribute to the evaluation/analysis of nutrition policies and guidelines
|
X1
|
N
|
|
6.2 Advocacy: Demonstrates knowledge and skills necessary for planning and managing nutrition-related advocacy campaigns
|
X1
|
N
|
|
6.2.1 Demonstrates knowledge and skills required to undertake evidence-based policy and budget advocacy at different levels to influence change for nutrition
|
X1
|
N
|
|
6.2.2 Demonstrates knowledge of the different phases in developing advocacy strategies/plans (goal development; identification of primary and secondary audiences; identifying potential allies and opponents; selecting effective advocacy approaches; identification/development of advocacy messages; budgeting and identification of resources; and undertaking risk assessments for the developed strategies/plans)
|
X1
|
N
|
|
6.2.3 Demonstrates knowledge and skills to use different advocacy techniques (e.g. policy monitoring and public accountability, policy dialogues, capacity building of stakeholders advocacy)
|
X1
|
N
|
|
6.2.4 Demonstrates knowledge and skills to develop different advocacy tools (e.g. clear and concise audio messages) suitable for use across different channels
|
X1
|
N
|
|
6.2.5 Demonstrates knowledge and skills to use different advocacy tactics (e.g. letter writing, lobbying, use of media and internet, legal actions, campaigns, protests, and demonstrations)
|
X
|
X
|
|
X: All statements for which the 80% set level of participant consensus was attained for both levels of assessment (i.e. relevancy and suitability for undergraduate training) in the first modified Delphi round; N: Statements for which the 80% set level of participant consensus was not attained in either round; X1 :Statements for which the 80% set level of participant consensus was attained on only one of the levels of assessment in the first round; X2: Statements for which the 80% set level of participant consensus was attained for only one of the levels of assessment but in the second round
Table 3 Continued: Competency-Based Education Model Framework for Training of Human Nutrition/Human Nutrition and Dietetics at the Undergraduate Level in Uganda as Developed in this Study
ese
Competency domains, subdomains, and competencies required for the practice of Human Nutrition/Human Nutrition and Dietetics in Uganda
|
Relevancy to HN/HND Practice
|
Suitability for Undergraduate HN/HND Training
|
|
|
6.2.6 Demonstrates knowledge and skills to undertake national and local level nutrition advocacy targeting decision-makers or influencers
|
X1
|
N
|
|
6.2.7 Demonstrates knowledge and skills to monitor and evaluate the impact of advocacy initiatives
|
X1
|
N
|
|
6.3 Social and Behaviour Change Communication: Demonstrates knowledge and skills necessary for planning, undertaking, and managing SBCC
|
X
|
X
|
|
6.3.1 Demonstrates knowledge and skills to analyse and understand health and nutrition behaviours and the context in which they occur
|
X
|
X
|
|
6.3.2 Demonstrates knowledge and skills of identifying and addressing the undesirable/un-intended culture/religious beliefs, practices, and food taboos existing in communities
|
X
|
X
|
|
6.3.3 Demonstrates knowledge and skills to use/apply different theories of behaviour change (e.g. Health Belief Model, Theory of Planned Behaviour, Stages of Change/Trans-theoretical Model, Social Learning Theory) in different contexts
|
X
|
X
|
|
6.3.4 Demonstrate knowledge and skills to network and work with other partners in the development of context-specific communication strategies for use in influencing positive behaviour change
|
X
|
X
|
|
6.3.5 Demonstrates knowledge and skills to develop and promote the use of appropriate IEC materials for influencing positive behaviour change in different settings
|
X
|
X
|
|
6.3.6 Demonstrates knowledge of and adheres to ethical and ‘do no harm’ principles (Respect everyone equally; Use acceptable methods for influence; Be conscious about power dynamics and risks of violence; Be transparent; Ensure people’s rights to privacy; Do not allow the shaming of individuals or groups; Establish and implement a clear Code of Conduct; Monitor and encourage feedback) in SBCC programming
|
X
|
X
|
|
6.3.7 Demonstrates knowledge and skills to mobilize community members, community groups, and existing community organizations towards undertaking sustainable engagements for influencing positive behaviour change
|
X
|
X
|
|
6.3.8 Demonstrates knowledge and skills to use different communication channels (e.g. face-to-face, broadcast media, mobile, electronic, and written) in undertaking SBCC
|
X
|
X
|
|
6.3.9 Demonstrates knowledge and skills to monitor and evaluate the impact of SBCC initiatives on nutrition-related outcomes
|
X
|
X
|
|
Domain 7: Nutrition Leadership and Management: Demonstrates knowledge of leadership and management skills necessary for nutrition programming
|
X
|
X
|
|
X: All statements for which the 80% set level of participant consensus was attained for both levels of assessment (i.e. relevancy and suitability for undergraduate training) in the first modified Delphi round; N: Statements for which the 80% set level of participant consensus was not attained in either round; X1 :Statements for which the 80% set level of participant consensus was attained on only one of the levels of assessment in the first round; X2: Statements for which the 80% set level of participant consensus was attained for only one of the levels of assessment but in the second round
Table 3 Continued: Competency-Based Education Model Framework for Training of Human Nutrition/Human Nutrition and Dietetics at the Undergraduate Level in Uganda as Developed in this Study
ese
Competency domains, subdomains, and competencies required for the practice of Human Nutrition/Human Nutrition and Dietetics in Uganda
|
Relevancy to HN/HND Practice
|
Suitability for Undergraduate HN/HND Training
|
|
|
