University of Ghana http://ugspace.ug.edu.gh
 UNIVERSITY OF GHANA 
COLLEGE OF HUMANITIES 
SCHOOL OF LANGUAGES 
DEPARTMENT OF FRENCH 
 
 
 
SPECIALISED LANGUAGE COLLOCATIONS: A FRENCH-ENGLISH 
TRANSLATION OF A PORTION OF “PROTOCOLE NATIONAL DE PRISE EN 
CHARGE DE LA MALNUTRITION AIGUË GLOBALE EN HAÏTI” 
                                       
     
                                                                        BY 
 
                                               JENNIFER TALUAH WEBADUA 
                                                                 (10454461) 
 
A DISSERTATION SUBMITTED TO THE UNIVERSITY OF GHANA, LEGON, IN 
PARTIAL FULFILLMENT OF THE REQUIREMENT FOR THE AWARD OF MASTER 
OF ARTS IN TRANSLATION 
  
OCTOBER, 2020
  
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DECLARATION 
 
I, Taluah Webadua Jennifer, hereby declare that apart from the cited references, all other 
information in this work is my own production. This dissertation has never been submitted to any 
institution for the award of any degree. 
 
 
Taluah, Webadua Jennifer 
(Student) 
 
Date: 05/11/21 
 
Dr. Emmanuel K. Kuto 
(Supervisor) 
 
Date: 05/11/21 
 
 
 
 
  
 
 
 
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DEDICATION 
 
I dedicate this work especially to my dear parents, brothers, colleagues and incoming students of 
this programme. 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
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ACKNOWLEDGEMENT 
 
I give thanks to the Almighty God for the wisdom, knowledge, strength and grace to write this 
wonderful dissertation. Initially, it was not easy at all for me to put my thoughts together to write 
this work but He made it possible and I am forever grateful to Him. 
I would also like to acknowledge my Supervisor, Dr. Emmanuel Kuto, who was always at my beck 
and call. He worked tirelessly with me to make sure that I did a great job. He made ample time out 
of busy schedules to help me finish my work. His words of encouragement, guidance and above 
all, exceptional knowledge and personality made my work quite easy. 
I wish to appreciate Mr. Luke Liebzie for his time, guidance and support through my work. He 
gave me lofty ideas on some issues I could write on and was always there for me when I needed 
help.  
My special thanks to my deceased parents Mr. Charles Taluah and Mrs. Victoria Navro as well as 
my auntie Janet Taluah and my brothers Reginald, Francis and Raphael. I am grateful to them for 
their immense love, care and support. 
I would like to express my sincere gratitude to Samuel Odenkey, Andrews Obeng Kwakye, Madam 
Sara Botchwey and Ruth Mango for their immense support, love, care and words of 
encouragement.   
Finally, I want to thank all my lecturers who imparted me with great knowledge in diverse areas 
in this programme. Their immense support and words of encouragement saw me throughout this 
work. Not forgetting my dear comrades who showed me love, care and also made me learn a lot 
from them. Indeed, we shared rich experiences and knowledge. 
 
 
 
 
 
 
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TABLE OF CONTENTS 
DECLARATION.......................................................................................................................... iii 
DEDICATION.............................................................................................................................. iv 
ACKNOWLEDGEMENT ............................................................................................................ v 
ABSTRACT ................................................................................................................................ viii 
ABBREVIATIONS ....................................................................................................................... x 
CHAPTER ONE ........................................................................................................................... 2 
1.0 INTRODUCTION ............................................................................................................... 2 
1.1 Background ...................................................................................................................... 2 
1.2 Problem Statement .......................................................................................................... 7 
1.3 Significance of the study.................................................................................................. 8 
1.4 Research Questions.......................................................................................................... 9 
1.5 Objectives of the study .................................................................................................. 10 
1.6 Theoretical Framework ................................................................................................ 10 
1.7 Hypotheses ...................................................................................................................... 12 
1.9 Methodology ................................................................................................................... 19 
1.10 Source text .................................................................................................................... 20 
CHAPTER TWO ........................................................................................................................ 22 
2.0 CORPORA ALIGNMENT............................................................................................... 22 
CHAPTER THREE .................................................................................................................... 70 
3.0 Structured Analysis and Discussions of Translation problems .................................... 70 
3.1 Types of specialised language collocations ................................................................. 71 
3.2 Acronyms and Abbreviations ........................................................................................... 77 
3.3 False cognates .................................................................................................................... 78 
3.4 Polysemy ............................................................................................................................. 80 
3.5 Technical terms ................................................................................................................. 80 
CONCLUSION ........................................................................................................................... 84 
FINDINGS ............................................................................................................................... 84 
RECOMMENDATIONS ........................................................................................................ 88 
REFERENCES ............................................................................................................................ 94 
SITOGRAPHY ............................................................................................................................ 98 
 
 
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LIST OF TABLES 
Table 1: The examples below are corresponding pairs of open specialised language collections 
and restricted specialised language collocations in French with their equivalents in English in 
nutrition ......................................................................................................................................... 73 
Table 2. Examples of polysemic words used in the source text ................................................... 80 
Table 3. Source text (French)                                  Target text (English) .................................... 81 
Table 4: GLOSSARY ................................................................................................................... 90 
 
 
 
 
                                                        
 
 
 
 
 
 
 
 
 
 
 
 
 
 
  
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ABSTRACT 
 
This work focuses on Specialised Language Collocations in translating texts from French into 
English. The source text, “Protocole National de Prise en Charge de la Malnutrition Aiguё 
Globale en Haїti” [National Protocol for the Management of Global Acute Malnutrition in Haiti] 
was chosen as a primary source material. Descriptive, analytical and comparative methods were 
employed in identifying and analysing the similarities and differences between specialised 
language collocations in a medical text on nutrition, taking into account both linguistic and extra-
linguistic factors. The linguistic factors are types of specialised language collocations, 
transposition, adaptation, adjustment, acronyms, abbreviations, false cognates, polysemy and 
technical terms. The extra-linguistic factors are text type, professional knowledge and background 
experience and purpose of the translation. Additionally, translation theories and techniques helped 
in gaining a better understanding as well as surmounting some challenges encountered in 
translating the text.  The purpose of this study was to delve into specific problems that arise when 
translating specialised language collocations in order to achieve stylistic and semantic equivalence 
as this would help convey the intended meaning. Our research establishes that translators who are 
not native speakers of their working languages, generally, struggle to use appropriate collocations 
in their translations. Also, this work establishes that even when translators translate into their 
mother tongues, they struggle to appropriately capture certain collocations, specifically, in the area 
of nutrition if they do not have enough exposure to materials on nutrition. We can generalise this 
to mean that translators who do not have adequate knowledge in specific domains may not 
appropriately render collocations in their translations in those domains. It is hoped that this work 
would help professional translators whether they are native speakers or non-native speakers of 
their working languages including those, specifically, with little knowledge in nutrition to be 
mindful of the said challenges and translate with accuracy and precision.  
 
Key words:  Specialised language collocations, acute malnutrition, linguistic factors, extra-    
linguistic factors, stylistic equivalence, semantic equivalence, accuracy, precision. 
 
 
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RÉSUMÉ 
[[ 
La présente étude a pour objectif de cerner les collocations linguistiques spécialisées et les 
problèmes qu’elles posent lors de la traduction dans le texte source du francais vers l’anglais. Le 
texte source intitulé « Protocole national de prise en charge de la malnutrition aiguё globale en 
Haїti » a été selectionné comme texte de base. Cette étude examine et analyse les similitudes ainsi 
que les différences entre des collocations linguistiques spécialisées dans un texte caractère médical  
sur la nutrition de façon descriptive, analytique et comparative en tenant compte des facteurs 
linguistiques et extra-linguistiques dont quelques-un sont les types de collocations linguistiques 
spécialisées, la transposition, l'adaptation, l’adjustement et les acronymes, les abréviations, les 
faux amis, la polysémie et les termes techniques ; les facteurs extra-linguistiques sont le type de 
texte, les connaissances professionnelles et l'expérience de base et le but de la traduction. De plus, 
les théories et les techniques de la traduction ont permis de mieux comprendre et de surmonter 
certaines difficultés rencontrées lors de la traduction du texte.  Le but de cette étude est de faire 
ressortir les problèmes spécifiques qui se posent lors de la traduction de collocations linguistiques 
spécialisées afin d'obtenir une équivalence stylistique et sémantique, car cela permettrait 
d'atteindre la bonne reformulation du sens. Nous espérons que ce travail aidera les traducteurs 
professionnels, notamment ceux dont la langue maternelle est la langue de travail et ceux dont la 
langue maternelle n'est pas la langue de travail et qui n'ont pas assez de connaissances en nutrition, 
à être conscients de ces défis et à traduire avec exactitude et précision.  
 
Mots-Clés : Collocations linguistiques spécialisées, malnutrition aiguë, facteurs linguistiques, 
facteurs extra-linguistiques, équivalence stylistique, équivalence sémantique, exactitude, 
précision.  
 
 
 
 
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ABBREVIATIONS 
 
FRENCH ENGLISH 
1. ASPE - Aliments de Supplémentation Prêt à RUSF -Ready-to-Use Supplementary Foods 
l’Emploi   
2. ATPE - Aliments Thérapeutiques Prêts à l’Emploi  RUTFs -Ready-to-Use Therapeutic Foods  
3. PB - Périmètre Brachial  BP -Brachial Perimeter  
4. LANPE - Lait Artificiel Prêt à l’Emploi  RUAM -Ready to Use Artificial Milk 
5. MSSP - Ministère de la Santé Publique et de la MPHP - Ministry of Public Health and Population 
Population   
6. PCNB - Points de Conseil en Nutrition pour Bébé  BNAP - Baby Nutrition Advisory Points 
7. PNS - Programme de Nutrition Supplémentaire  SNP - Supplementary Nutrition Programme  
8. PTA - Programme Thérapeutique Ambulatoire  OTP -Outpatient Therapeutic Programme 
9. SIS - Système d’Information Sanitaire  HIS- Health Information System 
10. SMRRT-Spécifique Mésurable Réalisable Réaliste SMART-Specific Measurable Achievable Realistic and 
dans le Temps Time-bound 
11. SNC - Modèle de Soins Nutritionnels à Base CBN- Community-Based Nutrition Care 
Communautaire   
12. USN - Unité de Stabilisation Nutritionnelle  NSU -Nutritional Stabilisation Unit 
13. P/T – Poids/Taille W/H -Weight/Height 
14. PCIME – Prise en Charge Intégrée des Maladies de IMNCI – Integrated Management of Childhood Illness 
l’Efant 
 
  
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CHAPTER ONE 
 
1.0 INTRODUCTION 
1.1 Background 
 
In the 21st century, translation has witnessed a huge transformation due to the resurgence of 
modern technological developments in communication which facilitate the work of a translator. 
Modern technological developments such as Computer-Aided Tools, term bases, digital 
dictionaries and on-line research have made it possible for translators to translate with speed, 
quality, consistency and preserve the formatting and structure of the original document. The data 
bases stored in translation memories help translators track some previously used phrases and 
expressions that make it easier and faster to handle future projects.   
Dubois et al. (1972), define translation as an expression in another language (target language) of 
what has been expressed in a source language preserving the semantic and stylistic equivalences.  
Nida and Taber (1969), explain the process of translation as reproducing in the receptor language, 
the closest natural equivalent first, in terms of meaning and second, in terms of style. Generally, 
translation involves two or more languages, different cultures and sometimes, different eras are 
taken into consideration when translating.  Toury (1978: 200) asserts that “translation is a kind of 
activity which involves at least two languages and two cultural traditions”. However, Jakobson 
(1959) believes that translation can operate in one language by using synonyms in that same 
language to convey the same message. Jakobson (1959) calls this process, ‘intralingual 
translation’. Ladmiral (1979), supports the idea that translation traces its roots from the Biblical 
Tower of Babel where different languages came into existence resulting in the need for translators. 
Translators served as mediators to facilitate the transmission of information from one language to 
another in the ‘Pharaonic courts’.  
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In recent times, translation has become even more important due to the fact that it allows nations 
to forge interactive relationships by making the use of written and spoken language across barriers 
easier. Translation covers so many domains including communication and media, marketing, 
finance, science, technology, etc.  
An aspect of translation that has been very important since the middle of the twentieth century is 
medical translation. Henry Fischback (1921-2008) is well-known for his contribution to medical 
translation. He maintains that medical translation is the most universal and oldest form of scientific 
translation because of the ubiquitous nature of human anatomy and physiology. Medical 
translation within this context is the process of translating various medical documents including 
training materials, medico-legal documents, manuals, etc for multiple medical industries such as 
healthcare, pharmaceutics, psychiatry, medical jurisprudence and more.   Medical translation in 
the general context of community translation is rendering different medical texts originally written 
in certain languages into minority languages on medical issues surrounding the communities 
concerned. 
Medical translators are in high demand due to emigration and other factors. However, translators 
face a lot of challenges when rendering medical texts from the source language to the target 
language. This is due to the fact that the general public, mainly dominated by average literate 
adults, find it difficult to understand the medical register because of its intricate vocabulary and 
technicalities. Medical translators who are non-native speakers of their working language pairs 
usually have to contend with a lot of specialised language collocations used in medical texts 
because these specialised language collocations pose problems to non-native speakers due to an 
interference caused by their mother tongues (L1) and as a result of little or no background 
knowledge in the use of these collocations. Also, translators who are native speakers of their 
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working language pairs, with little or no background knowledge in the use of specialised language 
collocations, find it difficult to translate medical texts.  The translation of technical documents, 
specifically, medical documents, generally, require the use of appropriate terms in their prescribed 
order.  
Heid & Freibott (1991:82) define specialised language collocations as “independent lexical units 
with the same status as terms”. However, for the purpose of this research, specialised language 
collocations may be defined as the conscious use of appropriate medical terms by a translator by 
respecting their order in standard use so as to keep the medical register and express the intended 
meaning contained in the source text within the context of nutrition.   
Whereas medical translation covers a lot of subdomains such as pharmacology, obstetrics, 
paediatrics, psychiatry, this work focuses on nutrition precisely, acute malnutrition and how 
translators in the said field respect the rules of collocation. The idea that certain terms always go 
together is explained by the concept of Collocation. Hsu (2007); Mahvelati & Mukundan (2012: 
205) assert that collocation is from a Latin verb ‘collocare’ which means ‘to set in order/ to 
arrange’. Firth (1957) was the first to bring this term into the field of Linguistics after it was first 
introduced by Palmer (1933) defines ‘collocare’ as a combination of words associated with each 
other. For instance, the word ‘night’ naturally associates itself with ‘dark’. Collocations are, 
therefore, words that naturally go together and there are some with more than one collocates. 
Generally, translators are required to respect the said concept.   
According to Firth (1957) collocations are a syntagmatic and paradigmatic relation between lexical 
units which can be shown by horizontal and vertical axes. He further explains that the paradigmatic 
axis is vertical and includes words which belong to the same class and can be inter-changed. The 
syntagmatic axis on the other hand, is horizontal and refers to the ability of words to be connected 
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with others. For example, in the phrase or sentence “Audrey ate rice” rice is in paradigmatic 
relation with “corn”, “flour” and in a syntagmatic relation with “Audrey” and “ate”. Narrowing it 
down to specialised language collocations in medical texts on acute malnutrition, the word 
‘operation’ is in paradigmatic relation with ‘surgery’ but in syntagmatic relation with ‘Mabel’ and 
‘had’ in the sentence ‘Mabel had an operation’. Also, in the sentence, ‘Michael reacts to treatment’, 
the word ‘treatment’ is in paradigmatic relation with ‘cure’ but in syntagmatic relation with 
‘Michael and reacts’. This means that the onus lies on the translator to get acquainted with the use 
of specialised language collocations to correctly translate the source text into the target language. 
Cruse (1986) gives a more concrete definition of collocations and develops a criterion to answer 
the questions associated with the distinction between collocations and idioms. According to him, 
collocation refers to sequences of lexical items which habitually co-occur, but which are 
nonetheless fully transparent in the sense that each lexical constituent is also a semantic 
constituent. Moreover, collocation has a kind of “semantic cohesion” where the constituent 
elements are mutually selective. For instance, the word “heavy” in “heavy drinker”, “heavy drug 
user” has a defined contextual environment which requires the selection of the notion of 
‘consumption’ in the immediate environment. Leech (1981:20) also talks about what he refers to 
as “collocative meaning” and notes that it “consists of the associations a word acquires on account 
of the meaning of words which tend to occur in the environment”. Taking into consideration 
specialised language collocations in a medical text on acute malnutrition such as “anthropometric 
data” and “anthropometric measurements’, we can say that the word “anthropometric” has a 
defined contextual environment which requires the selection of the notion ‘massive’. 
Zughoul (1991) posits that different languages have different collocation modes; what collocates 
in one language does not necessarily collocate in another language. Zughoul’s assertion explains 
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the reason why some collocations may render the translation meaningless within that particular 
context and this is as a result of differences in the grammar and structure of languages. In the case 
of translating a text from French to English, what may be a collocation in French may not 
necessarily be a collocation in English and vice versa. This could be a case in specialised texts, 
especially, those in the area of Nutrition.  Generally, translators have to contend with specialised 
language collocations which in one language could be collocations but not considered as 
collocations in the other language. 
Halliday & Hasan (1976: 258) define collocation as “les mots qui tendent à apparaître ensemble” 
[words that tend to appear together].  For example, laugh and joke, blade and sharp, garden and 
dig etc. That is to say, any two lexical items having similar patterns of collocation –that is tending 
to appear in similar contexts – will generate a cohesive force if they occur in adjacent sentences.  
In the case of Sinclair (1991), he defines collocation as “les mots qui tendent à apparaître ensemble 
de manière statistiquement  pertinenteˮ.  Meaning, more pertinent words are likely to co-occur. 
For example, we may have “crystal clear” and “nuclear family” in general language collocations. 
An example of a specialised language collocation in a medical text on acute malnutrition is 
‘immune system’ and ‘micronutrient supplementation’. Any time a translator is translating such a 
text from French to English and comes across ‘immune’, he automatically knows that what follows 
is ‘system’ without doubts. 
Professional translators and linguists have diverse definitions of collocations and would not agree 
on a definitive approach to identifying and classifying collocational expressions. However, from 
the above, it is obvious that collocations are either general or specialised. General language 
collocations are two or more words that go together. For example, “fast food”, “excruciating pain” 
and “smile gleefully”. With reference to a medical text with specialised language collocations, we 
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have the word “disease” which collocates with ‘severe’ therefore, making it “severe disease”. 
Another example is the word “prescribe” which associates itself with “drugs” and becomes 
“prescribe drugs”. In non-medical contexts, the same word, “prescribe” in a legal text, most likely, 
collocates with “rules, laws, criteria, requirements”. It is, thus, important for translators to know 
such terms and to know when to use them in texts. Therefore, a translator should not say: ‘The 
doctor defined the drugs for the patient’, instead of ‘the doctor prescribed the drug for the patient’. 
This means that in medicine, as in all specialised fields of knowledge, certain words that collocate 
in English may not necessarily express the same idea in medicine and may have to precede or 
follow other words in medical texts. Where the right collocations are not used in medical texts, the 
intended meaning is distorted. So, it behooves the translator to be well-versed in the use of these 
specialised language collocations.  More specifically, in nutrition, certain terms follow each other 
in a given text and any change in the order may render the portions in question meaningless. 
Hence, this research focuses on collocations within the context of nutrition and is considered to be 
of great importance to professional translators who translate medical texts as it will guide them to 
properly render specialised language collocations from the source text to the target text while 
maintaining the intended meaning. In the paragraphs that follow, the concept of collocation as a 
problem will be determined. This will be done by presenting relevant literature on research already 
conducted by others in the said area and clearly stating the objectives that will enable us to resolve 
the problem stated. 
1.2 Problem Statement 
[[[ 
There are several controversies surrounding specialised language collocations and how translators 
who are native speakers and those who are non-native speakers of their working language pairs, 
sometimes find it difficult to render them in medical texts. For some translators who are native 
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speakers, it is due to little or no background knowledge in the use of specialised language 
collocations. With regards to translators who are non-native speakers, it is as a result of the 
interference of their mother tongues (L1) as well as little or no background knowledge in the use 
of specialised language collocations. When such interferences occur, they distort the intended 
meaning and possibly, put the patients’ health at risk. Manan et al. (2017) observe that there are 
interferences of mother tongues (L1) in second language acquisition (L2) on Malay Learners. They 
posit that a lot of Malay learners in the quest of acquiring English as a second language (ESL) 
commit errors which are associated with mother tongue interference. Nesselhauf (2005) also 
conducted a research on collocations and found out that 50% of collocation errors are due to mother 
tongue interference. She uses data obtained from German advanced learners of English and 
demonstrates how collocations are employed by these learners and the errors they commit.  
Collocations play a vital role in a language and a misunderstanding of them especially in 
translating medical texts could be perilous. A lot of research has been conducted on general and 
medical collocations. However, there seems to be little or no research specifically on specialised 
language collocations in the area of acute malnutrition.  
1.3 Significance of the study 
 
