Assessing the Self-Efficacy and Barriers of Nutrition Counselors in Providing Nutrition Education in Cameroon, Africa

Abstract

To qualitatively assess the self-efficacy and perceived barriers of nutrition counselors after a 6-week training course. Most counseling in sub-Saharan Africa is conducted by mid-level nurses or community volunteers, and little is done to develop capacity for nutrition at the professional, organizational, or systemic levels. Since 2007, the Cameroon Baptist Convention Health Services (CBCHS) Nutrition Improvement Program has trained and integrated nutrition counselors into prevention of mother-to-child transmission of HIV programs, infant welfare clinics, and antenatal clinics to improve infant and young child feeding practices. At the beginning, middle, and end of the six-week training, nutrition counselors were asked to journal about their perceived barriers and self-efficacy to provide nutrition counseling. Thirty-nine nutrition counselors (1 male, 38 females) enrolled in a training at CBCHS. Using qualitative inductive content analysis, journals were coded, categorized for themes regarding perceived barriers and self-efficacy, and checked for inter-consistency. Nutrition counselors stated that role-playing, learning songs and dramas about young child feeding, and group discussions improved their self-efficacy. The perceived barriers included finances, concerns about communicating with clients, lack of cooperation with other health care providers, and transportation. Training a cadre of nutrition counselors is one approach towards increasing human resources to implement nutrition interventions. Trainings should include active teaching methods such as role-playing, dramas, songs and reflective journaling while attending to barriers such as transportation, interpersonal communication, and finances.