Situational analysis of infant and young child nutrition policies and programmatic activities in Burkina Faso

Abstract

Progress towards reducing mortality and malnutrition among children < 5 years of age has been less than needed to achieve related Millennium Development Goals. Therefore, several international agencies joined to 'Reposition children's right to adequate nutrition in the Sahel', starting with an analysis of current activities related to infant and young child nutrition (IYCN). The objectives of the present paper are to compare relevant national policies, training materials, programmes, and monitoring and evaluation activities with internationally accepted IYCN recommendations. These findings are available to assist countries in identifying inconsistencies and filling gaps in current programming. Between August and November 2008, key informants responsible for conducting IYCN-related activities in Burkina Faso were interviewed, and 153 documents were examined on the following themes: optimal breastfeeding and complementary feeding practices, prevention of micronutrient deficiencies, screening and treatment of acute malnutrition, prevention of mother-to-child transmission of HIV, food security and hygienic practices. National policy documents addressed nearly all of the key IYCN topics, specifically or generally. Formative research has identified some local barriers and beliefs related to general breastfeeding and complementary feeding practices, and other formative research addressed about half of the IYCN topics included in this review. However, there was little evidence that this formative research was being utilized in developing training materials and designing programme interventions. Nevertheless, the training materials that were reviewed do provide specific guidance for nearly all of the key IYCN topics. Although many of the IYCN programmes are intended for national coverage, we could only confirm with available reports that programme coverage extended to certain regions. Some programme monitoring and evaluation were conducted, but few of these provided information on whether the specific IYCN programme components were implemented as designed. Most surveys that were identified reported on general nutrition status indicators, but did not provide the detail necessary for programme impact evaluations. The policy framework is well established for optimal IYCN practices, but greater resources and capacity building are needed to: (i) conduct necessary research and adapt training materials and programme protocols to local needs; (ii) improve, carry out, and document monitoring and evaluation that highlight effective and ineffective programme components; and (iii) apply these findings in developing, expanding, and improving effective programmes.

© 2011 Blackwell Publishing Ltd.

Figures

Figure 1

Map of Burkina Faso. Courtesy of the United Nations Office for the Coordination of Humanitarian Affairs, Regional Office for West and Central Africa.

Figure 2

Burkina Faso – changes in indicators of malnutrition and progress towards Millennium Development Goal (MDG) I, to reduce hunger by half. (a) Progress towards MDG I, as measured by prevalence of underweight, 1992 to 2006. (b) Changes between 1992/1993 and 2006 national surveys in prevalence of stunting (height‐for‐age z‐score z‐score < −2, WHZ) among children < 5 years of age. Underweight, stunting, and wasting according to 2006 WHO Growth Standards. Figure demonstrates reported data from 1992 to 2006 in Demographic and Health Surveys (DHS) for 1992/1993, 1998/1999 and 2003 3, 4, 5 and *Multiple Indicator Cluster Survey (MICS) for 2006 (6); dotted line indicates target MDG for 2015.

Figure 3

Burkina Faso – progress towards MDG 4.1, to reduce child http://www.childmortality.org/; 1992, 1998/1999, and 2003 from DHS; 2006 from MICS, 2015 goal is one‐third of 1990 estimate.

Figure 4

Burkina Faso – breastfeeding practices by age according to Demographic and Health Surveys (DHS) (1992/1993, 1998/1999, 2003) and Multiple Indicator Cluster Survey (MICS) (2006) 3, 4, 5. (a) DHS 1992/1993. (b) DHS 1998/1999. (c) DHS 2003. (d) MICS 2006.