This study seeks to find an appropriate and easy method of translating specialised language 
collocations in medical texts, specifically, in the area of acute malnutrition by maintaining stylistic 
and semantic equivalence.  
The term ‘specialised language collocations’ is used because, whereas there are very many 
collocations in English, this work specifically deals with collocations employed in the medical 
field, particularly, in the area of acute malnutrition.  
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Additionally, it seeks to identify the types of specialised language collocations in the context of 
nutrition as well as highlight the need for translators to be well-versed in the use of specialised 
language collocations by gaining adequate background knowledge. This will enable translators 
who are native speakers and those that are non-native speakers of their working languages to avoid 
distorting the intended meaning, as a change in the intended meaning could be detrimental to the 
patient’s health. 
Finally, this study investigates the pitfalls and challenges that specialised language collocations in 
medical texts, (specifically, those on acute malnutrition) pose to translators and demonstrates how 
these challenges can be resolved. 
1.4 Research Questions 
The research questions guiding this study are as follows: 
 
1. To what extent would medical translators who are native speakers and those who are 
non-native speakers of their working language pairs achieve stylistic and semantic 
equivalence with little or no background knowledge in the use of specialised language 
collocations on acute malnutrition? 
2. To what extent would a professional translator who is not an expert in the medical field 
appropriately render a translation of a medical text on acute malnutrition full of 
specialised language collocations using the right medical register? 
3. How would translators who are not professionals but have a background knowledge in 
specialised language collocations face challenges when translating a medical text? 
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1.5 Objectives of the study 
The main objective of this study is to translate the source text, Protocole National de Prise en 
Charge de la Malnutrition Aiguë Globale en Haïti from French into English and examine the 
challenges the text poses to translators. Other objectives include:  
1. To identify and explain the types of specialised language collocations on acute 
malnutrition. 
2. To explain the nature of specialised language collocations in order for native speakers and 
non-native speakers of language working pairs to achieve stylistic and semantic 
equivalence in translating a medical text on acute malnutrition from French into English. 
3. To analyse and examine how professional translators with little or no background 
knowledge on acute malnutrition can employ specialised language collocations with the 
right medical register. 
1.6 Theoretical Framework 
 
The theories employed in this research are Vinay & Darbelnet’s (1977) linguistic theory, 
Vermeer’s (1996) Skopos theory of communicative purpose, Jakobson’s (1959) theory of 
intralingual and interlingual translation and Nida’s (1964) theory of Equivalence. 
Vinay & Darbelnet’s (1977) linguistic theory is employed by the researcher in this work.  They 
suggest some procedures that may be used in order to overcome some problems translation to fill 
grammatical gaps. For the purpose of this study, the researcher uses only transposition, adaptation 
and borrowing. Transposition as explained by Vinay and Darbelnet is when words change their 
positions or change their grammatical sequence. They also describe adaptation as expressing a 
sentence in a completely different way that suits another language culture and define borrowing as 
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the act of incorporating a word from one language into another without translating it. Thus, the 
researcher is able to appropriately translate the source text into the target text without altering the 
meaning. 
Jakobson’s (1959) theory of intralingual and interlingual translation is used in this work. He 
describes intralingual translation as the use of synonyms to convey the same message or idea and 
interingual translation as rendering a message from one language to another. The researcher 
employed interlingual translation in this work by translating the source text (French) into the target 
text (English). Intralingual translation was also adopted to some extent when it came to finding the 
full meanings of some acronyms and abbreviations in the target text. Therefore, interlingual and 
intralingual translation helped the researcher to use appropriate meanings that fit into the context. 
The right meaning of words as well as the right medical register are adopted in this study. 
The researcher’s work also anchors on Vermeer’s (1996) skopos theory on communicative 
purpose. His theory explains how a text is able to achieve its aim or intention in a given situation. 
This theory helped the researcher to achieve his/her goal by making the general public understand 
the medical register without distorting the meaning in relaying the information from the source 
text to the target text on acute malnutrition. He/she was able to shed more light on the causes, 
effects and solutions of acute malnutrition to the general public dominated by semi-literates. 
Finally, Nida’s (1964) theory of formal and dynamic equivalence is adopted in translating the text. 
The researcher considers both form and content to give the English equivalents a more appealing 
and appropriate meaning. In considering the form and content, the source language must also 
match the the target language. This would make make the translation flow naturally and carry the 
spirit of the source text while maintaining semantic and stylistic equivalence. 
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1.7 Hypotheses 
The hypotheses for this research are as follows: 
 
1. A translator’s mother tongue affects his ability to respect the principle of specialised 
language collocations on acute malnutrition to achieve stylistic and semantic 
equivalence. 
2. Professional translators who are not medical experts are unable to keep the medical 
register by respecting the principle of specialised language collocations in their translation 
of medical documents on acute malnutrition. 
3. One does not need any special training in order to respect the principle of specialised 
language collocations when translating medical documents. 
 
1.8 Literature Review 
 
A lot of research has been conducted on collocations and these studies have addressed collocations 
in a more generic sense although little or no research has been carried on those employed in the 
medical texts. However, the aim of this work is to discuss specialised language collocations used 
in medical texts, specifically, on acute malnutrition including how to surmount certain challenges 
they pose to translators.  
Larson (1984) argues that collocations concern how words go together, that is, which words 
usually co-occur with other words. It means that whereas some words may have one collocate 
(they always go together), others have more than one collocate (they can be used with two or more 
words). For example, words with one collocate are generally found in bound or fixed expressions 
like proverbs and idioms; “a stitch in time saves nine”. On the contrary, a word that goes with 
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more than one collocate is a free collocation like “go on, go through and go over”. He reiterates 
that for instance, in English, we normally say “heavy downpour”. Grammatically, it is correct to 
say “strong rain” but then it is inappropriate for a native English speaker to use that expression. 
Using the right collocations would sound more natural for native speakers to understand. However, 
Larson failed to talk about the fact that translators cannot use some technical words when 
translating for the target audience. For instance, in medical texts on acute malnutrition where 
translators need to render specialised language collocations from the source text to the target text 
with a word like “whooping cough” which is the general register. In this case, the translator is able 
to target the layman. On the contrary, the word “pertussis” can be employed in the hospital with 
the doctors and nurses since they are used to the medical terms. So, the researcher tries to fill the 
gap that the use of specialised language collocation in diverse fields of the medical environment 
is very key to helping those in the specialised areas to contextually understand the original intended 
meaning of the words used. 
Halliday & Matthiessen (2004), also define the term collocation as the co-occurrence tendency of 
items which are associative, meaning a combination of naturally-sounding words that are 
considered as single building blocks of language. They made frantic efforts in their contribution 
to collocations and their idea can be projected to specialised language collocations in acute 
malnutrition where a predictable co-occurrence of lexical items could be “immune system”, 
“appetite test” and “anthropometric indicator”. But then they did not really talk about the fact that 
some background knowledge may be needed in order to render specialised language collocations 
with regards to medical documents. This is because medical terms do not come naturally but rather 
have to be learnt. Therefore, translators need to gain some background knowledge in the medical 
jargons. 
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Baker (2011) notes that another definition of collocation could be derived from the tendency of 
certain words to co-occur habitually in a given language. This is to say, it is possible for a 
collocation in one language to have its equivalent in another language. Collocations such as “viens 
ici” in French have their equivalent in English as “come here”.  As in, the French version is a 
collocation and when translated into English, it still remains a collocation as seen in the afore-
mentioned example.   Baker failed to highlight the challenges that translators may face in rendering 
medical documents for words that may not collocate in other languages. This would make it 
difficult for translators to identify specialised collocations in the source text as well as 
appropriately render them in the target text to avoid distortion in the intended meaning. For 
example, “malnutrition aiguë” is translated into English as “acute malnutrition”. Therefore, we 
could say, those words collocate in both languages. However, a medical jargon like “whooping 
cough” has its French version as “coqueluche”. We realise that the word collocates in English but 
does not collocate in French.  Thus, she could have emphasised on the preoccupation of every 
translator to pay keen attention to the nature of collocations in both the source text and the target 
text of as well as have a background knowledge on collocations to properly translate them. 
Extending Baker’s view to specialised language collocations on acute malnutrition, it is expedient 
that the translators know these characteristics of these collocations so that they are able to give 
their equivalents in the target text in order not to endanger the lives of paients.  
Problems of collocations 
The problems of collocations have been examined by many translators and linguists such as 
identifying the collocational range of words as well as developing a criterion for defining them.  
According to Baker (2011:67), collocations are sub-divided into two major categories: (1) free 
word combinations (2) fixed expressions and idioms. She states that these collocations may 
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“consist of lexical items that enter mainly into high-frequency grammatical structures”. 
Translating the first category, ‘free word combinations’ to specialised language collocations on 
acute malnutrition using the word “severe”, we can have “severe disease”, “severe infections” and 
“severe dehydration”. That is to say, “severe” can collocate with more than one word and therefore, 
makes it a free word combination. With the second category which are ‘fixed expressions’, we can 
consider the word “nosocomial infections” and “stunted growth” where they always go together. 
Although Baker’s contribution to free and fixed expressions were useful to this study, she forgot 
to talk about the fact that idioms do not apply to all types of documents such as medical ones. 
Taking into consideration a medical text on acute malnutrition, we do not have such idioms. So, 
she should havee highlighted the fact that translators working on such medical documents should 
get acquainted with specialised language collocations for them to be able to easily identify the type 
of collocations they are to employ in their translations to maintain sematic and stylistic 
equivalence. 
Collocational Range and its Criteria 
Sinclair (1991: 170) defines collocations as “an occurrence of two or more words within a short 
space of each other in a text”. He gives the difference between the ‘node’ and the ‘span’ by 
explaining that the node is the main word in the collocation pattern and the words that come either 
to the left or to the right are collocates. Sinclair further argues that with regards to these collocates, 
each collocation has its span. The span is the distance between the number of lexical items on each 
side and the significant collocates can be found in a span of four words on each side of the node 
either before or after the word. Indeed, this number of words serve as a standard measurement of 
a span. Translating Sinclair’s idea to this study on acute malnutrition with specialised language 
collocations, the word “health” is the node and the words “care, facility and primary”, are 
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collocates. Hence, we have “health care” and “health facility”. However, the words “care” and 
“facility” collocate to the right and the word “primary” collocates to the left in “primary health 
care”.  Sinclair’s assertion of the node as being the main word in the collocation pattern is not well 
explained because with medical documents on acute malnutrition, it may be very difficult for one 
to identitfy the node since they have both right and left collocates. How then would one know that 
a word like “health care” has “health” and not “care” as its node. Therefore, he should develop a 
criterion that would be feasible in identifying the nodes so that translators with little or no 
background knowledge in collocations would be able to translate medical documents on acute 
malnutrition using the right medical register.  
Baker (1992) indicates that every word in a language has its own collocational range or a set of 
words, which usually goes with it.  She claims that the collocational range of a word solely relies 
on the specific or generic meaning of the word. When the word is more general, its collocational 
range is wider and vice versa. Baker defines collocational range as the different meanings and 
senses of a word. The set of collocates which are associated with the word is referred to as the 
range and it differs from word to word.  She further provides a criterion for determining the length 
and space of collocational range by stating that the more general a word is, the more collocates it 
has and the more specific a word is, the less collocates it has.  For instance, the word “shrug” has 
a limited collocational range because it only collocates with “shoulders” making it “shrug 
shoulders”. Conversely, the word “run” could have many collocational ranges such as “run a 
business”, “run fast”, “run a company” and “run a show”. Likewise, these two types of 
collocational ranges (wider and limited) could be extrapolated to a medical text on acute 
malnutrition where the word “nasogastric” collocates with “tube” making it “nasogastric tube” 
thereby classifying it as a limited collocational range because it is specific. However, Baker only 
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focused on determining and giving a criterion for collocational range but did not reveal the actual 
number of collocates a word employed in a specific context such as a medical document may have.  
The word “malnutrition” could collocate with “acute”-“acute malnutrition”, “severe” –“severe 
acute malnutrition” and “moderate”-“moderate acute malnutrition”. Thus, the translator who 
handles medical texts on acute malnutrition with specialised language collocations should not only 
be abreast of limited and wider collocational ranges but also, the actual number of collocates a 
word takes in order to correctly translate such texts from the source text to the target text by giving 
the right collocates.  
Lyons (1981:52) defines the collocational range of an expression as “the set of contexts in which 
it can occur”. He discusses synonyms which are not always necessarily interchangeable such as 
“big” and “large”. For example, “you are making a big mistake and not large mistake” whereas, 
“big house” can substitute for “large house”. He did a good work by telling us that synonyms may 
be contextually-restricted. Translating this point to a medical text on acute malnutrition with 
specialised language collocations, words “referred” and “transferred” are contextually-restricted, 
For instance, where we could say, “the malnourished baby was referred to sites with treatment 
services” and “the malnourished child was transferred from the in-patient care to the out-patient 
care”. Alternatively, Lyons did not go the extent of explaining how one who is not a native speaker 
of a language could know how best to use these synonyms in order not to interchange them.  
Therefore, he should have reiterated that translators who are not native speakers of their working 
languages need to learn how well to use such synonyms in order not to distort the intended meaning 
in rendering a medical document on acute malnutrition. 
 
 
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Register and specialised language collocation 
Baker (2011) also observes that a collocation is a systematically arbitrary restriction which does 
not follow logically from the prepositional meaning of a word. For instance, it is typical for an 
English speaker to say, “toast bread” instead of “grill bread”.  The same thing applies to medical 
texts on acute malnutrition with specialised language collocations whereby a medical translator 
who is a native speaker of his or her working language pairs with adequate background knowledge 
in the medical field, finds it easy to render medical terms from one language to another. For 
example, a medical translator who is a native speaker of English and with adequate background 
knowledge on acute malnutrition would rather say, “nutrition interventions” instead of “nutrition 
strategies” , “health facility” and not “health structure” and “pertussis” and not “whooping cough”. 
This is because he or she is not only a native speaker of English but also, has adequate knowledge 
in the said field. So, anytime he or she is translating a text in his or her working language pairs, it 
is easier to properly render the text when such medical terms come in handy. Although Baker 
makes it clear that a native speaker stands a greater chance of properly using the right collocations 
as compared to a non-native speaker, she fails to acknowledge the fact that being a native speaker 
alone does not make one an expert in using collocations but also, adequate background knowledge 
in the subject area is needed. This is because accurate translation is built on adequate background 
knowledge in the subject area, experience and not just knowledge in the working languages to get 
acquainted with the correct use of these collocations. That is why the need for adequate background 
knowledge has been established by the researcher in the explanations above.  
It is evident from the afore-mentioned definitions and appropriate examples of various linguists 
that indeed, collocations could pose challenges to translators who are native speakers and non-
native speakers. This is with specific regard to a text on acute malnutrition with specialised 
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language collocations. Thus, native speakers and those who are non-native speakers of their 
working language pairs have to be well-versed in the use of specialised language collocations to 
appropriately render the source text to the target text without distorting the intended meaning.  
1.9 Methodology 
 
The primary aim of the research was to find out how medical professional translators who are 
native speakers and those who are non-native speakers of their working language pairs, with little 
or no background knowledge in specialised language collocations face challenges in appropriately 
rendering them. A qualitative method was employed in this study, precisely, content analysis, 
focusing on a medical text on acute malnutrition. The researcher also selected portions of a French 
text (source text) titled “Protocole national de prise en charge de la malnutrition aiguë globale en 
Haïti” which were translated into English (target text). This was purposively undertaken to 
examine specialised language collocations in the said field. Another method used in this research 
was gathering information from secondary sources such as medical books and articles, British 
National Corpus from the native speakers, previous works on general language collocations and 
specialised language collocations, manuals at the Department of French (University of Ghana) 
library, Internet sites as well as monolingual and bilingual dictionaries (hard copy and soft copy). 
The medical text was chosen to reveal the pitfalls and challenges that translators who are native 
speakers and those that are non-native speakers of their working language pairs face when 
translating specialised language collocations. Whereas the title of this work mentions specialised 
language collocations, the focus is on collocations employed in the medical field, specifically, 
acute malnutrition.  
 
