Planning Capacity, Determinants, and Challenges of Integrating Multisectoral Nutrition into Communal Development Plans in Burkina Faso
Science Journal of Public Health
Volume 7, Issue 3, May 2019, Pages: 74-82
Received: May 6, 2019;
Accepted: Jun. 6, 2019;
Published: Jun. 20, 2019
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Ousmane Ouedraogo, School of Public Health, Université Libre de Bruxelles (ULB), Brussels, Belgium
Maimouna Halidou Doudou, School of Public Health, Université Libre de Bruxelles (ULB), Brussels, Belgium; REACH Initiative, World Food Programme (WFP), Ouagadougou, Burkina Faso
Koiné Maxime Drabo, Department of Public Health, Research Institute of Health Sciences, Ouagadougou, Burkina Faso
Denis Garnier, Child Survival and Development Programme, United Nations Children's Fund (UNICEF), Abidjan, Ivory Coast
Noel Marie Zagré, West and Central Africa Regional Office, United Nations Children’s Fund (UNICEF), Dakar, Senegal
Kristina Reinhardt, UN Network for SUN/REACH Secretariat, World Food Programme (WFP), Rome, Italy
Philippe Donnen, School of Public Health, Université Libre de Bruxelles (ULB), Brussels, Belgium
Introduction Translating national policies into concretes actions at sub-national level is a prerequisite to scaling up interventions and ensuring an impact on the nutritional status of populations. The objective of this study was to analyze the overall process of local planning in Burkina Faso to identify factors that positively and negatively influence the process of integrating nutrition into communal development plans (CDP). Methods This was a qualitative study conducted through: (1) an analytical review of communal development plans (CDP) in ten municipalities from two regions, (2) individual interviews and focus groups with key informants and (3) a national triangulation workshop. The assessment was informed by a theoretical framework designed to determine the degree to which nutrition was integrated in the CDP, stakeholders’ capacities and resources, as well as the governance and the quality of the overall local planning process. The data were processed (transcription, coding, synthesizing) by themes using a deductive approach. Results The degree of nutrition integration in the CDP varied from one municipality to another. Despite the high prevalence of malnutrition in all municipalities, 60% of the CDP did not have a good nutrition coverage related to integration of nutrition into plans and had not planned multisectoral interventions to combat malnutrition. The main obstacles to this integration included ignorance of malnutrition by local elected officials, low planning capacity of stakeholders and scarcity of resources, insufficient participative and inclusive local planning approaches, a lack of guidelines about nutrition integration, a preference among officials to invest in physical infrastructures and obstacles related to governance. The key factors facilitating integration of nutrition included the internationalization of the local planning process, the presence of nutrition partners in the municipalities and the existence of financial prospects. Conclusion Nutrition integration in the CDP is a major challenge for Burkina Faso. However, revising or developing CDP is an opportunity to improve nutrition.
Maimouna Halidou Doudou,
Koiné Maxime Drabo,
Noel Marie Zagré,
Planning Capacity, Determinants, and Challenges of Integrating Multisectoral Nutrition into Communal Development Plans in Burkina Faso, Science Journal of Public Health.
Vol. 7, No. 3,
2019, pp. 74-82.
Doudou MH, Ouedraogo O, Ouaro B, Bidault N, Reinhardt K. Mapping Nutrition Interventions, a Key Analytical Tool for Informing the Multisectoral Planning Process: Example From Burkina Faso. Food Nutr Bull. 2018; 39 (3): 449-464.
Bhutta ZA, Ahmed T, Black RE, Cousens S, Dewey K, Giugliani E, et al. What works? Interventions for maternal and child undernutrition and survival. The lancet. 2008; 371 (9610): 417–440.
Bhutta ZA, Das JK, Rizvi A, Gaffey MF, Walker N, Horton S, et al. Evidence-based interventions for improvement of maternal and child nutrition: what can be done and at what cost? The Lancet. 2013; 382 (9890): 452–477.
Reinhardt K, Fanzo J. Addressing Chronic Malnutrition through Multi-Sectoral, Sustainable Approaches: A Review of the Causes and Consequences. Front Nutr. 2014; 1: 13.
Doudou M, Ouedraogo O. REACHing for the SUN: UN support for scaling up nutrition in Burkina Faso | ENN.
Pelletier D, Gervais S, Hafeez-ur-Rehman H, Sanou D, Tumwine J. Boundary-spanning actors in complex adaptive governance systems: The case of multisectoral nutrition. Int J Health Plann Manage. 2017.
Gillespie S, Haddad L, Mannar V, Menon P, Nisbett N. The politics of reducing malnutrition: building commitment and accelerating progress. The Lancet. 2013;382 (9891): 552–69.
Lapping K, Frongillo EA, Nguyen PH, Coates J, Webb P, Menon P. Organizational Factors, Planning Capacity, and Integration Challenges Constrain Provincial Planning Processes for Nutrition in Decentralizing Vietnam. Food Nutr Bull. 2014; 35 (3): 382–91.
Reme A-K. Nutrition policy in developing countries: large-scale implementation constraints and the case of Mozambique. Høgskolen i Oslo og Akershus. Fakultet for samfunnsfag; 2012.
Fajardo L. Integrated Multisectoral Nutrition Intervention at the Community Level. In: Scrimshaw NS, Wallerstein MB, editors. Nutrition Policy Implementation. Springer US; 1982. p. 231–45.
