By Leah Salm and Roos Verstraeten
What are the key ingredients for prioritizing nutrition in policy – both at a national and local level? Recent research has shined a spotlight on this process in Burkina Faso.
Transform Nutrition West Africa’s evidence brief strengthens and widens our understanding of the current direction of nutrition-relevant policy in Burkina Faso and its implications. Nutrition policy is examined in terms of i) nutrition context, objectives, indicators, budget, and activities; ii) key beneficiaries, actors and coordination, iii) monitoring, evaluation, and accountability, and iv) finally whether current policies are aligned with the World Health Assembly (WHA) targets. We found that nutrition is featured most prominently in nutrition, health, and agriculture/food security policies. Policies’ content focuses most on the WHA targets of under-five year old child stunting and wasting, and children and women are the most frequently mentioned beneficiary groups. A key gap identified is the need for multisectoral prioritization of nutrition outside of the traditional health and agriculture or food security areas.
What does such multisector collaboration look like in action? Dr Ouedraogo and colleagues in their recent publication Policy overview of the multisectoral nutrition planning process: The progress, challenges, and lessons learned from Burkina Faso have taken an in-depth look into the stages of development of Burkina Faso’s first Multisectoral Nutrition Strategic Plan (MNSP). Dr Ouedraogo notes that “The results of this study contribute to a better understanding of the multisectoral planning process in Burkina Faso bringing out key steps, progress, challenges and prospect.” The study outlines the essential dimensions of the policymaking process through key informant interviews (steps include: 1. policy review and multisector analysis 2. defining problem and agenda-setting and 3. steps in the formulation of MNSP) as well as identifying the key actors both within government, and the wider SUN movement, incorporating civil society and academia. Going forward this study identifies sustained funding and effective monitoring and evaluation of this policy as key priorities. In relation to dissemination the success of this process within the West Africa region Dr Ouedraogo hopes that “…lessons learned… could improve the multisectoral nutrition planning process in other SUN countries and inform the design of similar studies”
Whilst policy is most often set at a national level, there is a lot of potential for success when there is local ownership of nutrition priority-setting and action planning as this can improve intervention coverage. Another recent publication Planning Capacity, Determinants, and Challenges of Integrating Multisectoral Nutrition into Communal Development Plans in Burkina Faso also by Dr Ouedraogo and colleagues investigates the benefits and challenges of integrating multisector nutrition policy into Communal Development Plans (CDPs). In Burkina Faso, each commune or municipality is responsible for creating their own CDP. This study analyzes the process of local planning and finds that 60% of CDPs do not have good nutrition coverage. Dr Ouedraogo notes that “This study contributes to improve knowledge of key factors influencing the integration process of nutrition in communal development plans (CDP) through the analysis of the level of nutrition coverage, determinants of integration and challenges. This study will be able to inform the discussions and could inform the design of strategies to improve the level of nutrition consideration in the CDP. This may also guide the design of similar studies in other countries.”
As well as research on nutrition policy, new evidence has emerged from various nutrition interventions in Burkina Faso.
A first study evaluates the Impact on child acute malnutrition of integrating a preventive nutrition package into facility-based screening for acute malnutrition during well-baby consultation: A cluster-randomized controlled trial in Burkina Faso. Author Dr. Lieven Huybregts explains that “Community-based Management of Acute Malnutrition is widely acknowledged as a successful program to fight child acute malnutrition. However, in many West African countries its effectiveness is hampered by poor treatment and screening coverage. In Burkina Faso, this study led by IFPRI (in collaboration with Hellen Keller International) found that screening coverage for acute malnutrition was significantly boosted by offering additional preventive services during routine well-baby consultations organized at primary health services. However, the higher screening coverage did not translate into higher treatment coverage and, ultimately, did not lead to fewer acutely malnourished children, which suggests that beneficiaries face important barriers to initiate or adhere to treatment schedules”. For more on this intervention read this blog post.
Another relevant study explores Using structural equation modelling to understand the contributors to anaemia among young Burkinabe children. Author Lily Bliznashka explains “Child anemia is nearly universal among preschool children in Burkina Faso, and only small reductions have been achieved in the past decade. This study published in Maternal & Child Nutrition examines the determinants of anaemia among young Burkinabe children and identifies potential entry points for future interventions to reduce anaemia. The results show that iron deficiency, malaria and inflammation are the main contributors to child anaemia in the study sample, with iron deficiency contributing less than typically expected. Potential intervention entry points identified by the study include improving: children’s iron and vitamin A status; mothers’ health-, hygiene- and malaria-related practices; household dietary diversity; and timely identification and treatment of malaria. The study highlights the importance of addressing the multiple context-specific determinants of anaemia to reduce anaemia among young Burkinabe children”.
Other publications focus on both nutrition-sensitive and -specific interventions aiming to reduce child malnutrition either through women’s empowerment – Is women’s empowerment a pathway to improving child nutrition outcomes in a nutrition-sensitive agriculture program?: Evidence from a randomized controlled trial in Burkina Faso, school gardens – Impact of school gardens and complementary nutrition education in Burkina Faso, or varying the dose of ready-to-use-therapeutic foods – Impact of reduced dose of ready-to-use therapeutic foods in children with uncomplicated severe acute malnutrition: A randomised non-inferiority trial in Burkina Faso. With this high-quality evidence on nutrition strategies and action, Burkina Faso is becoming a shining star for the West African region.