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1.10 Source text 
  
The source text is taken from the field of Health Science, specifically, Nutrition. It is a document 
with the title, ‘Protocole National de Prise en Charge de la Malnutrition Aigüe Globale en Haїti’  
This document is a revised version written in May 2010 although the original version was 
published in December 2009. The aim of the original document was to sensitise the people of Haiti 
(medical practitioners and citizens) on Acute Malnutrition, especially, in children, in the face of a 
very alarming situation. It was written and compiled by Dr. Alex Larsen with the help of the 
Ministry of Public Health and Department of Public Health and Population National Food and 
Nutrition Programme Coordinating Unit (UCPNANU).  The document discusses maternal and 
child malnutrition as the most important factor contributing to child mortality all over the world, 
specifically, in Haiti, according to the Ministry of Public Health.  
This child mortality is, partly, attributed to nutrition-related conditions such as muscle wasting, 
stunted growth and intra-uterine development of the foetus. Therefore, through the Government of 
Haiti, the National Protocol for the Management of Global Acute Malnutrition has been put in 
place to reduce morbidity and mortality rate resulting from malnutrition in the very short term. 
The author underscores the causes and effects and gives possible solutions to curtail this problem 
among children who are prone to such conditions.  
The source text is made up of one hundred and fifty pages and is divided into seven chapters. These 
seven chapters are made up of main and sub-headings that explain the types and management of 
malnutrition. However, some portions of the source text were selected namely: overview, 
screening, community mobilisation and finally, emotional and physical stimulation. The 
researcher chose those portions because they give a complete understanding of the source text on 
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acute malnutrition without losing any vital information. They give detailed information on the 
types, causes, effects and management of acute malnutrition. However, the rest of the text mainly 
provides extra information on the types of acute malnutrition such as severe acute malnutrition 
and moderate acute malnutrition which are already mentioned in the selected portions. The total 
number of words translated from the document (source text) is 8,006 as a prerequisite of the Master 
of Arts in Translation Programme.  
The use of acronyms and abbreviations is one style the author employed in writing this medical 
text. The author used a lot of acronyms and abbreviations in the source text. Some instances are: 
“PCNB (Points de Conseil en Nutrition pour Bébé”- “NBAP (Baby Nutrition Advisory Points)”, 
“LANPE (Lait Artificiel Prêt à l’Emploi)”- “RUAM (Ready-to-Use Artificial Milk)”, “ATPE 
(Aliments Thérapeutique Prêts à l’Emploi)”- “RUTFs (Ready-to-Use Therapeutic Foods)” and 
“PTA (Programme Thérapeutique Ambulatoire)”- “OTP (Outpatient Therapeutic Programme)”.  
Another style used by the author in the source text is borrowing. A word like “Kwashiorkor” was 
borrowed from the target language (English) which was taken from Ga (Ghanaian language) to the 
source language (French). Also, the word “chemen lasante” was incorporated from the source text 
(French) into the target text (English).  
 
 
 
 
 
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CHAPTER TWO 
 
2.0 CORPORA ALIGNMENT 
 
 
Le Protocole National de Prise en Charge de la National Protocol for the Management of 
Malnutrition Aiguë Globale en Haïti                                G    o bal Acute Malnutrition in Haiti 
VUE D’ENSEMBLE OVERVIEW 
Cible Target Audience 
La stratégie globale de la prise en charge de la The overall strategy for the management of 
malnutrition en Haïti s’adresse aux groupes malnutrition in Haiti targets the following 
vulnérables suivants: vulnerable groups: 
- Enfants de 0 à 6 mois, -Children aged 0 to 6 - months, 
- Enfants de 6 à 23 mois, -Children aged 6 to 23 months, 
- Enfants de 24 à 59 mois, - Children aged 24 to 59 months, 
- Femmes enceintes, - Pregnant women, 
- Femmes allaitantes, - Breastfeeding women, 
- Personnes vivant avec le VIH, - People living with HIV, 
- Tuberculeux, - Tuberculosis patients, 
- Personnes âgées, - Aged, 
- Déplacés / réfugiés - Displaced persons / refugees 
 
Enquêtes et Évaluations rapides Surveys and Rapid Assessments 
Pour pouvoir planifier et cibler les interventions In order to plan and target nutrition 
nutritionnelles, il est important d’avoir des interventions, it is important to have reliable 
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données fiables et représentatives. La méthode and representative data. The recognised 
reconnue pour l’organisation d’enquêtes method for conducting nutrition surveys is 
nutritionnelles est la méthode SMART qui doit the SMART method, which should be 
être adaptée selon les normes du MSPP afin de adapted to MPHP principles to standardise 
standardiser la technique d’échantillonnage, la sampling technique, data collection and 
collecte et l'analyse des données. La stratification analysis. Stratification by agricultural, 
par zones agricoles, écologiques et culturelles peut ecological and cultural areas can give a better 
aider à mieux comprendre la problématique understanding of the nutrition problem. It is 
nutritionnelle. Il est important que les enquêtes important that nutrition surveys should not 
nutritionnelles ne se limitent pas seulement aux only include anthropometric data but also, 
données anthropométriques mais aussi collectent collection of data on the determinants of 
des données sur les déterminants de la malnutrition. 
malnutrition.  
S’il n'est pas possible de réaliser des enquêtes If it is not possible to conduct nutrition 
nutritionnelles par échantillonnage, permettant surveys by sampling to obtain an estimate of 
d'obtenir une estimation de la situation the nutritional situation which is 
nutritionnelle représentative de la population, une representative of the population, a rapid 
évaluation rapide de la situation nutritionnelle peut assessment can be carried out; the results will 
alors être effectuée dont les résultats permettront give a rough assessment of the nutritional 
une appréciation grossière de la situation. Les situation. The results of a rapid assessment 
résultats d'une évaluation rapide ne sont pas do not represent the whole population and 
représentatifs de l'ensemble de la population et should, therefore, be interpreted with 
doivent donc être interprétés avec précaution. A la caution. Following the assessment, a 
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suite de l'évaluation, un rapport de situation est situation report shall be presented and 
présenté et des recommandations émises sur les recommendations for actions made. 
actions à envisager.  
Dépistage systématique Routine screening 
Le dépistage systématique de la malnutrition doit Routine screening for malnutrition should be 
se faire aussi bien au niveau de la communauté que carried out both at the community and health 
dans les institutions de santé, quel que soit leur facilities at all levels of the health pyramid to 
niveau dans la pyramide sanitaire, en vue identify people in need of treatment. 
d’identifier les personnes nécessitant un Concerning health facilities, all 
traitement. Au niveau des institutions de santé, anthropometric indicators of nutritional 
tous les indicateurs nutritionnels seront intégrés status will be integrated into the Health 
dans le système d’information sanitaire (SIS). Au Information System (HIS). At the 
niveau communautaire, une revitalisation de la community level, a revitalisation of the 
promotion du suivi de la croissance à assise promotion of community-based growth 
communautaire permettra d’identifier à temps les monitoring will provide early identification 
enfants à risque et de les référer immédiatement si of children at risk and immediate referral 
besoin. where necessary. 
Interventions nutritionnelles Nutrition Interventions 
Les termes USN, PTA et PNS sont utilisés The terms NSU, OTP and SNP are used in 
dans le modèle de soins nutritionnels à base the Community-Based Nutrition Care (CBN) 
communautaire (SNC). Ce modèle vise à model which aims at achieving better 
atteindre une meilleure couverture et une coverage and accessibility through a package 
meilleure accessibilité grâce à un paquet de 
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services offerts à différents niveaux des of services offered at different levels of 
structures sanitaires : health facilities like: 
• L’Unité de Stabilisation Nutritionnelle  
(USN) correspond aux services offerts pour  The Nutritional Stabilisation Unit (NSU) 
les enfants souffrant d’une malnutrition aiguë which renders services to children 
sévère avec un appétit médiocre et/ou suffering from severe acute malnutrition 
présentant des complications médicales. with poor appetite and/or medical 
• Le Programme Thérapeutique Ambulatoire complications. 
(PTA) correspond aux services offerts pour  The Outpatient Therapeutic Programme 
les enfants souffrant d’une malnutrition aiguë (OTP) which refers to services provided 
sévère, avec appétit conservé et ne présentant for children with severe acute 
pas de complications médicales. malnutrition, with appetite and no 
• Le Programme de Nutrition Supplémentaire medical complications. 
(PNS) correspond aux services offerts pour les  The Supplementary Nutrition 
enfants souffrant de malnutrition aiguë modérée. Programme (SNP) which renders 
services to children with moderate acute 
malnutrition. 
L’adoption de cette terminologie a l’avantage The advantage of adopting this terminology 
de systématiser les services de prise en charge is that it systematises care services at 
à différents niveaux de la pyramide sanitaire different levels of the health pyramid and the 
et au niveau communautaire. Elle ne substitue community. It does not replace existing 
pas les structures existantes : Hôpitaux structures like: Departmental and Communal 
Départementaux et Communaux, Centres de 
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Santé (avec et sans lits), Dispensaires et Points Hospitals, Health Centres (with and without 
de rassemblement. beds), Dispensaries and Assembly Points. 
Les enfants atteints d’une malnutrition aiguë Children with moderate acute malnutrition 
modérée seront référés pour leur prise en will be referred to health centres or clinics 
charge aux centres de santé ou aux that have an SNP for treatment.  Patients 
dispensaires qui disposent d’un PNS.  Les suffering from moderate acute malnutrition 
patients souffrant de malnutrition aiguë and with medical complications should be 
modérée et présentant des complications managed in the nearest and most appropriate 
médicales doivent être pris en charge pour existing health facilities (health centres or 
leurs complications médicales dans les hospitals), while continuing their SNP 
structures sanitaires (centres de santé ou treatment. 
hôpitaux) existantes les plus proches et les  
plus appropriées, tout en continuant de suivre 
leur traitement en PNS. 
Les enfants atteints d’une malnutrition aiguë Children suffering from severe acute 
sévère sans complication médicale seront malnutrition without medical complications 
référés pour leur prise en charge aux Centres will be referred to and managed by the Health 
de Santé ou aux cliniques externes des Centres or outpatient clinics of hospitals that 
hôpitaux qui disposent d’un PTA. have an OTP. 
Les enfants atteints d’une malnutrition aiguë Children suffering from severe acute 
sévère avec complications seront référés pour malnutrition with complications will, after 
leur prise en charge aux USN (Unités de permission from MPHP, be referred for 
Stabilisation Nutritionnelle) incluses dans les treatment to Nutritional Stabilisation Units 
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services de pédiatrie des hôpitaux et toutes (NSUs) located in paediatric services of 
institutions avec lit et personnel médical hospitals and all health facilities with beds 
qualifié et disponible 24h/24h, ayant reçu and qualified medical staff available around 
l’autorisation du MSPP. the clock.  
Quelle que soit la localisation des USN, ces salles Irrespective of the location of the NSU, these 
devront être réservées uniquement aux enfants rooms shall only be reserved for 
malnutris étant donné que ces enfants ont un malnourished children since they have a very 
système immunitaire très affaibli et sont très weak immune system and are very 
vulnérables aux infections nosocomiales. vulnerable to nosocomial infections. 
Mobilisation communautaire Community mobilisation 
La mobilisation communautaire est indispensable Community mobilisation is indispensable in 
pour assurer une couverture adéquate des activités ensuring adequate coverage of activities by 
en dépistant et référant les personnes souffrant de screening and referring malnourished people 
malnutrition et en offrant un suivi à domicile to health facilities and providing follow-up at 
durant leur traitement en ambulatoire lorsque home during outpatient treatment when 
nécessaire. Pour y arriver, il est important de briser necessary. To achieve this, it will be 
les barrières sociales, physiques et économiques important to break down social, physical and 
face à l'accès au service sanitaire. economic barriers to access to health 
services. 
Les activités de prévention et de dépistage Prevention and screening activities ensure 
assurent le renforcement des capacités au capacity building at the community level and 
niveau communautaire et permet ainsi thus, enable community ownership of the 
l'appropriation des activités par la activities. Through continuous community 
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communauté. Par une mobilisation mobilisation, the health worker at the facility 
communautaire continue, le prestataire de gets a better understanding of malnutrition, 
soins de la structure sanitaire acquiert une its causes and possible solutions, hence, 
meilleure compréhension de la malnutrition, ensuring communication and better 
ses causes et solutions possibles ce qui assure understanding with beneficiaries and the 
une communication et une compréhension community. Community mobilisation also 
renforcées avec les bénéficiaires et la fosters the coverage and effectiveness of 
communauté. La mobilisation communautaire encouraging breastfeeding and managing 
permet aussi d'augmenter la couverture et acute malnutrition. 
l'efficacité en matière de promotion de  
l’allaitement et de prise en charge de la  
malnutrition aiguë. 
Cette stratégie globale, si elle s’adresse If this overall strategy primarily aims at 
essentiellement à la prise en charge de la managing malnutrition, it does not 
malnutrition, n’occulte pas l’importance des overshadow the importance of strategies that 
stratégies qui s’adressent aux causes sousjacentes address the underlying causes of malnutrition 
de la malnutrition (accès aux aliments, accès aux (access to food, health services, care, 
services de santé, accès aux soins, accès aux resources and improvement of the 
ressources et amélioration de l’environnement, de environment, water and sanitation). For this 
l’eau et de l’assainissement). C'est pourquoi la reason, the management of malnutrition 
prise en charge de la malnutrition doit intégrer au needs to integrate other broader activities at 
niveau communautaire des activités plus larges the community level than just treatment. 
que le traitement seulement. 
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Promotion de la croissance Promotion of Growth 
La promotion de la croissance consiste à Promotion of Growth involves motivating 
motiver les responsables d'enfants, les guardians, families, community members 
familles, les membres de la communauté et les and health workers to engage in behaviours 
agents de santé à avoir des comportements qui that contribute to proper growth both in the 
contribuent à une croissance adéquate, en weight and height of young children. 
taille et en poids, des jeunes enfants.  
La surveillance de la croissance comporte la Growth monitoring involves measuring each 
mesure mensuelle du poids et/ou de la taille de child's weight and/or height on a monthly 
chaque enfant et noter l'évolution de la croissance basis and recording the change in growth on 
sur la carte "Chemen lasante" pour vérifier la the "Chemen lasante" chart to check on the 
progression normale de sa croissance. Cette normal progression of growth. This practice 
pratique permet de détecter précocement les ensures early detection of underlying 
problèmes de nutrition sous-jacents avant qu'ils ne nutritional problems before they aggravate 
s'aggravent, et de renforcer les bonnes pratiques en and reinforces good care practices. 
matière de soin. 
A l’aide de l’indice P/T, poids par rapport à Using the W/H index, weight for age, the 
l’âge, on peut évaluer l’état nutritionnel de child's nutritional status can be assessed. This 
l’enfant. Cet indice met en relation le poids index relates a child's weight to his or her 
d’un enfant avec son âge. Il a l’avantage de age. It has the advantage of giving an overall 
donner une appréciation globale de l’état assessment of a child's nutritional status, but 
nutritionnel d’un enfant, mais le désavantage its disadvantage is that it is not able to 
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de ne pas permettre de distinguer le retard de differentiate stunted growth from thinness or 
croissance de la maigreur ou de l’émaciation. emaciation. 
Cet indice est souvent utilisé dans les The index is often used in national health 
politiques nationales de santé pour le suivi de policies to monitor child growth. The weight 
la croissance de l'enfant. Le poids de l'enfant of the child in relation to the age is recorded 
en fonction de son âge est inscrit sur une carte on a map in Haiti known as "Chemen lasante" 
connue en Haïti comme « Chemen lasante » (appendix 3), which consists of a graph 
(annexe 3) qui se compose d’un graphique sur showing the weight of the child at different 
lequel on inscrit le poids de l’enfant à ages. 
différents âges.  
Les actions pour surveiller et promouvoir la Actions to monitor and promote growth 
croissance doivent se concentrer sur le jeune should focus on the young child of 0 to 2 
enfant de 0 à 2 ans et de préférence, débuter years and preferably, begin with the 
avec le contrôle des pratiques nutritionnelles monitoring of nutritional practices in 
chez les femmes enceintes, puisque la période pregnant women, since the prenatal period 
prénatale et les deux premières années de vie and the first two years of life are crucial for 
sont cruciales pour le développement the physical and cognitive development of 
physique et cognitif de l’enfant. Les activités the child. Growth-monitoring activities 
de surveillance de la croissance doivent aller should be combined with vaccinations, early 
de pair avec les vaccinations, une détection detection of infections, risk signs in pregnant 
précoce des infections, des signes de risque women, micronutrient supplementation and, 
chez les femmes enceintes, la if necessary, malaria prophylaxis and 
supplémentation en micronutriments et, si deworming. 
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besoin, la prophylaxie du paludisme et le  
déparasitage. 
Système de surveillance nutritionnelle Nutritional surveillance system 
En plus du dépistage systématique compris In addition to the routine screening included 
dans les structures de santé la mise en place in the health structures, establishing a 
d’un système de surveillance nutritionnelle nutritional surveillance system is essential. 
devient indispensable.  
Le but de la surveillance nutritionnelle est de The purpose of nutrition surveillance is to 
détecter des changements du statut nutritionnel de detect changes in the nutritional status of the 
la population pendant une période de temps. population over a period of time. 
Un système de surveillance continu facilitera A continuous surveillance system will 
considérablement les évaluations rapides tremendously facilitate rapid assessments 
lorsqu’il y aura un changement des when there is a change in anthropometric 
indicateurs de la situation nutritionnelle, indicators of nutritional status, especially in 
spécialement dans les zones prédisposées aux areas prone to natural disasters. It will also 
désastres naturels. Il indiquera également indicate when an emergency nutritional 
quand une intervention nutritionnelle response can be completed, ensuring that 
d’urgence peut être terminée en s’assurant there is no relapse in the nutritional status of 
qu'il n'y a aucune rechute dans le statut the population.  Surveillance involves the 
nutritionnel de la population. La surveillance systematic collection and analysis of such 
implique la collecte et l'analyse systématiques data as: 
des données :  
• Résultats des enquêtes nutritionnelles ;  Nutrition survey results; 
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• Résultats des screenings périodiques au sein  Periodic community screening results; 
de la communauté ;  
• Rapports des programmes de nutrition  Reports on Supplementary and 
supplémentaire et thérapeutique ; therapeutic feeding programmes; 
• Rapports du dépistage systématique des  Routine screening reports of health 
structures de santé (nombre de cas avec facilities (number of cases with GAM); 
MAG);  
• Morbidité et mortalité.  Morbidity and mortality. 
Des informations sur la distribution de l’aide Information on the distribution of food aid, 
alimentaire, sur la production agricole, la agricultural production, rainfall distribution 
pluviométrie et l’évolution du taux d’emploi and changes in the employment rate among 
parmi la population affectée, devraient the affected population as well as other 
également être collectées, ainsi que d’autres vulnerability factors should be collected and 
facteurs de vulnérabilité, et considérées considered alongside the nutritional data. 
parallèlement aux données nutritionnelles.  
Le flux d’information sera établi de la The flow of information will be established 
périphérie jusqu’au niveau central, en passant from the periphery through all levels of the 
par tous les niveaux de la pyramide sanitaire. health pyramid to the central level. An agile 
Un système agile d’analyse des données, system for data analysis, provided for 
fournies pour la surveillance nutritionnel, et nutrition surveillance and feedback is 
de retour de l’information, s’avère obligatoire mandatory in order to have an effective 
afin d’avoir une réponse efficace à la situation response to the identified situation. 
identifiée.  
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Situation d’urgence Emergency Cases 
Les catastrophes naturelles et les situations Natural disasters and complex emergencies 
d’urgence complexes ont en général des usually have very serious consequences on 
conséquences très graves sur la vie des people as they become homeless will often be 
populations qui deviennent sans-abri et, forced to leave their original homes. In 
souvent, doivent quitter la région dont elles complex emergencies, health systems often 
sont originaires. Dans les urgences collapse and access to primary healthcare 
complexes, les systèmes de santé s’effondrent becomes difficult or impossible. Nutritional 
souvent, et il devient difficile, voire status during these situations is often 
impossible, d’accéder aux soins de santé delicate, especially when there was 
primaire. L’état nutritionnel pendant ces malnutrition before the disaster. 
situations est souvent délicat, particulièrement  
quand la malnutrition est présente avant la  
catastrophe.  
En conséquence, pour prévenir une Thus, to prevent deterioration in the 
détérioration de l’état nutritionnel des plus nutritional status of the most vulnerable 
vulnérables, il faut mettre en place les persons, response strategies must be put in 
stratégies de réponse dans les heures/jours place in the hours/days which immediately 
immédiatement suivants à l’urgence et il est follow the emergency and it is also important 
aussi important de maintenir un système to maintain an early warning system linked to 
d’alerte précoce lié au système de surveillance the nutrition surveillance system. 
nutritionnelle. 
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Dans le cadre du système de surveillance Within the nutrition surveillance system’s 
nutritionnelle, les interventions doivent être framework, interventions should be 
déterminées par une augmentation inattendue determined by an unexpected increase in 
des cas de malnutrition aiguë détectés par le cases of acute malnutrition detected by the 
système de surveillance épidémiologique ou à epidemiological surveillance system or 
travers l’analyse des résultats des enquêtes through the analysis of the results of nutrition 
nutritionnelles ou des évaluations rapides surveys or rapid assessments in children aged 
chez les enfants de 0 à 59 mois en triangulant 0 to 59 months by triangulating the data. 
les données.  
Le seuil d’urgence est déterminé à 15% de According to the WHz-scores, the 
malnutrition aiguë globale, selon l’indice P/T, emergency threshold is determined at 15% of 
chez les enfants de moins de 5 ans. the global acute malnutrition in under 5 
children.  
Le seuil d’alerte est déterminé à 10 – 14% de Calculating the Weight for Height z-scores 
malnutrition aiguë globale, selon l’indice P/T, (WHz) under aggravating factors, (family 
chez les enfants de moins de 5 ans, en ration below energy requirements; crude 
présence de facteurs aggravants (ration mortality rate > 1/10,000 persons/day; 
familiale inférieure aux besoins énergétiques; measles or pertussis epidemic; high 
taux de mortalité brut > 1 / 10 000 personnes incidence of respiratory or diarrhoeal 
/ jour; épidémie de rougeole ou de disorders), the alert threshold is set at 10% to 
coqueluche; forte incidence des troubles 14% of the global acute malnutrition in under 
respiratoires ou diarrhéiques). 5 children. 
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Cependant, ces seuils sont discutés au niveau However, these thresholds are discussed at 
international et ils varient selon l'ampleur de the international level and they vary 
l'urgence et des réponses nécessaires. Par according to the scale of the emergency and 
exemple, certains fixent les seuils d'urgence à the responses required. For instance, some 
10% et alerte à 5-9% avec facteurs aggravant. set emergency thresholds at 10% and alert 
 thresholds at 5-9% with aggravating factors. 
Une fois que l’urgence est déclarée, il faut Once an emergency is declared, an 
élaborer et mettre en œuvre un plan d’urgence emergency plan must be drawn up and 
: implemented: 
1) Mise en place d’un outil permettant de 1) Establish a tool to strengthen 
renforcer la surveillance ; surveillance; 
2) Mobilisation des ressources humaines, 2) Mobilise of human, material and financial 
matérielles et financières ; resources; 
3) Renforcement des structures de prise en 3) Reinforce structures to manage 
charge de la malnutrition ; malnutrition; 
4) Distribution gratuite ciblée des vivres (aux 4) Target free distribution of food (to 
familles, aux enfants de moins de cinq ans et families, children under five and the most 
zones les plus vulnérables) ; vulnerable areas); 
5) Renforcement de la coordination de la 5) Strengthen the coordination of the 
réponse. response. 
En situation d’urgence, il faut maintenir et In emergency cases, exclusive breastfeeding 
renforcer l’allaitement exclusif des of infants of 0 to 6 months and breastfeeding 
nourrissons de 0 à 6 mois et la poursuite de should be maintained and reinforced; 
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l’allaitement au moins jusqu’aux 24 mois de breastfeeding should be continued until the 
l’enfant et, pour le reste de groupes child is 24 months old. Concerning the rest of 
vulnérables (enfants de 6 à 59 mois, femmes vulnerable groups (children from 6 to 59 
enceintes et femmes allaitantes), les plans de months, pregnant and breastfeeding women), 
contingence spécifiques de la santé, de la specific contingency plans should be adapted 
nutrition et de l’aide alimentaire, entre autres, accordingly for health, nutrition and food aid, 
indiquent les adaptations nécessaires. among others. 
Promotion et protection de l’allaitement Promoting and protecting the practice of 
Maternel 
breastfeeding 
 