Lamstein S, Pomeroy-Stevens A, Webb P, Kennedy E. Optimizing the Multisectoral Nutrition Policy Cycle A Systems Perspective. Food Nutr Bull. 2016; 37 (4 suppl): S107–S114.
Ruel MT, Alderman H, Maternal, Group CNS. Nutrition-sensitive interventions and programmes: how can they help to accelerate progress in improving maternal and child nutrition? The Lancet. 2013; 382 (9891): 536–551.
Zon H, Pavlova M, Drabo KM, Groot W. Municipal health services provision by local governments: a systematic review of experiences in decentralized Sub-Saharan African countries. Health Policy Plan. 2017; 32 (9): 1327–36.
Atun R, de Jongh T, Secci F, Ohiri K, Adeyi O. Integration of targeted health interventions into health systems: a conceptual framework for analysis. Health Policy Plan. 2010; 25 (2): 104–11.
Greenhalgh T, Robert G, Macfarlane F, Bate P, Kyriakidou O. Diffusion of Innovations in Service Organizations: Systematic Review and Recommendations. Milbank Q. 2004; 82 (4): 581–629.
Shiffman J, Smith S. Generation of political priority for global health initiatives: a framework and case study of maternal mortality. The Lancet. 2007; 370 (9595): 1370–9.
Harris J, Nguyen PH, To Q, Frongillo EA, Menon P. Progress in improving provincial plans for nutrition through targeted technical assistance and local advocacy in Vietnam. Health Policy Plan. 2016; czw067.
Hipgrave DB, Laksmono LH, Koemarasakti GM, Nandy R, Setiawan B, Hermawan L, et al. District team problem solving as an approach to district health programme planning: a review, and survey of its status in selected districts in Indonesia. Health Policy Plan. 2018; 33 (4): 555–63.
David L. Pelletier, Purnima Menon, Tien Ngo, Edward A. Frongillo, Dominic Frongillo. The Nutrition Policy Process: The Role of Strategic Capacity in Advancing National Nutrition Agendas. Food Nutr Bull. 2011; 32 (2_suppl2): S59–69.
Pelletier DL, Shrimpton R. The role of information in the planning, management and evaluation of community nutrition programmes. Health Policy Plan. 1994; 9 (2): 171–84.
Lapping K, Frongillo EA, Studdert LJ, Menon P, Coates J, Webb P. Prospective analysis of the development of the national nutrition agenda in Vietnam from 2006 to 2008. Health Policy Plan. 2012; 27 (1): 32–41.
Pelletier D, Haider R, Hajeebhoy N, Mangasaryan N, Mwadime R, Sarkar S. The principles and practices of nutrition advocacy: evidence, experience and the way forward for stunting reduction. Matern Child Nutr. 2013; 9: 83–100.
Pelletier DL, Frongillo EA, Gervais S, Hoey L, Menon P, Ngo T, et al. Nutrition agenda setting, policy formulation and implementation: lessons from the Mainstreaming Nutrition Initiative. Health Policy Plan. 2012; 27 (1): 19–31.
Pearson BL, Ljungqvist B. REACH: an effective catalyst for scaling up priority nutrition interventions at the country level. Food Nutr Bull. 2011; 32 (2_suppl2): S115–S127.
Deconinck H, Hallarou ME, Pesonen A, Gérard JC, Criel B, Donnen P, et al. Understanding factors that influence the integration of acute malnutrition interventions into the national health system in Niger. Health Policy Plan. 2016; 31 (10): 1364–73.
Alpha A, Fouilleux E. How to diagnose institutional conditions conducive to inter-sectoral food security policies? The example of Burkina Faso. NJAS - Wagening J Life Sci. 2018 Mar 1; 84 (Supplement C): 114–22.
Fox AM, Balarajan Y, Cheng C, Reich MR. Measuring political commitment and opportunities to advance food and nutrition security: piloting a rapid assessment tool. Health Policy Plan. 2015; 30 (5): 566–78.
Haddad LJ, Achadi E, Ag Bendech M, Ahuja A, Bhatia K, Bhutta Z, et al. Global Nutrition Report 2014: Actions and accountability to accelerate the world s progress on nutrition. Intl Food Policy Res Inst; 2014.
Azfar O, Kahkonen S, Lanyi A, Meagher P, Rutherford D. Decentralization, governance and public services: the impact of institutional arrangements. Cent Institutional Reform Informal Sect. 1999; 1–37.
Patrick Webb, Shibani Ghosh, Robin Shrestha, Grace Namirembe, Sabi Gurung, Diplav Sapkota, et al. Measuring Nutrition Governance: An Analysis of Commitment, Capability, and Collaboration in Nepal. Food Nutr Bull. 2016; 37 (4_suppl): S170–82.
Pines JM. National nutrition planning: lessons of experience. Food Policy. 1982; 7 (4): 275–301.
Tui et al. Exploring multi-sector programming at the sub-national level in Senegal, Nepal and Kenya. www.ennonline.net/exploringmspsubnationallevel. 2018.
Sardan J-PO de. De la nouvelle anthropologie du développement à la socio-anthropologie des espaces publics africains, From a new anthropology of development to a socio-anthropology of African public spheres. Rev Tiers Monde. 2007; (191): 543–52.