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Martha Nakakande is the Global Nutrition Cluster’s CMAM Advisor, and co-chair to its Anti-racism & Localisation Working Group. She has extensive experience delivering Training of Trainers (ToTs) in various nutrition technical areas, including In-patient care, Outpatient care, Coaching and Simplified Approaches.

ToTs are a type of training where participants – local and national actors (LNAs) – are taught how to develop and deliver the training themselves. Participants are then able to conduct training sessions in their region, to their staff, ultimately enabling local actors to lead humanitarian activities in their settings – where they really own the expertise. As a result, ToTs increase the competency of local and national trainers and therefore has an important role in fostering localisation* efforts.  

“ToTs are one of the best ways in which LNAs are able to get extensive knowledge within their fields, especially when time and funding are limited. That is because ToTs create a pool of subject-matter individuals who continue to support and ensure better working of the LNAs. The newly trained professionals can ensure greater capacity strengthening in their organisations by cascading the knowledge to all staff. Even if many LNAs are affected by staff turnover, the knowledge remains in the community. And this training provides local actors with an edge to compete with International Non-Governmental Organisations (INGOs).”

To mark International Education Day, Martha talks about the positive aspects and main challenges of this type of training, and highlights key aspects to consider when organising it. 

How do ToTs support localisation efforts?

“ToTs are one of the best ways in which LNAs are able to get extensive knowledge within their fields, especially when time and funding are limited. That is because ToTs create a pool of subject-matter individuals who continue to support and ensure better working of the LNAs. The newly trained professionals can ensure greater capacity strengthening in their organisations by cascading the knowledge to all staff. Even if many LNAs are affected by staff turnover, the knowledge remains in the community. And this training provides local actors with an edge to compete with International Non-Governmental Organisations (INGOs).”

GNCs Martha Nakakande delivering a ToT in Somalia
Martha, GNC CMAM Advisor, delivering a ToT in Somalia (2023)

 

What are the strengths of the ToT model in Nutrition in Emergencies (NiE) contexts?

“ToTs are, overall, great avenues to practise specific skills. These are some of the positive outcomes I would highlight:

  • They create a pool of persons with in-depth knowledge on a thematic area.
  • The methodology used promotes practical training, which results in better outcomes than purely classroom-based training.
  • By training just a few individuals, who will then pour the knowledge across their staff, you can ensure that the support reaches many different organisations.”
ToT session
Participants of ToT in Somalia (2023)

 

What are areas where the ToT model in NiE contexts can be strengthened?

“Some aspects to consider are:

  • There is a potential for staff turnover towards INGOs because trained staff becomes attractive and INGOs can offer a better pay.
  • They can be expensive, especially for LNAs.
  • There is a risk that participants will not be able to carry out training for their own staff without proper funding and/or planning support.”

What are the main aspects to consider when designing ToTs in NiE contexts? 

“We must always consider the full training cycle, from assessment to post training support. These are some aspects that can be key when organising ToTs in a nutrition emergency context:

  • Location: ToTs should be conducted in an environment that allows for practical aspects to be implemented. Within the context of Somalia, for instance, it’s important that the location is conducive in terms of security, allowable work time and limited distractions. 
  • Selection of participants: It's important to invite the ‘right’ persons for the training. These should be staff members who have a direct managerial role and would be able to cascade training and utilise the gained knowledge in their communities.
  • Immediate needs and expected outcomes. ToTs are generally intensive, time consuming and costly. Therefore, it is important to set a clearly defined objective considering the context, the time available, and challenges at hand.
  • Available resources. It’s essential to plan considering what assets are available.
  • Language to use. Not all LNAs have staff that are fluent in English. In the case of Somalia, we use both English and Somali.”
Training participants
Two participants in ToT in Somalia (2023)

 

The positive impact of ToTs on the ground 

In May 2023, Martha travelled to Galkacyo (Somalia) to deliver a ToT on In-patient Management of Severe Acute Malnutrition to actors involved in the preparedness and coordination of the nutrition response to emergencies. The feedback from the participants was overwhelmingly positive. They considered the training a true form of learning exchange, especially because they were taught by staff at the Galkacyo South Hospital Stabilisation centre. 

Five months after the training, ToT participant and Sub-cluster Nutrition Manager in Somalia, Aden Mohamed Ali, explains the impact of the training on the ground:

“I have seen the positive impact of the training in Hirshabelle state stabilisation centres. The training has helped improve the knowledge and skills of the staff from local partners and Government on how to conduct effective and participatory training sessions, how to coach and mentor health workers, and how to monitor and evaluate the quality of the training.The training has also contributed to the improvement of the overall performance of these stabilisation centres, such as reducing the mortality rate, increasing the cure rate, and decreasing the default rate. As a trainer and a nutritionist, I believe it has made a difference in the lives of the children who suffer from severe acute malnutrition.”  

Aden Mohamed
Aden Mohamed Ali during ToT on Stabilization Case Management in Galkacyo in May 2023

 

The importance of prioritising localisation in humanitarian settings

Alexandra Humphreys is the Interim Localisation Helpdesk for the GNC and co-chairs the Anti-racism & Localisation Working Group with Martha. She is adamant on the importance of prioritising local expertise in nutrition interventions:

“LNAs overwhelmingly carry the risk of humanitarian intervention and the majority of humanitarian deaths are among local staff. Meanwhile, LNAs are the best positioned to provide appropriate aid in most cases, given their access to affected populations and their contextual expertise (knowledge of the local language(s), customs, ways of being, communication channels, existing relationships, and partnerships with nutrition actors and beyond) in addition to technical expertise. 

Despite this, LNAs received just 1.2% of direct humanitarian funding in 2021. Donors need to prioritise flexible, multi-year, direct funding to LNAs while making space for LNAs to lead how crises are managed. Only then can LNA operations be more responsive, sustainable, and better funded to provide adequate salaries and benefits for their staff.”

*We acknowledge that the term 'localisation' is an imperfect term that is top-down in nature and will likely be replaced in the future.

 


 

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