 
En situation d’urgence, comme après un In emergency situations, like right after a 
cyclone, un séisme ou d’autres catastrophes à cyclone, earthquake or other disasters that the 
laquelle le pays peut faire face, les pratiques country may face, breastfeeding practices are 
d’allaitement risquent de détériorer d’autant likely to deteriorate even further as a result of 
plus suite au stress, dégradation des stress, deteriorating living conditions, lack of 
conditions de vie, manque de personnes de support from people and other factors. 
support et autres. 
La première action à prendre est de soutenir The first action to take is to support 
les mères qui allaitent au sein pour qu’elles ne breastfeeding mothers so that they do not lose 
perdent pas confiance et qu’elles confidence and do not introduce artificial 
n’introduisent pas les aliments artificiels dans foods into their infants' diets when it is not 
la nourriture de leurs nourrissons alors que necessary. The next step is to identify and 
cela n’est pas nécessaire. Il convient ensuite help women who find it difficult to feed their 
d’identifier les femmes qui ont des difficultés infants. The aim is to restore the most 
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à alimenter leur nourrisson et de les aider. Le appropriate feeding method for the infant or 
but est de rétablir le mode d’alimentation le young child. Caregivers who care for infants 
plus approprié pour le nourrisson ou le jeune and young children and for whom artificial 
enfant. Les personnes qui s’occupent des feeding is the only feasible option also need 
nourrissons et des jeunes enfants et pour qui to be supported. 
l’alimentation artificielle est la seule option  
possible ont aussi besoin d’aide. 
Un enfant nourri de manière artificielle fait A child who is fed with artificial milk faces a 
face à un double risque : il ne reçoit pas les double risk: he or she does not receive 
anticorps du lait de sa mère et il existe un antibodies from the mother's milk and there 
risque de contamination par le processus de is a risk of contamination in the process of 
préparation du lait artificiel. Il est donc vital preparing artificial milk. It is, therefore, vital 
que l'allaitement soit activement protégé, that breastfeeding is actively protected, 
encouragé et soutenu. encouraged and supported. 
Points de Conseil en Nutrition pour Bébé Baby Nutrition Advisory Points (BNAP) 
(PCNB) 
 
 
 
L’un des buts principaux des points de conseil One of the main goals of nutrition 
en nutrition est d’offrir un espace agréable counselling points is to provide a conducive 
dans lesquels les femmes peuvent allaiter environment for women to breastfeed 
convenablement et trouver également le properly and also find support from other 
support d’autres femmes et des équipes en women and the teams in place, allowing them 
place, leur permettant de (re)trouver leur to (re)boost their confidence  and their ability 
confiance en elles et en leur capacité d’allaiter to breastfeed their infants. In the emergency 
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leur nourrisson. Dans les circonstances de vie living circumstances that Haitian women 
dans une situation d’urgence auxquelles les may face (deteriorating living conditions, 
femmes haïtiennes peuvent être confrontées lack of privacy, breastfeeding in the midst of 
(détérioration de conditions de vie, manque strangers, especially men), breastfeeding can 
d’intimité, le fait de devoir allaiter parmi des become difficult. Consequently, some 
inconnus, spécialement des hommes), women are no longer able to breastfeed as 
l’allaitement peut devenir difficile. Ainsi, before. Some women may also have beliefs 
certaines femmes ne se sentent plus capables concerning the quality and quantity of milk. 
d’allaiter comme auparavant. Certaines  
femmes peuvent également avoir des  
croyances liées à la qualité et la quantité du 
lait. 
Les points de conseil en nutrition pour bébé Baby nutrition advisory points should be 
doivent être mis en place dans les situations established in the following situations 
suivantes conformément aux directives qui according to the guidelines that govern their 
règlent leur fonctionnement : operation: 
• Lorsque les pratiques d’allaitement maternel  When breastfeeding and feeding practices 
et d’alimentation sont mises en danger suite à are endangered due to a traumatic situation 
une situation traumatisante tel qu’un such as an earthquake, cyclone, population 
tremblement de terre, un cyclone, un displacement (including lack of privacy 
déplacement de population (incluant le related to these situations) or related to lack 
manque d’intimité lié à ces situations), ou lié of support for breastfeeding mothers. 
au manque de support aux mères allaitantes.  
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• Lorsqu’il y a un besoin de contrôler les  When there is a need to control 
distributions de laits artificiels inappropriées inappropriate formula distribution and 
avec un suivi adéquat quand à leur utilisation. ensure adequate monitoring of its use. 
Lait Artificiel Prêt à l’Emploi (LANPE) Ready-to-Use Artificial Milk (RUAM) 
L’allaitement maternel est la meilleure Breastfeeding is the best way to bring 
manière d’amener une alimentation et une optimal nutrition and protection to infants, 
protection optimale aux nourrissons, en temps both in ordinary times and in emergencies. 
normale comme en urgence. Par contre, il est Conversely, it is also necessary that in 
aussi nécessaire qu’en situation d’urgence un emergency situations, adequate support is 
support adéquat soit donné aux enfants et given to children and their families for whom 
leurs familles pour qui allaiter n’est pas une breastfeeding is not an option. 
option.  
La préparation de formules pour nourrissons Preparing powdered infant formula requires 
en poudre exige grande quantité d’eau propre lots of potable water and other resources, 
et d’autres ressources, comme le carburant et such as fuel and utensils, as well as 
les ustensiles, ainsi que des connaissances et knowledge and time. However, especially in 
le temps nécessaire. Cependant et emergency situations, these things may be 
spécialement en situations d’urgence ces lacking and thus leads to an inappropriate 
choses font défaut, et ceci entraine que la preparation of formula, may result in 
formule est préparée de manière incorrecte increased illnesses and deaths. 
ayant comme conséquence une augmentation 
des maladies et des décès.  
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Le Lait Artificiel pour Nourrissons Prêt à Ready-to-use Artificial Milk for infants has 
l’Emploi a été conçue par le fabricant pour been designed by the manufacturer to be used 
être utilisé immédiatement. Il n’est pas immediately. It is not necessary to make any 
nécessaire de faire aucune préparation additional preparation or to add water before 
supplémentaire où d’y ajouter de l’eau avant consumption. Simply open the can and pour 
la consommation. Il suffit d’ouvrir la boite, et the prepared formula into a cup before giving 
de verser la formule déjà préparée dans une it to the infant. 
tasse avant de la donner au nourrisson.  
Programme de nutrition supplémentaire Supplementary Coverage Nutrition 
de couverture Programme 
  
Les programmes de nutrition supplémentaire Supplementary Coverage Nutrition 
de couverture ont comme objectif prévenir la Programmes aim at preventing the 
détérioration de l’état nutritionnel des deterioration of the nutritional status of 
populations particulièrement vulnérables : les particularly vulnerable populations: children 
enfants de 6 à 59 mois, les femmes enceintes aged 6-59 months, pregnant and lactating 
et allaitantes. Souvent ce type de programmes women. Such programmes often supplement 
complètent la ration fournie par les the ration provided during general 
distributions générales. distributions. 
Les produits nutritionnels que puissent The nutritional products that can be used are        
s’utiliser sont les aliments de supplémentation Ready-to-Use Supplementary Foods (RUSF) 
prêt à l’emploi (ASPE) en forme de pate in the form of plumpy nut [peanut butter] or 
d’arachide ou de biscuits d’haut valeur high-energy biscuits (see Appendix 12). 
énergétique (voire annexe 12). Dans un Subsequently, following the first phase of 
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deuxième temps, suivant la première phase de emergency response, a dry or prepared ration 
réponse à l’urgence, peut s’utiliser pour la may be used for supplement as explained in 
supplémentation une ration sèche ou ration section 4.4. 
préparée comme il est expliqué dans la section  
4.4.  
Coordination et partenariat Coordination and partnership 
La coordination et le partenariat font partie Coordination and partnership are an integral 
intégrante de la stratégie globale. Le part of the overall strategy. The 
renforcement d’un cadre national de reinforcement of a national coordination, 
coordination et d’un cadre de suivi et monitoring and evaluation framework will 
d’évaluation permettra de mieux coordonner enable better coordination of efforts at the 
les efforts au niveau central et au niveau central and decentralised levels. 
décentralisé. 
Le rôle de coordination et de leadership du The coordination and leadership role of the 
Ministère de la Santé Publique et de la Ministry of Public Health and Population 
Population (MSPP) doit être encore plus (MPHP) must be more effective, during both 
effectif tant durant les périodes d’urgence que emergency and non-emergency periods to 
de non urgence pour un respect strict du ensure strict compliance with the national 
protocole national et une répartition protocol and a relevant geographical 
géographique pertinente des ressources et distribution of resources and means of 
moyens d’intervention en fonction des intervention based on needs. 
besoins.  
LE DÉPISTAGE SCREENING 
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L'évaluation du statut nutritionnel est une Assessment of nutritional status is a routine 
activité de routine dans les structures activity in health facilities as an essential act 
sanitaires en tant qu'acte essentiel dans les in primary health care. Growth monitoring 
soins de santé primaire. Le suivi-promotion de and promotion should be done monthly for 
la croissance doit être fait de façon mensuelle all children who come to the health centre 
chez tous les enfants se présentant au centre (passive screening). Alternatively, 
de santé (dépistage passif). Cependant, les communities should also assist health 
communautés doivent aussi aider les services services in screening and referring children 
sanitaires dans le dépistage et la référence des to appropriate facilities through active 
enfants vers les structures appropriées par du screening. 
dépistage actif.  
La référence des malnutris est importante It is important that malnourished children are 
pour s'assurer que les soins appropriés sont referred to ensure that proper care is 
offerts. Le dépistage et la référence peuvent provided. Screening and referral can be done 
être faits de plusieurs façons : in several ways: 
• Visite spontanée à la structure sanitaire  Spontaneous visit to the health facility 
• Référence de mère à mère dans la  Mother-to-mother referrals in the 
communauté community 
• Référence par les agents communautaires  Referral by community workers after 
après dépistage avec le Périmètre Brachial Brachial Perimeter (BP) or oedema 
(PB) ou les œdèmes screening 
• Référence par les structures sanitaires ou les  Referral by health facilities or other 
autres programmes, telles que suivipromotion programmes, such as growth monitoring/ 
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de la croissance, consultation prénatales ou promotion, antenatal or postnatal 
post-natales, pédiatrie, etc. consultations, paediatrics, etc. 
Il est important de noter les points suivants : It is important to note the following 
points: 
Pour les enfants < 6 mois : For children <6 months: 
• Les balances pour bébé devraient être  Baby scales should be used for children < 
utilises pour les enfants < 6 mois pour obtenir 6 months of age to achieve maximum 
le maximum de précision dans le changement accuracy in weight change. 
de poids.          
Pour les enfants >6 mois:         For children >6 months: 
• Les balances de type Salter peuvent être  Salter type scales can be used for children 
utilises pour les enfants de moins de 25kg. under 25kg. 
• Les balances électroniques de type Seca  Seca type electronic scales can be used 
peuvent être utilises pour peser les enfants et for weighing children and adults over 
les adultes de plus de 25kg. 25kg. 
• Il est important de toujours peser les enfants  It is important to always weigh children 
sans vêtements et sans couches puisque ces without clothing and diapers to prevent 
items peuvent entraîner un mauvais wrong diagnosis of acute malnutrition. 
diagnostique de la malnutrition aigue.  
• La taille doit être mesurée avec une toise  
prévue à cet effet. Il ne faut jamais utiliser de  The height must be measured with a 
ruban à mesurer. gauge provided for this purpose. Never 
use a measuring tape. 
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• Les enfants de moins de 87 cm devraient être  Children under 87 cm should be 
mesurés en position couché et ceux de plus de measured lying down and those over 87 
87 cm en position debout. cm should be measured standing upright. 
  
