Suchergebnisse

A growing literature highlights complexity of policy implementation and governance in global health and argues that the processes and outcomes of policies could be improved by explicitly taking this complexity into account. Yet there is a paucity of studies exploring how this can be achieved in everyday practice. This study documents the strategies, tactics, and challenges of boundary‐spanning actors working in 4 Sub‐Saharan Africa countries who supported the implementation of multisectoral nutrition as part of the African Nutrition Security Partnership in Burkina Faso, Mali, Ethiopia, and Uganda. Three action researchers were posted to these countries during the final 2 years of the project to help the government and its partners implement multisectoral nutrition and document the lessons. Prospective data were collected through participant observation, end‐line semistructured interviews, and document analysis. All 4 countries made significant progress despite a wide range of challenges at the individual, organizational, and system levels. The boundary‐spanning actors and their collaborators deployed a wide range of strategies but faced significant challenges in playing these unconventional roles. The study concludes that, under the right conditions, intentional boundary spanning can be a feasible and acceptable practice within a multisectoral, complex adaptive system in low‐ and middle‐income countries.

Introduction: Burkina Faso is a landlocked West African country, where livelihoods are heavily dependent on subsistence agriculture, and the humanitarian crisis has increased populations vulnerability to malnutrition. Aim: This article presents an update of the food and nutrition situation. Methodology: Documents from government surveys and reports, peer-reviewed articles and other reliable sources were retrieved and analyzed. Results: According to the 2019 National Nutrition Survey, 25.4% of children under 5 years old are stunted and 8.1% are wasted. These rates exceed the WHO critical thresholds suggesting that child malnutrition is still a public health problem in Burkina although trend analysis suggests continuous improvement over the past ten years. Childhood overweight fluctuates between 1% and 2% while childhood obesity remains below 1% since 2014. Poor infant and young child feeding (IYCF) practices are key drivers of child stunting. In fact, 59% of infants are exclusively breastfed while only 17% of 6 – 23-month children receive a minimally acceptable diet. Children and pregnant and lactating women are deeply affected by micronutrient deficiencies including vitamin A and iron. Adult overweight is on the rise and high blood pressure and diabetes levels have reached 18% and 5% respectively in adults aged 25 to 64 years with huge disparities between men and women. Conclusion: While the country had made important progress in reducing child malnutrition, it is still facing double burden of malnutrition namely undernutrition comprised of stunting, wasting and micronutrient deficiencies and overweight/obesity, hence the need to embrace a double duty approach to policy response to simultaneously reduce both undernutrition and overweight/obesity.