7.1 Planning and Budgeting: Demonstrates knowledge and skills to develop and operationalize nutrition program/project proposals, plans and budgets
|
X
|
X
|
|
7.1.1 Demonstrates knowledge and skills to develop nutrition program or project proposals, work plans, and budgets
|
X1
|
N
|
|
7.1.2 Demonstrates knowledge and skills to undertake resource mobilization (e.g. through the raising of new resources, maximizing the use of already existing resources, and mapping of potential funders)
|
X1
|
N
|
|
7.1.3 Demonstrates knowledge and skills to undertake nutrition program/project budget tracking
|
X1
|
N
|
|
7.2 Human Resource Management: Demonstrates knowledge of and skills to undertake different human resource managerial roles (staff recruitment, training; motivation; appraisal and employee relations management)
|
X
|
X
|
|
7.2.1 Demonstrates knowledge of leadership and management principles
|
X
|
X
|
|
7.2.2 Demonstrates knowledge and skills to contribute to the recruitment of program/project staff and related support teams
|
X
|
X
|
|
7.2.3 Demonstrates knowledge of the processes and the benefits of supportive supervision
|
X
|
X
|
|
7.2.4 Demonstrates skills to set up organizational supportive supervision systems (plan, conduct, and follow up supportive supervision activities)
|
X
|
X
|
|
7.2.5 Demonstrates knowledge and skills to organize, coordinate, and contribute to training and mentorships of program/project staff and related stakeholders
|
X
|
X
|
|
7.3 Multi-sectoral and multi-stakeholder engagement: Demonstrates knowledge and skills to engage in multi-sectoral and multi-stakeholder partnerships to maximize collaboration and ensure proper coordination of joint activities
|
X
|
X
|
|
7.3.1 Demonstrates knowledge and skills to map relevant program/project stakeholders at different levels of planning and or implementation
|
X1
|
N
|
|
7.3.2 Demonstrates knowledge and skills to work in multistakeholder nutrition partnerships/engagements
|
X
|
X
|
|
7.3.3 Demonstrates knowledge and skills to identify and manage conflicts of interest (whether potential, real, perceived, and divergent, or convergent) that arise in multi-sectoral and multi-stakeholder partnerships
|
X
|
X
|
|
7.3.4 Demonstrates knowledge on the composition, governance, and functionality of Multi-sectoral Coordination Committees at different levels
|
X1
|
N
|
|
X: All statements for which the 80% set level of participant consensus was attained for both levels of assessment (i.e. relevancy and suitability for undergraduate training) in the first modified Delphi round; N: Statements for which the 80% set level of participant consensus was not attained in either round; X1 :Statements for which the 80% set level of participant consensus was attained on only one of the levels of assessment in the first round; X2: Statements for which the 80% set level of participant consensus was attained for only one of the levels of assessment but in the second round
Table 3 Continued: Competency-Based Education Model Framework for Training of Human Nutrition/Human Nutrition and Dietetics at the Undergraduate Level in Uganda as Developed in this Study
ese
Competency domains, subdomains, and competencies required for the practice of Human Nutrition/Human Nutrition and Dietetics in Uganda
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Relevancy to HN/HND Practice
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Suitability for Undergraduate HN/HND Training
|
|
|
7.3.5 Demonstrate knowledge and skills to support Nutrition Coordination Committees in developing Multi-sectoral Nutrition Action Plans
|
X
|
X
|
|
7.4 Program/project Implementation: Demonstrates knowledge and skills to oversee timely and efficient program/project implementation
|
X
|
X
|
|
7.4.1 Demonstrates knowledge and skills necessary for program/project implementation in line with agreed-upon protocols
|
X
|
X
|
|
7.4.2 Demonstrates knowledge and skills to plan and lead organizational committee meetings
|
X
|
X
|
|
7.4.3 Demonstrates knowledge and skills to analyse technical program/project reports and follow up on the implementation of recommendations
|
X1
|
N
|
|
7.5 Monitoring and Evaluation: Demonstrates knowledge and skills to plan, collect, and analyse data in regards to program/project implementation schedules, inputs, processes, and outputs/deliverables to enable the undertaking of timely decisions for improving performance and accountability
|
X
|
X
|
|
7.5.1 Demonstrates competency in undertaking monitoring and evaluation of program/project
|
X1
|
N
|
|
7.5.2 Demonstrates knowledge and skills on the use of the Development Assistance Committee principles (relevance, effectiveness, efficiency, impact, and sustainability) in program/project evaluation
|
X1
|
N
|
|
7.5.3 Demonstrates knowledge and skills to analyse program/project monitoring and evaluation data to make relevant recommendations for performance improvement
|
X1
|
N
|
|
7.5.4 Demonstrates knowledge and skills to prepare and present timely reports on program/project outcomes, activities, processes, and lessons learned to different stakeholders
|
X
|
X
|
|
7.5.5 Demonstrates knowledge of quality improvement (QI) and the skills to undertake and coordinate QI activities for improving program/project performance
|
X
|
X
|
|
X: All statements for which the 80% set level of participant consensus was attained for both levels of assessment (i.e. relevancy and suitability for undergraduate training) in the first modified Delphi round; N: Statements for which the 80% set level of participant consensus was not attained in either round; X1 :Statements for which the 80% set level of participant consensus was attained on only one of the levels of assessment in the first round; X2: Statements for which the 80% set level of participant consensus was attained for only one of the levels of assessment but in the second round