• Pour les enfants de moins de 65 cm, le  For children under 65 cm, the diagnosis 
diagnostique de la malnutrition aigue ne peut of acute malnutrition cannot be made 
pas être fait seulement avec le rapport solely on the basis of the weight/height 
poids/taille mais doit être accompagné d'une ratio but must be accompanied by a 
évaluation clinique. clinical assessment. 
Le périmètre brachial (PB) peut facilement The brachial perimeter (BP) can easily be 
être utilisé par les agents communautaires lors used by community workers during active 
de dépistage actif de maison en maison ou house-to-house or community screening. The 
dans la communauté. Le PB doit toujours être BP should always be measured on the left 
mesuré sur le bras gauche et à mi-distance arm and midway between the shoulder and 
entre l'épaule et le coude. Le ruban de PB est elbow. The BP tape is a special portable 
un ruban de mesure spécial, léger et facile à measuring tape. Using the BP helps to 
manipuler. L'utilisation du PB permet identify severely or moderately 
d'identifier les enfants malnutris sévères ou malnourished children between 6 and 59 
modérés âgés entre 6 et 59 mois ou ceux de months of age or those over 65 cm and under 
plus de 65 cm et moins de 110cm. 110 cm. 
Les agents communautaires doivent aussi être Community workers should also be able to 
en mesure d'identifier les œdèmes identify bilateral nutritional oedema. 
nutritionnels bilatéraux. Les œdèmes Nutritional oedema is present on both sides 
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nutritionnels sont présents sur les 2 côtés du of the body at the same height, starting from 
corps à la même hauteur en commençant par the feet. The classification of nutritional 
les pieds. La classification des œdèmes oedema is presented in Appendix 1. 
nutritionnels est présentée en Annexe 1.  
L'examen Clinique Clinical Examination 
La consultation médicale de tous les enfants The medical consultation of all children 
se présentant à la structure sanitaire est taken to the health facility is carried out by 
réalisée par l’infirmier au niveau de la the nurse at the health facility. The nurse 
structure sanitaire. Il reprend l’histoire de takes the history of the child and the illness 
l’enfant et de la maladie avec la mère ou with the help of the mother or the caregiver. 
l’accompagnant. Ensuite, l'infirmier effectue The nurse then performs a complete clinical 
un examen clinique complet afin d’évaluer la examination in order to diagnose the child's 
condition de l’enfant, suivant les paramètres condition, following the classic parameters 
classiques de la PCIME. of IMNCI. 
Parmi tous les critères PCIME, il est important Among all the IMNCI criteria, it is important 
de rechercher les paramètres de maladie grave to look for the following severe disease 
suivante : parameters: 
• Vomissement incoercibles et frequents  Incoercible and frequent vomiting 
• Hypothermie < 35°C  Hypothermia < 35°C 
• Pneumonie 60 resps/ min pour les moins de  Pneumonia 60 resps/minute for less than 
2 mois 50 resps/ minute pour les 2 à 12 mois 2 months; 50 resps/minute for 2 to 12 
> 40 resps/minute pour les 1 à 5 ans 30 months; > 40 resps/minute for 1 to 5 
resps/minute pour les plus de 5 ans ou 
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 years; 30 resps/minute for more than 5 
• Tout tirage sous-costal years or 
• Infection sévère,  Any intercostal muscle strain, 
• Très faible, apathique, inconscient,  Severe infection, 
• Convulsions,  Very weak, apathetic, unconscious, 
• Déshydratation sévère basée sur l’anamnèse  Seizure, 
et l’examen du malade  Severe dehydration based on the patient's 
• Toute condition nécessitant une perfusion ou history and examination 
une sonde naso-gastrique.  Any condition requiring an infusion or 
• Fièvre > 39°C, nasogastric tube. 
• Très pâle (anémie sévère) 
 Fever > 39°C, 
• Hypoglycémie 
 Very pale (severe anaemia) 
• Tout autre signe que le clinicien juge 
 Hypoglycaemia 
important pour décider du transfert des 
 Any other signs that the clinician 
patients de l’ambulatoire en structure 
considers important in deciding whether 
hospitalière. 
to transfer patients from outpatient care 
to inpatient care. 
Cependant, les signes cliniques sont However, clinical signs are important in 
importants dans le dépistage de la screening for malnutrition but it is important 
malnutrition mais il est important de to consider that anthropometric 
considérer que les mesures anthropométriques measurements (and the presence of 
(et la présence d'œdèmes nutritionnels) nutritional oedema) PRECEDE all clinical 
PRÉCÈDENT tous les signes cliniques. En signs. Indeed, in acute malnutrition, the 
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effet, dans la malnutrition aiguë, le child's metabolism may be troubled to the 
métabolisme de l'enfant peut être perturbé au extent that some of the typical clinical signs 
point que certains signes cliniques classiques may not be present during the medical 
peuvent ne pas être présents lors de l'examen examination. This really depends not only on  
médical. Ceci dépend vraiment du degré de the degree of malnutrition but also, on the 
malnutrition et aussi de l'évolution de cette evolution of this malnutrition. 
malnutrition.  
Le test de l'appétit Appetite test 
La malnutrition modifie la façon dont les Malnutrition changes the way infections and 
infections et autres maladies affectent l’état other diseases affect the clinical condition of 
clinique du patient, les enfants sévèrement the patient. Children who are severely 
affectés par les signes classiques de PCIME et affected by the classic signs of IMNCI and 
qui sont malnutris ne montrent souvent aucun who are malnourished often do not show any 
signe clinique en rapport avec ces maladies clinical signs related to these diseases. 
cependant ces complications sévères However, these severe complications lead to 
conduisent à une perte de l’appétit. De plus a loss of appetite. In addition, a person with 
une personne avec un appétit médiocre ne a poor appetite will not take the RUTF 
prendra pas les produits ATPE à la maison et products at home and their condition will 
il va donc continuer à se détériorer ou décéder. therefore, continue to deteriorate or they will 
die. 
Pour tous les enfants identifiés comme For all children identified as severely 
sévèrement malnutris, il est dont important malnourished, it is, therefore, important that 
que le test de l'appétit soit fait en complément the appetite test be done in addition to the 
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de l'examen médical et des mesures medical examination and anthropometric 
anthropométrique afin de déterminer si measurements to determine whether the child 
l'enfant est affecté par des complications is affected by complications that are difficult 
difficiles à diagnostiquer. Le test de l’appétit to diagnose. The appetite test enables us to 
nous permet de prendre la décision sur decide on the direction of care: outpatient 
l’orientation de la prise en charge: en (OTP) or inpatient (NSU) for children > 6 
ambulatoire dans le centre (PTA) ou en months and > 3.5 kg. 
hospitalisation (USN) pour les enfants > 6  
mois et > 3,5 kg.  
Pendant le test de l’appétit, le prestataire doit During the appetite test, the health service 
aussi observer le lien entre l’enfant et sa mère provider should also observe the relationship 
ou son accompagnant afin de conseiller la between the child and the mother or caregiver 
mère sur l'importance de l'alimentation active so as to advice the mother on the importance 
dans le développement de l'enfant. of active feeding in the child's development. 
Comment faire un test de l'appétit How to conduct an appetite test 
Il est important avec les enfants, que le test de It is important with children that the appetite 
l'appétit se fasse dans un endroit calme où test is conducted in a quiet area where the 
l'appétit ne sera pas modifié par les activités appetite will not be affected by external 
environnantes. Avant de commencer, il faut factors. Before the test is conducted, you 
expliquer à l'accompagnant de l'enfant le but must explain its purpose and how it will be 
et le déroulement du test. Il faut aussi vérifier carried out to the caregiver. The time the last 
l'heure du dernier repas (avant le test de meal was taken (before the appetite test) 
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l’appétit) afin de connaître le niveau d’appétit should also be checked to find out the 
de la personne. person's appetite level. 
L’accompagnant et l’enfant ou l'individu The caregiver and the child or individual 
doivent tout d’abord se laver les mains à l'eau must first wash their hands with potable 
propre et au savon. Tous les PTA doivent water and soap. All OTPs must, therefore, be 
donc pouvoir fournir les installations able to provide the necessary facilities for the 
nécessaires à la première leçon d'éducation : first education lesson on hygiene. 
L'hygiène.  
L'accompagnant s’assoit confortablement The caregiver sits comfortably with the child 
avec l’enfant sur ses genoux et lui offre de on his/her laps offering RUTF without force 
l’ATPE sans le forcer et en l’encourageant. Il and by encouraging the child. She can also 
peut aussi mettre un peu de pâte sur son doigt put some paste on her finger or in the child's 
ou dans la bouche de l’enfant. Si celui-ci mouth. If the child refuses, then he or she 
refuse, il doit alors continuer gentiment à should gently continue to encourage the 
encourager l’enfant et prendre son temps. Le child, taking his or her time. Normally, the 
test doit normalement prendre peu de temps test should only take a short time, but it can 
mais cela peut aller jusqu'à une heure. last for an hour. 
Les ATPE ne contiennent pas d'eau pour RUTFs do not contain water for better 
favoriser une meilleure conservation donc il preservation so the child should be offered 
faut offrir à l'enfant de l'eau potable à boire drinking water in a cup. 
dans une tasse.  
Comment décider si le résultat du test de How to decide whether the appetite test 
l’appétit est positif ou négatif result is positive or negative 
  
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La personne malnutrie doit consommer un The malnourished person must consume a 
minimum d'ATPE pour réussir le test minimum amount of RUTF to pass the 
d'appétit. Cette quantité se calcule à partir de appetite test. This amount is calculated from 
son poids et de la ration journalière qui lui the person's weight and the corresponding 
correspond. Il ne faut JAMAIS forcer l’enfant daily ration. NEVER force the child to eat 
pendant le test. La première fois, il faut être during the test. For the first time, you must 
vigilant et donner du temps et de l’espace à la be vigilant and give time and space to the 
mère (ou à l’accompagnant) pour que petit à mother (or caregiver) so that little by little the 
petit l’enfant s’habitue au produit. child gets used to the product. 
La quantité consommée et ne pas forcer The quantity consumed and not forcing the 
l'enfant sont les deux facteurs déterminants child are the two final determining factors for 
finaux pour l’orientation de la prise en charge the orientation of patient management: 
du patient:  
• En ambulatoire dans le même centre (PTA)  In the outpatient care unit of the same 
si aucune maladie grave n'a été diagnostiquée centre (OTP), if no serious illness has 
et que l'appétit est bon been diagnosed and the appetite is good. 
• En hospitalisation (USN) si une ou des  In the inpatient care unit (NSU), if one or 
maladies graves ont été identifiées ou s’il y a more serious illnesses have been 
un manque d’appétit diagnosed or if there is a lack of appetite. 
MOBILISATION COMMUNAUTAIRE COMMUNITY MOBILISATION 
La mobilisation communautaire est un Community mobilisation is a continuous 
processus continu, qui doit démarrer en même process, which should start simultaneously 
temps que la planification des activités de with planning nutrition care activities. Most 
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prise en charge nutritionnelle. La plupart des activities need to be continually reinforced to 
activités doivent être continuellement be effective. There must be a continuous 
renforcées pour être efficaces. Il doit y avoir dialogue between health facilities and 
un dialogue continu entre les structures communities in which the population can 
sanitaires et les communautés dans lequel la express themselves regularly and suggest 
population peut s’exprimer régulièrement et new actions to be implemented. 
suggérer de nouvelles actions à mettre en  
œuvre.  
La qualité de l’engagement communautaire The quality of community involvement is an 
est un facteur essentiel de réussite pour la essential factor of success in the management 
prise en charge de la malnutrition aiguë en of acute malnutrition in outpatient settings. 
ambulatoire. La compréhension et Community understanding and ownership of 
l’appropriation du problème « malnutrition » the "malnutrition" problem and the response 
de la part de la communauté ainsi que la that the health system puts in place 
réponse que le système de santé met en place (nutritional interventions) is key to achieving 
(interventions nutritionnelles) est déterminant maximum coverage of activities, reducing 
pour atteindre la couverture maximale des the fatality associated with acute 
activités, diminuer la létalité associée à la malnutrition and improving the final impact 
malnutrition aigue et améliorer l’impact final of the programme. 
du programme.  
Objectif de la participation Purpose of community participation 
communautaire 
 
 
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La mobilisation communautaire est un Community mobilisation is a set of 
ensemble d’activités participatives créées participatory activities created with the aim 
dans le but de rendre les activités de nutrition of making nutrition activities capable of 
capables d’atteindre leurs objectifs : meilleure achieving their objectives like: better use of 
utilisation des services, augmenter la services, increased coverage of needs and 
couverture des besoins et obtenir peu less rejection. 
d’abandon.  
• Développer une stratégie de prise en charge  Develop a strategy peculiar to the socio-
de la malnutrition aiguë spécifique au cultural context to manage acute 
contexte socioculturel pour amener la malnutrition so as to enable the 
communauté à s’approprier des activités community to take ownership of 
nutritionnelles; nutritional activities; 
• Dépister activement des cas de malnutrition  Actively screen for cases of acute 
aiguë dans la communauté avant toute malnutrition in the community before 
dégradation de leur état générale et les référer their general condition deteriorates and 
vers les structures de santé les plus proches refer them to the nearest health facilities to 
pour réévaluer leur état nutritionnel reassess their nutritional status: 
• Assurer le suivi des cas à domicile;  Follow -up cases at home; 
• Sensibiliser la communauté sur les mesures  Sensitise the community to prevent 
de prévention de la malnutrition. malnutrition. 
Etapes de la mobilisation communautaire Stages of community mobilisation 
La mobilisation communautaire comprend les Community mobilisation includes the 
étapes et activités suivantes : following steps and activities: 
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1. Compréhension communautaire : 1. Community understanding:  Gathering 
Collecte des informations et information and initial planning; 
planification initiale ;  
2. Sensibilisation communautaire : 2. Community Awareness: Awareness-
Activités de sensibilisation ; raising activities; 
3. Dépistage actif : recherche et 3.  Active screening: Searching for and 
référence des enfants malnutris dans la referring malnourished children in the 
communauté ; community; 
4. Suivi des enfants admis dans le 4. Follow-up of children admitted to the 
programme : à partir des visites à programme: based on home visits; 
domicile ;  
5. Recherche des absents et des abandons 5.  Search for absentees and dropouts; 
6. Education pour la santé et la nutrition. 6.  Health and nutrition education. 
Compréhension communautaire Community Understanding 
Pour que les programmes à base For community-based programmes to be 
communautaire soient efficaces, ils doivent effective, the context in which they are 
prendre en compte le contexte dans lequel ils implemented should be taken into 
sont mis en œuvre. Ceci demande une collecte consideration. This requires initial 
d’information initiale que va aider à : information gathering that will help to: 
1. Connaître les besoins que la communauté 1. Know the needs that the community itself 
elle-même exprime par rapport à la expresses in relation to malnutrition and 
malnutrition et sa prise en charge ; its management; 
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2. Définir quels sont les messages à passer 2. Identify the messages to be conveyed (or 
(ou à ne pas passer) à la communauté et not to be conveyed) to the community and 
aux différents groupes ; to different groups; 
3. Identifier la meilleure manière de diffuser 3. Identify the best way to disseminate these 
ces messages. Quelques unes de ces messages. Some of the information to be 
informations à collecter sont : collected are: 
• Identifier les principales caractéristiques de  Identify the main characteristics of the 
la communauté pouvant influencer community that can directly or indirectly 
directement ou indirectement le programme influence the nutrition programme 
nutritionnel (cartographie de la zone (mapping of the programme's area of 
d’influence du programme; population cible influence; target population for activities, 
des activités, etc.) etc.). 
  
