Nutrition Education and Counselling

Learning objectives

At the end of the lecture students should be to;

• Explain the meaning of nutrition education and how to apply it
• Explain the meaning of nutrition counselling and how apply it
• Nutrition education presents general information related to health
and nutrition, often to groups in clinic waiting rooms or community
settings.
• Nutrition education can be defined as learning experiences designed
to facilitate the voluntary adoption of eating and other nutrition-
related behaviors conducive to health and well-being.
• Educators may be nutritionists, trained counselors or health
volunteers who deliver prepared talks on specific topics, often using
visual aids.
• They should encourage clients to ask questions and direct them to
additional information as needed.
• Nutrition education can also be referred to as behavioral change
communication (BCC)
• Nutrition education centres on people, their lifestyles, motivations
and and social context
• It is also demonstrably capable of improving dietary behaviour and
nutrition status.
• It is low-cost, practicable and sustainable.
• It is mainly concerned with whatever influences food consumption and
dietary practices: food habits and food purchasing, food preparation, food
safety and environmental conditions.
• Many causes of poor nutrition are attitudes and practices which can be
influenced by education e.g
✓food taboos,
✓long established dietary and snacking habits,
✓agricultural production decisions,
✓food distribution in the family,
✓ideas about child feeding,
✓misleading food advertising,
✓ignorance of food hygiene,
✓negative attitudes to vegetables.
• Education is becoming critically necessary in countries affected by
globalisation and urbanization which are experiencing a dangerous
dietary transition to cheap processed foods rich in sugar, fat and salt.
• Nutrition counseling is a two-way interaction through which a client
and a trained counsel or nutritionist interpret the results of nutrition
assessment, identify individual nutrition needs and goals, discuss
ways to meet those goals, and agree on next steps.
• Nutrition counseling aims to help clients understand important
information about their health and focuses on practical actions to
address nutrition needs, as well as the benefits of behavior change.
• Nutrition counselors may be nutritionists, nurses or other facility-
based providers or community health workers or volunteers.
What makes nutrition counselling effective

• Optimal counseling contributes to successful health and nutrition

outcomes.
• Ideally, counseling should be done in a place where the client feels
comfortable and has privacy.
• This may be more challenging in a busy health facility than in a
community setting, but adjustments can be made to improve the
situation.
• Counselors should be trained to understand and use support
materials such as flipcharts, counseling cards, take-home brochures,
data collection forms, and referral forms effectively.
Ethical principles for counseling

Upholding ethical standards is also essential for effective counseling.

1. Provide accurate information. Clients should be able to trust that
counselors’ words and actions are truthful
and reliable.
2. Keep client information confidential. Clients need to know that
counselors will keep their information confidential except as needed for
their treatment or recovery.
3. Respect clients’ autonomy. Clients have the right to make their own
decisions without coercion.
4. Keep clients’ interests in mind. Advise them based on professional
assessment and offer alternatives if you cannot help them.
5. Do no harm. Avoid any interventions that could harm or exploit
clients emotionally, financially, or medically.
6. Be fair. Treat all clients fairly and without discrimination. Respect
clients’ rights, dignity, and individual difference.
• The foundation of effective counseling is asking questions about the
client’s symptoms and situation to be able to give appropriate
information and support the client to make healthy choices at home.
• Just telling people what to do does not mean that they will do it,
because knowledge is not enough to change behavior.
• Counselors need to know not only what messages are appropriate,
but also how to prioritize those messages depending on clients’ needs
and how to deliver them effectively in a short time.
• This requires practice and experience. Different mnemonic devices
have been developed to help counselors remember the steps in
counseling and guide sound technique.
• These can also be used during training role-plays and supervision and
mentoring visits.
Tips for Effective Counseling

• Do more listening than talking.

• Ask open-ended questions, not just questions clients can answer
with “yes” or “no.”
• Repeat what clients say to make sure you understood them correctly.
• Show interest in and empathy for clients’ problems and situations.
• Avoid judging clients.
• Listen to what clients think and respect their feelings, even if
information may need correction.
• Recognize and praise what clients are doing correctly.
• Suggest actions that are possible for clients given their situations.
• Give only a little bit of information at a time.
• Use simple language.
• Give suggestions, not commands.
GALIDRAA approach to counseling
• GALIDRAA has proven effective in many settings and captures the
essential elements of effective counseling interactions. It can be
adapted as needed for other languages.
•
GALIDRAA
1. Greet the client. Ask him or her to sit down and then exchange introductions to establish a
comfortable atmosphere.
2. Ask the client about his or her situation and current practices using open-ended questions
and familiar language.
3. Listen to what the client and/or caregiver says. Notice body language, use probing
questions, and reflect back what the client says to make sure you understand it correctly.
4. Identify the client’s key problems and help select the most important ones to address.
5. Discuss options, considering what is realistic and using visual materials to engage the client
and/or caregiver in discussion.
6. Recommend and negotiate a small, doable action, explaining the rationale and benefits.
7. Ask the client to repeat what he or she understood from the discussion and what action he
or she Agrees to try at home.
8. Make a follow-up Appointment and ask the client to repeat the date.
• The graphic below shows best practices for effective counseling. It can
be used as a handy job aid to help counselors follow the essential
steps in a counseling session.
• To test which behaviors recommended in counseling are acceptable
and feasible, counselors can give clients a choice of
recommendations, ask them which action they can carry out given
their situation, and follow up to find out whether they tried the new
practice or modified it and how they felt it worked.