• Identifier les termes locaux utilisés pour  Identify the local terms used to describe 
décrire la malnutrition, ses causes telles que malnutrition, its causes as perceived by 
perçues par la communauté ainsi que les the community as well as the solutions 
solutions proposées par elle proposed by the community. 
• Identifier les personnes clés de la  Identify key people in the community: 
communauté: chef d’église, Hougan, etc. Pastors, Hougan [Fetish Priests], etc. 
• Identifier les groupes communautaires  Identify pre-existing community groups: 
existant préalablement : groupes de femmes, women groups, etc. 
etc.  
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• Identifier les moyens de communication  Identify effective means of 
efficaces : crieurs, radio, etc. communication: towncriers, radio, etc. 
Sensibilisation communautaire Community Outreach 
La sensibilisation communautaire est le Community outreach is the process by which 
processus par lequel une communauté est a community is informed about main aspects 
informée sur les principaux aspects d’une of an intervention. 
intervention.  
En particulier, les gens doivent savoir ce que People need to know specifically how useful 
le programme signifie dans la pratique pour the programme is to them: the aim of the 
eux: ce que le programme va faire, où il va programme, where it will take place, how to 
avoir lieu, comment les gens vont pouvoir y access it, and the essence of the programme to 
avoir accès et ce que le programme va faire au the individual. The basic elements that need to 
niveau individuel. Les éléments de base be included in a message are: 
devant être inclus dans un message sont :  
• La population cible: quels sont les  The target population: who are the eligible 
bénéficiaires éligibles pour ce programme ? beneficiaries of this programme? 
• La localisation des structures qui font la  The location of the facilities that provide 
prise en charge nutritionnelle ; nutritional care; 
• Les jours et horaires de fonctionnement ;  The days and hours of operation; 
• Les services offerts: que va-t-on donner au  The services offered: what will be given to 
bénéficiaire admis dans le programme ? the beneficiary admitted to the 
 programme? 
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• La dynamique du programme: que ce passe-  The dynamics of the programme: what 
t-il lors des visites ? Pour avoir un impact happens during the visits? To have a major 
majeur sur la communauté, les messages impact on the community, the messages 
doivent être préparés dans un langage must be prepared in an easy and simple to 
compréhensible et simple. Ils doivent être understand language. They should be brief 
brefs et cibler la population à qui ils sont and target the intended population. 
destinés. 
En tenant compte des informations collectées, Taking into account the information 
la stratégie de sensibilisation peut être collected, the awareness-raising strategy can 
orientée vers des personnes précises ou des be directed towards specific people or places 
lieux précis tel que : such as: 
• Leaders religieux                Eglises  Religious leaders           Churches 
• Leaders culturels                Marchés  Cultural Leaders            Markets 
• Agents communautaires     Points d’eau  Community workers     Water sources 
• Scouts                                 Ecoles  Scouts                            Schools 
• Matrones, etc.  Matrons, etc. 
Les messages doivent passer à travers Messages must be conveyed through 
différentes sources de communication que la different sources of communication that the 
communauté utilise de façon habituelle. Ceci community usually uses. This can be done 
peut se faire de manière formelle ou through a formal or informal, traditional or 
informelle, traditionnelle ou moderne : crieurs modern method: town criers, radios, posters, 
publiques, radios, affiches, etc. etc. 
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Il est important que les personnes ou groupes It is important that individuals or groups 
reconnu (es) par la communauté soient recognised by the community are particularly 
particulièrement sensibilisés. sensitised. 
Dès que la communauté reconnaît l’effet As soon as the community recognises the 
positif des aliments thérapeutiques prêts à positive effect of Ready-to-Use Therapeutic 
l’emploi (ATPE), la fréquentation des Foods (RUTFs), attendance at health care 
structures de prise en charge augmente facilities will automatically increase. The 
automatiquement. « L’expérience positive » "positive experience" of the first 
des premiers bénéficiaires sera la meilleure beneficiaries will be the best publicity to 
publicité pour inciter ceux de l’entourage et encourage those around them with the same 
vivant la même situation à se décider à se predicament to come to the centre. This will 
présenter au centre. Ce qui améliorera la improve the coverage of the activities. 
couverture des activités.  
Les accompagnants des bénéficiaires    The caregivers of beneficiaries discharged 
déchargés du programme feront également from the programme will also play their roles 
leur part de sensibilisation en référant dans le in raising awareness by referring other 
programme, d’autres accompagnants caregivers of malnourished children to the 
d’enfants malnutris. programme. 
Dépistage actif dans la communauté Active screening in the community 
Pour faciliter l’accès aux soins des malnutris, To facilitate access to care for malnourished 
le dépistage de cas par le PB ou la présence people, screening for cases with BP or the 
d’œdèmes bilatéraux au niveau presence of bilateral oedema at the 
communautaire permet de faire une première community level would ensure a first 
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sélection de ceux qui devraient être dans le selection of those who should be in the 
programme. programme. 
Si la communauté est avertie du programme et If the community is informed of the 
que celui-ci connaît un succès, que la qualité programme and that the programme is 
des soins est reconnue par la communauté, les successful with the quality of care recognised 
enfants malnutris seront ainsi plus facilement by the community, malnourished children will 
identifiés et référés par celle-ci. be more easily identified and referred by the 
community. 
Suivi des enfants admis dans le programme Follow-up of children admitted to the 
programme 
 
 
Le progrès des enfants doit être suivi chaque 
Children's progress should be monitored 
semaine au niveau des PTA ou toutes les deux 
weekly at the OTP level or every two weeks 
semaines au PNS. La visite à domicile entre 
at the SNP. The home visit between visits to 
deux visites au centre représente un support 
the centre will serve as a support for families 
pour les familles quand : 
when: 
1. Les enfants perdent du poids ou ont un 
1. Children lose weight or have a stationary 
poids stationnaire ; 
weight; 
2. Les enfants développent des 
2. Children develop minor medical 
complications médicales mineures 
complications but which could lead to a 
mais qui pourraient entraîner une 
rapid deterioration in their nutritional 
détérioration rapide de leur état 
status; 
nutritionnel ; 
 
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3. L’accompagnant de l’enfant refuse 3. The child's caregiver objects to the health 
l’admission de l’enfant en USN contre worker’s advise with regards to the 
l’avis du personnel soignant ; child’s admission at the NSU; 
4. Les mères doutent de leurs capacités à 4. Mothers have doubts about their ability to 
prendre en charge les enfants à take care of the children at home. The 
domicile. Les moments des visites à times for home visits must be mutually 
domicile doivent être décidés d’un agreed on between the health care 
commun accord entre le personnel workers of the centres, the community 
soignant des centres, les agents workers and the people (caregivers, 
communautaires et les personnes mothers, etc.) caring for the children. 
(accompagnants, mères…) s’occupant  
des enfants. 
Recherche des absents et des abandons Searching for absentees and dropouts 
Toute absence en PTA ou PNS doit être Any absence from OTP or SNP must be 
investiguée par les agents communautaires. Il investigated by Community Agents. It is 
est important de connaître le plus tôt possible important to know the reason for the absence 
raison de l’absence et d’encourager les parents as soon as possible and to encourage parents 
à revenir au centre. Les familles des enfants to return to the centre. The families of absent 
absents ne doivent pas être réprimandées au children should not be scolded to avoid 
risque d’être démotivées. La raison de discouragement. The reason for the absence 
l’absence et la visite à domicile doit être and the home visit must be indicated on the 
consignée sur la fiche de l’enfant. child's record. 
Education pour la santé et nutrition       Health and nutrition education 
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Les parents ou accompagnants d’enfants Generally, parents or caregivers of 
malnutris, sont issus généralement des malnourished children come from modest 
groupes sociaux de conditions modestes. Il est social backgrounds. They may have limited 
possible que leurs connaissances soient knowledge about the nutritional needs of 
limitées sur les besoins nutritionnels de leurs their children, the importance of play and 
enfants, de l’importance du jeu et des psychosocial stimulation in child 
stimulations psychosociales dans le development, the harmful effects of poor 
développement de l’enfant, des effets nocifs hygiene and pollution as a cause of illness, 
d’une hygiène défectueuse et de la pollution basic hygiene conditions to be practised 
comme cause de maladie, des mesures during breastfeeding, and the harmful effects 
d’hygiène élémentaires à observer lors de of certain practices. 
l’allaitement maternel, et des effets néfastes  
de certaines pratiques.  
Il est important que tous les accompagnants It is important that all caregivers in 
séjournant dans les programmes de nutritional recovery programmes benefit 
récupération nutritionnelle bénéficient des from health education sessions. These 
séances d’éducation pour la santé. Ces sessions should be held daily for those 
séances doivent être tenues chaque jour pour admitted in the hospital at the NSUs and 
ceux admis à l’hôpital dans les USN et chaque weekly or every two weeks on the Ready- to- 
semaine ou deux semaines dans les sites de Use Therapeutic Food (RUTF)/dry ration 
distribution des Aliments Thérapeutiques Prêt distribution sites: OTP and SNP. 
à l’Emploi (ATPE)/rations sèches : PTA et  
PNS. 
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Les agents communautaires transmettent à la Community workers deliver messages to the 
population des messages en rapport avec la population related to the promotion of key 
promotion des pratiques clés de santé et le health practices and the home treatment of 
traitement à domicile de la malnutrition aiguë acute malnutrition: 
:  
• Les signes d’alerte conduisant au Centre de  Warning signs that should lead one to 
Santé (fièvre, diarrhée, etc.) the Health Centre (fever, diarrhoea, 
 etc.); 
• Les signes de la malnutrition et des maladies  Signs of malnutrition and related 
associées ; diseases; 
• L’allaitement maternel ;  Breastfeeding; 
• L’alimentation complémentaire des enfants  Complementary feeding of children 
après 6 mois ; after 6 months; 
• L’alimentation de l’enfant malade ;  Feeding the sick child; 
• Utilisation de l’ATPE à la maison ;  Use of RUTF at home; 
• La vaccination ; 
 Immunisation; 
• La supplémentation en vitamine A et le 
 Vitamin A supplementation and 
déparasitage ; 
deworming; 
• La planification familiale ; 
 Family planning; 
• Lavage de mains, hygiène corporelle et des 
 Hand washing, personal and food 
aliments ; 
hygiene; 
• Le traitement de l’eau. 
 Water treatment. 
Couverture d’un programme de nutrition Nutrition Coverage Programme 
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La couverture d’un programme exprime le Coverage Programme expresses the number 
nombre d’enfants malnutris aigus étant pris en of acutely malnourished children being 
charge dans un programme nutritionnel sur managed in a nutrition programme out of all 
l’ensemble des enfants malnutris aigus dans acutely malnourished children in a specific 
une zone précise. area. 
Les facteurs principaux susceptibles The major factors that can improve coverage 
d’influencer la couverture d’un programme of aprogramme are: 
sont:  
• La distance des sites et la qualité des soins  Distance from the sites and the quality of 
offerte dans les sites: A quelles distances les care offered at the sites: How far are the 
centres de nutrition sont ils de la population ? nutrition centres from the population? 
Quel est l'accueil offert par le personnel en What reception is offered by the health 
place et sont-ils suffisamment formés pour worker present and are they adequately 
prendre en charge les cas de malnutrition? trained to manage malnutrition cases? 
• La connaissance du programme de prise en  Knowledge about the acute malnutrition 
charge de la malnutrition aiguë: Quelles sont management programme: What is the 
les connaissances de la population quant à la population's knowledge about 
malnutrition et son traitement ? malnutrition and its treatment? 
• Rejet du programme : Le programme rejette-  Rejection of the programme: Does the 
il des enfants ? La communauté rejette-t-elle programme reject children? Does the 
le programme ? community reject the programme? 
Comment la participation communautaire How can community participation 
peut-elle influencer positivement ces positively      influence these factors? 
facteurs :  
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• La distance des sites :  Distance from the sites: 
- Mesurer la perception de la communauté par       -Measure the community's perception of the 
rapport à la qualité des soins et de la distance quality of care and distance from the health 
de la structure sanitaire ; facility; 
-Il est bon de trouver un équilibre entre la       -Balancing the feasibility of implementing 
faisabilité de la mise en œuvre du programme the programme with the best possible 
et la meilleure couverture possible à travers coverage through discussions with the 
les discussions avec les autorités, les authorities, community heads, etc.; 
personnes clés de la communauté, etc.  
• La connaissance du programme de prise en  Knowledge about the programme for the 
charge de la malnutrition aiguë : management of acute malnutrition: 
  
- Augmenter la compréhension de la -Improve the target population’s 
population cible par l’utilisation de la understanding   through the use of local 
terminologie locale dans les activités de terminology in awareness-raising activities; 
sensibilisation;  
- Disséminer l’information importante sur le     -Disseminate important information about 
programme et la prise en charge par la the programme and managing it through the 
formulation de messages courts et par l’usage composition of short messages and the use 
de supports-clé de communication. of key communication tools. 
• Rejet du programme par le bénéficiaire/rejet 
du bénéficiaire par le programme : 
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  Rejection of the programme by the 
- Augmenter la compréhension de la beneficiary / rejection of the beneficiary 
population ciblée par le programme ; by the programme: 
- Identifier et contrecarrer les perceptions -Improve the targeted population’s 
négatives quand au programme. understanding of the programme; 
-Identify and counteract negative perceptions 
of the programme. 
D’autres barrières empêchant une couverture Other barriers to optimal coverage can be 
optimales peuvent être identifiées lors de la identified during the implementation of a 
réalisation d’un programme telles que : travail programme. Such barriers include: 
agricole, situation sécuritaire, croyance agricultural work, security situation, cultural 
culturelle, non gratuité des soins, etc. Il est beliefs, lack of free health care, etc. When 
important lors de l’identification de telles identifying such barriers, it is important to 
barrières de les documenter et d’essayer de document them and endeavour to find their 
trouver des solutions dans la mesure du possible solutions. 
possible.  
Stimulation émotionnelle et physique Emotional and physical stimulation 
Établir de bonnes pratiques de soins Establishing good care practices 
  
Quand l’enfant évolue vers la malnutrition When a child develops acute malnutrition, 
aiguë, il réduit son activité. Dans une première his or her activity reduces. In the first stage, 
étape l’enfant atteint de marasme est fatigué the child with marasmus will feel tired but 
mais intéressé et l’enfant atteint de interested and the child with kwashiorkor is 
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kwashiorkor, craintif et replié sur lui-même. scared and reserved. When they are really 
Lorsqu’ils sont vraiment sévèrement severely malnourished, they no longer play, 
malnutris, ils ne jouent plus, ne pleurent plus, cry, smile, complain or react - they become 
ne sourient plus, ne se plaignent plus et ne lethargic and weakened. Since the child no 
réagissent plus– ils deviennent léthargiques et longer cries when he/she is hungry, thirsty, or 
s’affaiblissent. Parce que l’enfant ne pleure stressed, the mother presumes her child no 
pas quand il a faim, qu’il a soif, ou qu’il est longer needs attention. Nurses also neglect 
stressé, la mère pense que son enfant n’a plus the child in the hospital for the same reason. 
besoin d’attention. Les infirmières négligent Adults answer children's requests; if the child 
aussi l’enfant à l’hôpital pour la même raison. does not ask, the child is ignored. This is the 
Les adultes répondent à la demande des main reason why these children should be 
enfants, si l’enfant ne demande pas, il est treated together and isolated from other 
ignoré. Ceci est la raison principale pour children with other conditions. 
laquelle ces enfants doivent être traités  
ensembles et séparés des autres enfants  
présentant d’autres conditions.  
Parce que l’enfant ne joue pas, il n’a pas Since the child does not play, he or she does 
l’occasion d’apprendre. A la longue, ceci peut not have the opportunity to learn. In the long 
retarder son développement mental et run, this can delay his or her mental and 
comportemental. La stimulation émotionnelle behavioural development. Emotional and 
et physique à travers le jeu devrait commencer physical stimulation through play should 
durant la réhabilitation et continuer après la begin during rehabilitation and continue after 
sortie, elle peut de cette façon réduire les 
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risques de dommages mentaux et discharge, since it can reduce the risk of 
émotionnels. mental and emotional injuries. 
 
Il est essentiel que le personnel de santé It is important for health personnel to 
comprenne les besoins émotionnels de ces understand the emotional needs of these 
enfants et crée une atmosphère joyeuse et children and create a joyful atmosphere that 
favorable à l’éveil psychologique. Les will be conducive to psychological 
accompagnants ne doivent jamais être châtiés awakening. Caregivers should never be 
et le personnel ne doit jamais crier ou chastised and staff should never shout or 
s’énerver contre eux. Les enfants qui ne sont become angry with them. Children who are 
pas souriants, ont besoin de l’attention des not lively need the parents’ attention. The 
parents. Le personnel doit toujours prendre staff must always take time to explain this to 
soin de l’expliquer aux parents et de suivre the parents and monitor their efforts. It is 
leurs efforts. Il est important que les parents important that the parents carry them in their 
les prennent dans les bras et leur apportent arms and give them the necessary affection. 
l’affection nécessaire. 
Il est essentiel que les mères, pères ou It is important for mothers, fathers or 
substituts soient avec leurs enfants à l’hôpital caregivers to be with their children in the 
dans l’USN et qu’elles soient encouragées à NSU and encouraged to feed their children, 
nourrir leurs enfants, les tenir, les entourer et carry them, be around them and play with 
jouer avec eux autant que possible. them as much as possible. 
Stimulation émotionnelle et Jeux Emotional Stimulation and Play 
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L’enfant ne doit pas souffrir de privations The child should not suffer sensory 
sensorielles. Le visage de l’enfant ne doit pas deprivation. The child's face should not be 
être couvert; il doit pouvoir voir et entendre ce covered; he or she should be able to see and 
qui se passe autour de lui. Il ne doit jamais être hear what is happening around him or her. 
emmailloté. L’enfant malnutri a besoin The child should never be swaddled. The 
d’interagir avec les autres enfants durant sa malnourished child needs to interact with 
réhabilitation. other children during rehabilitation. 
Dès que possible, il doit avoir des temps de   As soon as possible, the malnourished child 
jeux et d’interaction avec les autres enfants should have time to play and interact with 
sur un matelas de jeux, et avec sa mère ou un other children on a play mat, and with his/her 
animateur. Il n’y a aucune évidence que cela mother or a facilitator. There is no proof that 
augmente les infections nosocomiales. this will increase nosocomial infections. 
Les jeux sont une partie importante du Play is an important part of a child's 
développement de l’enfant, c’est un moyen development, it is a way to learn, explore and 
d’apprendre, d’explorer et c’est aussi une express oneself. For this reason, it is 
façon de s’exprimer. Pour cela c’est important important to provide space in the nutrition 
de fournir de l’espace dans les centres de centres, OTP and NSU, where children can 
nutrition, PTA et USN, où les enfants peuvent run or play. The provision of simple toys, 
courir ou jouer. L’approvisionnement en songs, stories etc. is also useful (make sure 
jouets simples, chants, histoires etc. est aussi they are culturally acceptable). "Play 
utile (il faut s’assurer qu’ils sont therapy" helps sick or psychologically fragile 
culturellement acceptable). « La thérapie par children to heal (see Appendix 15). 
le jeu » aide les enfants malades ou  
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psychologiquement fragiles à guérir (voir 
annexe 15). 
Les jouets doivent être aussi bien dans les lits  Toys should be in the beds as well as in the 
que dans la salle de jeux. Les jouets doivent playroom. Toys should be cheap and safe, 
être peu onéreux et sans danger, confectionnés made from cardboard boxes, plastic bottles, 
à partir de boites en carton, bouteilles en tins, old clothes, wooden blocks and similar 
plastique, boîtes de conserves, vieux habits, materials. This is best because mothers can 
cubes en bois et autres matériels similaires. make the toys themselves and continue to 
C’est ce qu’il y a de mieux car les mères make them even after the child leaves the 
peuvent les fabriquer elles mêmes et continuer centre. 
à en faire après que l’enfant soit sorti du  
centre.  
Activité Physique Physical Activity 
L’activité physique vise essentiellement à Physical activity is primarily aimed at 
promouvoir le développement de l‘agilité promoting the development of motor agility 
motrice et peut aussi promouvoir la croissance and growth during rehabilitation. For 
durant la réhabilitation. Pour des enfants children who are rather immobile, passive 
plutôt immobiles, des mouvements passifs de movements of their limbs or bathing at body 
leurs membres ou la prise de bain à la temperature often help to stimulate them. 
température du corps aident souvent à les  
stimuler. 
Pour les enfants capables de se mouvoir sans For children who are able to move without 
problème, le jeux doit inclure des activités difficulty, play should include activities such 
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comme se rouler ou faire des culbutes sur un as rolling or tumbling on a mattress, kicking 
matelas, donner un coup de pied dans un or throwing a ball, climbing stairs and 
ballon ou le lancer, grimper les escaliers et climbing up and down an embankment. The 
monter et descendre d’un talus. La durée et duration and intensity of physical activity 
l’intensité des activités physiques doivent should increase as the child's condition 
augmenter suivant l’amélioration de l’état improves. A member of the health care team 
del’enfant. Un membre de l’équipe soignante should be responsible for all these activities 
doit être chargé de toutes ces activités pour les for malnourished children. 
enfants malnutris. 
 
 
 
 
 
 
  
 
 
 
  
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CHAPTER THREE 
 
3.0 Structured Analysis and Discussions of Translation problems 
 
This chapter aims at approaching the theories and principles that were used to surmount some 
challenges in rendering the source text into the target text.  Chesterman (1997) argues that 
translating a text from a source language to a target language without using theories to back one’s 
translation is to translate blindly. Meaning, it is important to buttress a translation with theories 
used in rendering the text. Pym (2014:24) supports the idea that translation strategies help 
translators in their work by stating that “in translation process, the translator has a choice between 
several translation strategies without being wholly dictated by the source text.   
The translation theories and strategies employed by the researcher to translate the text are grouped 
into linguistic factors and extra-linguistic factors. The linguistic factors considered are types of 
specialised language collocations, transposition, adaptation, adjustment, acronyms, abbreviations, 
false cognates, polysemy, multiple register, morphological processes and technical terms. The 
extra-linguistic factors are text type, professional knowledge and background experience and 
purpose of the translation.  
This chapter seeks to demonstrate how those factors affected the translation process. Various 
portions of the translation will be highlighted and analysed below in line with the afore-mentioned 
items. 
The first area of discussion in this chapter concerns Linguistic factors and this is expounded as 
follows: 
As already presented in chapter one, collocations have been grouped by different linguists 
according to their research and different names are given to these collocations. However, for the 
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purpose of this work, our focus is on specialised language collocations in Nutrition. This research 
analysis uses Benson et al’s (1997) classification of collocations which groups collocations into 
(i) open collocations, that is, two or more words that occur together and have no relation and can 
be freely combinable and (ii) restricted collocations where the word collocates with limited or 
fixed words. In addition, these specialised language collocations could either be to the left or to 
the right and are discussed below: 
3.1 Types of specialised language collocations 
 
A. Specialised language lexical collocations 
 
(i) Verb + Noun: access health services, visit the hospital, breastfeed babies, identify cases 
of malnutrition, monitor child growth, , measure the weight of a child, conduct nutrition 
surveys, take the history of the child, plan nutrition care activities, facilitate access to 
health care, develop a strategy for the management of acute malnutrition, sensitise the 
community , lose weight, gain weight, monitor children 
(ii) Noun + Noun: appetite test 
(iii) Verb + Adjective + Noun: develop minor medical complications, develop acute 
malnutrition, treat acute malnutrition, detect nutritional planning, perform a clinical 
examination, refer malnourished chidren, conduct nutrition surveys, manage 
malnutrition cases 
(iv) Adjective + Noun: nutritional recovery programmes, nutritional situation, nutritional 
oedema, bilateral oedema, breastfeeding mothers, active screening, stationary weight 
(v) Noun + Verb: children suffering from acute malnutrition 
(vi) Adverb + Adjective: severely malnourished, acutely malnourished 
(vii) Verb + Adverb + Adjective + Noun: identify severely malnourished children 
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From the examples given above, it is clear that most of the specialised language collocations 
within this context are Verb and Noun collocations as well as Verb and Adjective collocations. 
B. Specialised language grammatical collocations 
Grammatical collocation is a combination between a content word and a function /grammatical 
word (a preposition or particle) and between a content word (a noun or an adjective) and a 
grammatical structure (to infinitive or that clause).  
From the definition above of grammatical collocations, we could consider the specialised language 
collocations as a content word (noun or an adjective) and a grammatical structure. Therefore, we 
have: 
(i)  To infinitive + Verb: to lose weight, to admit a child 
(ii) Verb + Preposition: referred to health services, suffer from acute malnutrition, screen 
for cases, admitted to heath care,  
(iii) Noun + Preposition: access to health services, lack of appetite, loss of appetite 
Using Benson et al’s (1997) classification of grammatical collocations, there are very few 
examples that fall under this category. Also, the researcher found out “to infinitive + verb” exist. 
For example, to infinitive + verb: to lose weight, to admit a child.  
 
 
 
 
 
 
 
 
 
 
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Table 1: The examples below are corresponding pairs of open specialised language collections 
and restricted specialised language collocations in French with their equivalents in English in 
nutrition  
  
Open specialised language collocations              Restricted specialised language collocations 
French English French English 
Malnutrition  Malnutrition  
Interventions 
Nutrition interventions 
nutritionnelles 
(pg. 30) 
Malnutrition aiguë sévère Severe acute malnutrition 
Supplémentation en  Micronutrient 
 (pg.25) 
micronutrient  supplementation (pg.30) 
Malnutrition  Moderate  
  
aiguë modérée acute malnutrition (pg. 25) 
 
 
 
Santé Health Planification familiale 
Family planning 
 
 (pg. 60) 
Pyramide de la santé Health pyramid (pg. 22)  
Soins de santé Health care (pg. 25)  
Services de santé Health services (pg.30)  Dépistage systématique Routine screening  
Établissement de santé Health facility (pg. 25) (pg. 23) 
Soins de santé primaires Primary health care (pg. 36)  
 
Prophylaxie du Malaria prophylaxis 
Soins Care 
paludisme (pg. 28) 
 
Soins prénatals Prenatal care (pg. 42) 
Soins anténatals Antenatal care (pg. 42) 
Soins postnatals Postnatal care (pg. 42) Allaitement exclusive Exclusive breastfeeding 
Hospitalisation Inpatient care (pg. 45)  (pg. 34) 
Soins ambulatoires Outpatient care (pg. 45) 
 
Poids Weight  
 Infections nosocomiales Nosocomial infections 
Gain de poids Weight gain (pg. 42) (pg. 66) 
Changement de poids Weight change (pg. 42) 
 
Grave Severe 
 
 
Infection grave Severe infection (pg. 45)  
Croissance retardé 
Maladie grave Severe disease (pg. 44) Stunted growth (pg.29) 
 
Déshydratation sévère Severe dehydration (pg. 45) 
Malnutrition aiguë sévère Severe acute malnutrition 
(pg. 24) 
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To begin with, transposition as proposed by Vinay and Darbelnet (1977) was one of the methods 
that aided in the translation process. Transposition is when parts of speech change their sequence 
and this introduce a change in grammatical structure. Taking into account the text translated in 
Chapter 2, the researcher made use of transposition in the following instances; 
(i) “La référence des malnutris est importante pour s'assurer que les soins appropriés 
sont offerts” on page 41 was rendered as “it is important that malnourished children 
are referred to ensure that proper care is provided”. In this sentence, our main focus 
is on ‘la référence’ which has been translated as ‘referred’ and not ‘referral’ with 
more concentration on the noun ‘référence’. Thus, it is evident that ‘la référence’is 
a noun and has changed its grammatical sequence to ‘referred’ which is a verb in 
English. 
(ii) On page 23, “les termes USN, PTA et PNS sont utilisés dans le modèle de soins 
nutritionnels à base communautaire (SNC)” given as “the terms NSU, OTP and 
SNP are used in the Community-Based Nutrition Care (CBN) model”. Where 
(USN) Unité de Stabilisation Nutritionnelle is Nutritional Stabilisation Unit in 
English, (PTA) Programme Thérapeutique Ambulatoire means Outpatient 
Therapeutic Programme, (PNS) Programme de Nutrition Supplémentaire stands 
for Supplementary Nutrition Programme and then (SNC) modèle de soins 
nutritionnels à base communautaire which represents (CBN) Community-Based 
Nutrition Care model. It can therefore, be deduced that there is a change in the 
position of the abbreviations ‘USN, PTA, PNS et SNC’ in French rendered as 
‘NSU, OTP, SNP and CBN’ in English.  
 
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(iii) On page 21, “la stratégie globale de la prise en charge de la malnutrition en Haïti 
s’adresse aux groupes vulnérables suivants” translated as “the overall strategy for 
managing malnutrition in Haiti targets the following vulnerable groups” instead of  
“the strategy overall for managing malnutrition in Haiti targets the following 
vulnerable groups”. Considering this example, we realise that there is a shift in the 
position of the words “overall strategy”.  
(iv) On page 22, “pour pouvoir planifier et cibler les interventions nutritionnelles, il est 
important d’avoir des données fiables et representatives” rendered as “in order to 
plan and target nutrition interventions, it is important to have reliable and 
representative data”.  The words “données fiables et representatives” have changed 
positions in English “reliable and representative data”.  
(v)  On page 24 where “l’adoption de cette terminologie a l’avantage de systématiser 
les services de prise en charge à différents niveaux de la pyramide sanitaire et au 
niveau communautaire” has its English version as “the advantage of adopting this 
terminology is that it systematises care services at different levels of the health 
pyramid and the community”. The word “systématiser” in the source text changed 
its grammatical structure from an infinitve form to “systematising” which is a 
gerund.   
 
Another procedure proposed by Vinay and Darbelnet (1977) and used in this work is Adaptation. 
This is the act of expressing a sentence in a completely different way that suits another language 
culture. Below is an example of modulation used in the translated text:   
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(i) On page 39,“les produits nutritionnels que puissent s’utiliser sont les aliments de 
supplémentation prêt à l’emploi (ASPE) en forme de pâte d’arachide ou de biscuits 
d’haut valeur énergétique” translated as  “the nutritional products that can be used are 
Ready-to-Use Supplementary Foods (RUSF) in the form of plumpy nut [peanut butter] 
or high-energy biscuits”. With respect to this example, it can be concluded that the 
researcher applied adaptation procedure by rendering ‘pâte d’arachide’ as “plumpy 
nut” to give the target audience the idea that it makes malnourished children fat. So, 
we realise that there is a shift in cultural environment where ‘plumpy nut’ is used to 
suit the African context. However, the other version ‘peanut butter’ is put in square 
brackets to reveal its other name in the American context.  That is, how it is said in 
other contexts. 
 
The last translation technique used in this work is the technique of Adjustment by Nida (1964). 
Nida defines adjustment as making the form of the message fit the characteristics of the structure 
of the target language. This adjustment comes in three (3) forms: additions, subtractions and 
alterations. The following examples explain this technique. On page 29, “les actions pour 
surveiller et  promouvoir la croissance doivent se concentrer sur le jeune enfant de 0 à 2 ans et de 
préférence débuter avec le contrôle des pratiques nutritionnelles chez les femmes enceintes, 
puisque la période prénatale et les deux premières années de vie sont cruciales pour le 
développement physique et cognitif de l’enfant” translated as “actions taken on monitoring and 
promoting growth should focus on the young child of 0 to 2. First of all, this should be done by 
monitoring nutritional practices in pregnant women, since the prenatal period and the first two 
years of life are crucial for the physical and cognitive development of the child”.  
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Taking into consideration ‘actions taken on monitoring and promoting growth should focus on the 
young child of 0 to 2 years’, we realise that this sentence in English is shorter than it was written 
in French. Meaning, it has been subtracted. The sentence “first of all, this should be done by 
monitoring nutritional practices in pregnant women, since the prenatal period and the first two 
years of life are crucial for the physical and cognitive development of the child” has also undergone 
some additions and alterations. It is not the same way as it was written in the source text. The 
researcher adopted the adjustment technique to produce semantically equivalent structures, to 
evoke stylistic effect and lastly, to produce an equivalent communicative effect. 
 
3.2 Acronyms and Abbreviations 
 
 One of the challenges the researcher encountered in translating the source text was the use of 
acronyms. An acronym is an abbreviation consisting of the first letters of each word in the name 
of something, pronounced as a word. For example, an acronym that posed a challenge to the 
translator was GAM (page 31). This acronym had several meanings but when further research was 
conducted, the true meaning of the word was found. For instance, the online medical dictionary 
gave meanings like GAM- Global Acute Malnutrition, Gay Asian Men, Gene Activated Matrix, 
Genes and Metabolites and Glycogen Accumulating Metabolism. But a final decision was made 
by the researcher using Vermeer’s (1996) skopos theory which came in handy because the 
researcher had to relay the information on Global Acute Malnutrition in the translation. The aim 
was to sensitise the general public dominated by semi-literates to the causes, effects and solutions 
of acute malnutrition.  
Another challenge the researcher encountered was the use of abbreviations. Abbreviations are 
shortened forms of a written word or phrase used in place of the whole word or phrase. They are 
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used to save time and avoid repetition of long words or phrases. The author of the source text did 
not give the full meaning of the abbreviated letters below but in order to avoid obscurity, the 
researcher first of all, had to look up those letters in the source language (French).  Later, the 
researcher adopted Jakobson’s (1959) theory of intralingual translation in this section to find out 
the full meaning of the letters in English. Finding the right meaning of the abbreviated letters is 
very important to the researcher since a wrong rendition of a nutrition text can put patient’s health 
at risk.   
Examples of abbreviated forms used in the French and English medical language are as follows: 
The Abbreviation P/T in French is Poids/Taille with its English version as W/H -Weight/Height 
(page 33). Additionally, PCIME means Prise en charge intégrée des maladies de l’enfant which in 
English stands for IMNCI (page 44) - Integrated Management of Childhood Illness. 
3.3 False cognates 
 
The concept of false cognates was also a challenge encountered by the researcher in the translation 
process. False cognates are pairs of words that seem to be cognates because of similar sounds and 
meaning but have different etymologies; they can be within the same language family or from 
different languages. Considering this work, we realise that giving the correct versions in the target 
text to suit the target language was a herculean task for the researcher due to similar sounds of the 
words in both languages even though they are different entities.  However, the researcher resorted 
to Nida’s (1964) theory of dynamic equivalence whereby the terms below were translated as said 
in the target language (considering the culture) in order not to distort the meaning.   
The first version of ‘dépistage systématique’ (page 23) was translated as ‘systematic screening’ 
but after some analysis in the field of nutrition, ‘routine screening’ was found to be more 
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appropriate.  This is due to the fact that ‘dépistage systématique’ simply means ‘screening that is 
carried out in a particular order’ but ‘routine screening’ deals with ‘screening that is conducted on 
daily basis’ and this choice suits the context in the target text.  
 In addition, ‘la stratégie globale’ (page 21) was rendered as ‘global strategy’ but upon further 
research, the researcher realised it was ‘overall strategy’ in the target text instead. With regards to 
this work, translating ‘la stratégie globale’ as ‘global strategy’ would only be too linear and this 
does not convey the true meaning in this context as ‘overall strategy’.   
Furthermore, ‘la structure sanitaire’ (page 25) in the source text is translated in the target text as 
‘health facility’ and not ‘health structure’ after thorough research because the researcher noticed 
that the medical jargon commonly used is ‘health facility’ and not ‘health structure’. Besides, 
‘health structure’ seems to carry a meaning of ‘just one single building in the hospital’ but then, 
‘health facility’ kind of  ‘covers a range of buildings in the hospital’ for instance, from small clinics 
and doctor’s offices to urgent care centres.   The same thing applies to the words, ‘la surveillance 
de croissance’ (page 29) given as ‘growth monitoring’ rather than ‘growth surveillance’ since 
‘growth monitoring’ is what is normally used in nutrition. 
 Lastly, ‘les activités environnantes’ (page 48) has its English version as ‘external factors’ instead 
of ‘environmental activities’. The expression ‘Environmental activities’ that has to do with the 
‘environment itself’ was neither used in this context nor ‘environmental factors’ which include 
water, soil ,etc. as a result of their meanings which do not reflect the real idea or meaning the 
researcher tries to express.  Alternatively, ‘external factors’ was chosen because it gives the exact 
meaning in that context in which it was employed, that is: ‘the influences or circumstances that 
can affect lactating mothers when breastfeeding their babies in public’   
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3.4 Polysemy 
 
Some polysemic words posed a challenge as their meanings could be different depending on the 
context.  Polysemy is the capacity for a word or phrase to have multiple meanings, usually related 
by contiguity of meaning within a semantic field. 
Table 2. Examples of polysemic words used in the source text  
Word Common use                        Medical term 
History (page 44)                        p  a  s t studies                                  p  a  t i ent’s record 
 
Perform (page 44) a play (theatre) undertake an operation 
to pass an exam(academics) 
Condition (page 44)                    r  e q  u  i rement disease 
 
The words ‘history’, ‘perform’ and ‘condition’ posed a problem in translating the source text due 
to their diverse meanings but upon further analysis in the field of medicine by adopting  Jakobson 
(1959) theory of intralingual translation, the correct meanings of ‘history’, ‘perform’ and 
‘condition’ were found. Besides, the researcher noticed those words depended on the context and 
since the source text is a medical one, it was definitely their medical use and not their common use 
that was adopted.  
3.5 Technical terms 
 
One major challenge the researcher encountered was the use of medical terminology. Medical 
translation is noted for its complexity due to its common use of medical terminology which makes 
medical texts so intricate. These terms are really technical to the extent that when the right meaning 
is not appropriately rendered in the translation, it can put the patient’s health in danger. A layman 
without any background knowledge in nutrition would definitely not find it easy translating these 
texts and that is what posed a challenge to the researcher. The researcher applied three (3) theories 
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here.  First of all, with Nida’s (1964) theory of formal equivalence, stating that translation should 
be done considering both form and content, the researcher in rendering the English equivalents for 
the terms below appreciated Nida’s view by applying it to the work. In addition, using Newmark’s 
(1988) theory of maintaining the medical register in medical texts, the appropriate medical terms 
in the table below were used instead of its general register. Lastly, adopting Kenny’s (2009) 
classification of terms, some technical terms in the text were grouped as zero articles and 
prepositions.  They neither have articles (definite and indefinite) like ‘le, la, l’, un, une and des’ 
nor prepositions before them. This is evident in both the source and target languages, where these 
articles were intentionally omitted. The terms in which articles and prepositions are not present are 
termed ‘nil expressions’ and these are demonstrated in the table below: 
Table 3. Source text (French)                                  Target text (English) 
Œdème bilatérale Bilateral oedema (page 57) 
Hypoglycémie Hypoglycaemia (page 45) 
Hypothermie Hypothermia (page 45) 
Malnutrition aiguë sévère                                     S   e v  e  r e   a  c  u  t e   m   a l  n  u trition (page 25) 
Malnutrition aiguë modérée                                  M   o  d  e  r a  t e    a  c  ute malnutrition (page 25) 
Perimètre brachial                                                 B   r a  c h  i  a l  p  e  r  i meter (page 42) 
Interventions nutritionnelles                                 N   u  t r  i t i o  n    i n terventions (page 50) 
Allaitement exclusif                                              E  x  c  l u  s  i v  e   b  r e astfeeding (page 34) 
 
The second area of translation analysis invloves Extra-linguistic factors such as text type, 
professional knowledge and background experience and purpose of the translation. These afore-
mentioned extra-linguistic factors are elaborated in the following lines:  
First of all, in translating the source text into the target text, the researcher acknowledged the fact 
that the text type represented a challenge. Tomaskaszkiewicz (2006: 112) defines text typology as 
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“a certain system of classifying texts on the basis of the field they belong to, their genre and 
purpose as well as the type of discourse”.  The text considered was a medical one and there is no 
doubt that the medical register had to be kept in mind without distorting the intended meaning. 
This was evident in the translation of certain medical jargons. Since the researcher is not an expert 
in the said field, he/she adopted Nida’s (1964) theory of dynamic equivalence by conveying the 
source language message to match the target language. This made the translation flow naturally 
and by so doing, carried the spirit of the source text.  This can be seen in the translated version 
where some technical terms in the source text were rendered as they are supposed to be in the 
target text. It is the case of ‘supplémentation en micronutrient’ (page 30). It was initially rendered 
as ‘micronutrient supplement’ in English. The reason being that ‘food supplements’ is often heard 
but upon further research in nutrition, the researcher had to change it to ‘micronutrient 
supplementation’. Another example is the word ‘appétit conservé’ (page 25), whereby it was first 
translated as ‘conserved appetite’ but later changed to ‘maintained appetite’ because that is what 
is used by medical practitioners and Dieticians. 
One would attest that indeed the work of a translator could be as difficult as a Greek puzzle with 
lack of training and experience. Dongfeng & Dan (1999) believe that the translator’s professional 
and psychological state may either have a positive or negative effect on the translation. The 
professional knowledge and background experience give translators the chance to acquire top 
notch skills in translation as well as harness those skills in their translations. With regard to medical 
texts in subdomains like Nutrition, the researcher’s professional knowledge and background 
experience though needed were limited. The researcher is yet to get exposed to such technical texts 
and get to that point of attaining those top-notch skills and expertise. Moreover, there is not much 
background knowledge in this area of Nutrition where the rendition could be appropriately done 
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without much difficulty without consulting different sources. So, a lot of research was done on the 
internet on nutrition-related articles and documents like that of the World Health Organisation 
(WHO) and it took a lot of time to read those documents, understand and then translate the source 
text. On page 21 , a word like ‘stratégie globale’ had its English equivalent as ‘global strategy’ 
but it took some background research by the researcher to recognise the fact that the text had to do 
with ‘case management’ and so, ‘overall strategy’ suited that phrase. Additionally, it took a lot of 
research adopting Jakobson’s (1959) theory of intralingual translation to distinguish between the 
abbreviations ‘Poids/Taille (P/T)’ –‘ Weight for Height z scores (WH z-scores)’ and ‘Poids/Age 
(P/A)’ –‘Weight/Age’ on page 33, line 1 in order not to either interchange or use the same thing 
for both.  
Lastly, the purpose of the translation plays a key role in the translation process. The purpose of the 
translation is relevant and thus, it is the duty of every translator to keep in mind the receptors as 
this would help him or her to tone the language to improve their (receptors) understanding of the 
text. Considering this work on Nutrition, the researcher employed Vermeer’s (1996) skopos theory 
on communicative purpose by bringing to light the causes, effects and solutions of Acute 
Malnutrition to the public’s understanding, of what the original text says without distorting the 
intended meaning.  With such texts, a distortion in the intended meaning can endanger the lives of 
patients. Newmark (1981: 86) sheds more light on communicative translation claiming that “it is 
social, concentrates on the message and the main force of the text”. This means that, translators 
should focus on translating the content and language of the message for the recipients to understand 
and that is exactly what the researcher attempted to do in this work. 
 
 
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CONCLUSION 
 
The following lines elucidate the findings of this work, conclusion and recommendations. 
 FINDINGS 
 
There are so many works on general language collocations but little is said of specialised language 
collocations even though specialised language collocations exist. This is a very serious area that 
needs to be considered because professional translators come across diverse texts in different 
domains of which some are so technical. The medical field for instance, has its medical jargons 
and so there is the need for translators to get acquainted with such terms in order to keep the 
medical register (Newmark 1988) because it could put the patients’ or public’s health at risk. We 
also notice that the most common types of specialised language collocations in nutrition are ‘verb 
+ noun’ –access health service, visit the hospital, identify cases of malnutrition and breastfeed 
babies and ‘verb + adjective + Noun’-develop minor medical complications, detect nutritional 
planning, treat acute malnutrition, etc (page 70). 
The quality of a translation into a translator’s second or other language(s) may be affected due to 
an interference of their mother tongue(s) (L1). Generally, there is the need for a native-level 
knowledge of the source and target languages in order to capture the accurate and intended 
meaning in the translation. This is because, when specialised language collocations are 
appropriately rendered in a technical text, particularly one on acute malnutrition, stylistic and 
semantic equivalence are preserved.  The knowledge and use of these specialised language 
collocations can be successfully achieved through extensive research and building glossaries on 
them. This will enable student translators and professionals to easily render such collocations in 
medical and other texts. 
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Specialised language collocations pose problems to most professional medical translators, whether 
or not such translators are native speakers of their working language pairs, due to little or no 
background knowledge in the medical field, especially in the context of nutrition. Besides 
interference from the mother tongue(s) of translators, our study establishes that little or no 
background knowledge in the medical field, especially in the context of nutrition, may affect 
translators’ ability to capture certain collocations in their translations. More specifically, our study 
establishes that native speakers struggle to capture the appropriate collocations in their 
translation(s), as a result of little or no background knowledge in the medical field. 
Also, our study tries to establish that translators who have not studied translation as a course but 
who are well-exposed to medical texts through practice may even end up translating medical texts 
better than trained professional translators who may not have enough exposure to medical texts. 
However, being a translator without any training, or a bilingual or native speaker of a language 
does not necessarily mean that they are fully acquainted with all register specific collocations of 
specialised fields. Professional training is still needed to become a better translator. 
Professional translators with little or no background knowledge in the medical field may find it 
difficult translating a text on acute malnutrition with specialised language collocations using the 
right medical register. Even professional medical translators are to have hands-on experience, a 
flawless command of theoretical frameworks and also, background knowledge of field-specific 
terminology in order to be great translators. This is actually because in medical translation, terms 
are used differently in the various medical fields since the translations are aimed at a specialised 
community. Therefore, it is required that professional medical translators have some background 
medical knowledge and expertise. 
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The aim of this research was to underscore the importance of specialised language collocations as 
words that help to make the language more appealing while maintaining stylistic and semantic 
equivalence. This is because a distortion in the intended meaning could be very dangerous 
particularly, with medical texts. Newmark (1988) highlights the importance of collocation for 
written texts. He posits that even though grammar forms the main part of a text, collocations help 
in controlling the text by giving the required meaning. He further states that collocations add to 
the understanding of words in a text. He believes that the most powerful contextual influence on 
words is the collocation. Baker (1992) reiterates that what a word means often depends on its 
association with certain collocates. Therefore, a lot of care must be taken to avoid 
miscommunication when it comes to translating and giving the right collocations of technical terms 
from the source language to the target language. 
This work presented how translation began and how it has evolved over time with citations from 
eminent authors who have contributed massively in translation by giving their distinct definitions 
and theories about it. Such authors are Dubois et al (1973), Nida (1969), Jakobson (1959) and 
Ladmiral (1979).  
The qualitative method was employed in this work on content analysis in a medical text on acute 
malnutrition and by selecting portions in the source text to critically examine specialised language 
collocations.  Information was ascertained from primary and secondary sources to give a 
comparative, descriptive and analytical view on specialised language collocations anchored by 
some ideas on general language collocations. 
A brief introduction of the source text was giving insight to the readers of about this work. The 
causes, effects and solutions of acute malnutrition in Haiti were highlighted. The researcher gave 
some types of specialised language collocations adopting Benson et al’s (1997) classification of 
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collocations. The analysis revealed some challenges encountered in the translation process, the 
style employed by the author, as well as demonstrated the theories and strategies from Vinay and 
Darbelnet (1977), Nida (1964), Vermeer (1996), Newmark (1988), Dongfeng & Dan (1999) and 
Kenny (2009) used to overcome those challenges.   
Based on the research, we realise that specialised language collocations represent a challenge not 
only to translators who are non-native speakers but also, translators who are native speakers of 
their working languages. For non-native speakers, it is due to an interference of their mother 
tongues (L1) and little or inadequate background knowledge. With respect to native speakers, it is 
due to little or inadequate background knowledge. Being a native speaker of a language does not 
necessarily mean that the translator is fully acquainted with all register specific collocations of 
specialised fields. What is very important is to have adequate background knowledge in the subject 
field whether one is a native speaker or a non-native speaker. According to Bartsch (2004), usually, 
people who have this background knowledge are experts in their various fields.  
To crown it all, it is crystal clear that the ability of translators, either native or non-native, to 
translate appropriately, does not only have to do with the level of speaking or mastering the 
working languages, but also, solid background knowledge is needed. Alternatively, all these 
challenges can be avoided when translators equip themselves with the necessary background 
knowledge in various fields and also overcome interferences of their respective mother tongues 
(L1). This would help them avoid incongruous sentences as the right collocations will be used and 
also make the translation flow naturally. 
 
 
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RECOMMENDATIONS  
 
We recommend that students get interested in specialised language collocations by probing deeper 
to gain a better understanding since little is said. This can be achieved by including more 
specialised and technical texts from more domains in the Master of Arts in translation programme 
for students to discover challenges in them. A lot of areas should be considered in teaching the 
students as this would enable students learn extensively to acquire rich vocabulary. Courses like 
Area Studies and Specialised Translation from English into French and vice versa should be 
maintained and improved. Specialised translators in legal, medical, etc domain could handle such 
courses. This would go a long way to help the students become great professional translators. They 
would also be able to translate with flair.  
Also, we recommend that students pay more attention to courses like Terminology Management 
and Information Technology where they are taught to explore British National Corpora in order 
for them to learn up-to date corpora on collocations (Baker 2011) used by the Native speakers. It 
should be part of the year-long courses so that they can have enough time to learn collocations. 
Conversely, courses which involve intensive research work like Research Methodology should be 
taught by a translator who has, specifically, studied project management in translation. When a 
project manager in translation teaches research, he or she is able to really help the students who 
are potential translators to appreciate research more and do great future projects.  
Moreover, it is our recommendation that students have access to online dictionaries and specialised 
documents where they can learn adequately and construct meaningful sentences when translating 
with more focus on specialised language collocations in fields like medicine, finance, business, 
communication and media. This would facilitate the translation process and equip them with the 
necessary skills for translation to achieve stylistic and semantic equivalence.  
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Students should cultivate the habit of reading extensively and researching to acquire new 
vocabulary and collocations. This can be done by striving hard to understand the concepts behind 
terms and expressions used in their glossaries. In addition, they should endeavour to completely 
understand the source language so that they could give proper renditions in the target language 
without distorting the intended meaning. Dolet (1540) anchors the principle of translators having 
a perfect knowledge in the language and subject of the working languages. According to Dolet 
(1540) cited by Cary (1963:29) “la manière de bien traduire d’une langue en aultre: que le 
traducteur entende parfaitement le sens et la matière de l’autheur qu’il traduit, que le traducteur 
ait parfaicte congnoissance de la langue de l’autheur”. [In order for the translator to properly 
translate an author is to perfectly understand the meaning and the subject matter of the author’s 
work as well as have a perfect knowledge of his language]   
Students should be well equipped with the necessary tools for translation. They should be given 
the chance to explore very useful sites as well as have access to termbases, vocabulary like DeepL 
Translator, Linguee, etc. Students should be introduced and taught how to use some complex 
translation CAT tools (Computer-Aided Tools) such as Memsource and SDL Trados, to aid in 
their translations, which give them options of expressions.  
 
 
 
 
 
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Table 4: GLOSSARY 
 
FRENCH ENGLISH 
1.  Accompagnants Caregivers 
2.  Alimentation complémentaire Complementary feeding 
3.  Aliments artificiels Artificial foods 
4.  Allaitement exclusif Exclusive breastfeeding 
5.  Allaitement maternel Breastfeeding 
6.  Ambulatoire Outpatient care 
7.  Anémie sévère Severe anaemia 
8.  Anticorps Antibodies 
9.  Appétit conservé Maintained appetite 
10.  Appétit médiocre Poor appetite 
11.  Balances de type salter Salter type scales 
12.  Balances électroniques Seca type electronic scales 
13.  Balances pour bébé Baby scales 
14.  Changement de poids Weight change 
15.  Complications médicales Medical complications 
16.  Convulsion Seizure 
17.  Coqueluche Pertussis (Whooping cough) 
18.  Couverture d’un programme de nutrition Nutrition coverage programme 
19.  Déparasitage Deworming 
20.  Dépistage actif Active screening 
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21.  Dépistage passif Passive screening 
22.  Dépistage systématique Routine screening 
23.  Déshydratation sévère Severe dehydration 
24.  Détection précoce des infections Early detection of infections 
25.  Déterminants de la malnutrition Determinants of malnutrition 
26.  Dommages mentaux et émotionnels Mental and emotional injuries 
27.  Emaciation Emaciation 
28.  Enfants malnutris Malnourished children 
29.  Examen clinique Clinical examination 
30.  Femmes allaitantes Lactating women 
31.  Femmes enceintes Pregnant women 
32.  Gain de poids Weight gain 
33.  Hospitalisation Inpatient care 
34.  Hypoglycémie Hypoglycaemia 
35.  Hypothermie Hypothermia 
36.  Indicateurs nutritionnels Nutritional indicators 
37.  Infections graves Severe infections 
38.  Infections nosocomiales Nosocomial infections 
39.  Interventions nutritionnelles Nutrition interventions 
40.  Lait artificiel Artificial milk 
41.  Maigreur Thinness 
42.  Maladies associées Related diseases 
43.  Malnutrition aiguë Acute malnutrition 
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44.  Malnutrition aiguë modérée Moderate acute malnutrition 
45.  Manque d’appétit Lack of appetite 
46.  Morbidité et mortalité Morbidity and mortality 
47.  Nourissons Infants 
48.  Œdème bilatérale Bilateral oedema 
49.  Œdèmes nutritionnels bilatéraux Bilateral nutritional oedema 
50.  Perfusion Infusion 
51.  Périmètre brachial Brachial perimeter 
52.  Planification familiale Family planning 
53.  Poids stationnaire Stationary weight 
54.  Pratiques clés de santé Key health practices 
55.  Prestataire de soins Health service provider 
56.  Problèmes de nutrition Nutritional problems 
57.  Progression normale de la croissance Normal progression of growth 
58.  Promotion de la croissance Growth promotion 
59.  Prophylaxie du paludisme Malaria prophylaxis 
60.  Pyramid de la santé Health pyramid 
Rapports des programmes de nutrition Supplementary and therapeutic feeding 
61.  
supplémentaire et thérapeutique programmes reports 
62.  Résultats des enquêtes nutritionnelles Nutritional survey results 
63.  Résultats des screening périodique Periodic community screening results 
64.  Retard de croissance Stunted growth 
65.  Rougeole Measles 
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66.  Sensibilisation communautaire Community awareness 
67.  Services de santé Health services 
68.  Soins anténatals Antenatal care 
69.  Soins de santé primaires Primary health care 
70.  Soins postnatals Postnatal care 
71.  Soins prénatals Prenatal care 
72.  Sonde naso-gastrique Nasogastric tube 
73.  Statut nutritionnel Nutritional status 
74.  Stratégie globale Overall strategy 
75.  Structure sanitaire Health facility 
76.  Supplémentation en micronutriments Micronutrient supplementation 
77.  Surveillance épidémiologique Epidemiological surveillance 
78.  Systématique immunitaire Immune system 
79.  Système de surveillance nutritionnelle Nutritional surveillance system 
80.  Système immunitaire très affaibli Very weak immune system 
81.  Tirage sous-costal Under-costal printing 
82.  Troubles diarrhériques Diarrhoeal disorders 
83.  Troubles respiratoires Respiratory disorders 
84.  Vaccination Immunisation 
85.  Vomissement incoercible Incoercible vomiting 
 
  
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SITOGRAPHY 
 
https://dictionary.cambridge.org>, Retrieved on 17 July, 2020 
https://www.merriam-webster.com>, Retrieved on 23 August, 2020 
https://www.thoughtco.com>register-nature of collocations, Retrieved on 30 August, 2020 
https://www.collinsdictionary.com>, Retrieved on 05 September, 2020 
https://en.m.wikipedia.org>wiki, Retrieved on 15 September, 2020 
https://www.lexico.com>definition, Retrieved on 25 September, 2020 
https://glossary.sil.org>term>mor, Retrieved on 02 October, 2020 
 
 
 
  
  
 
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