Facilitating factors and challenges of the implementation of multisectoral nutrition programmes at the community level to improve optimal infant and young child feeding practices: a qualitative study in Burkina Faso

Abstract

Objectives: To identify the drivers and challenges of successful nutrition programme implementation in a multisectoral, community-level approach to improve infant and young child feeding (IYCF) practices in northern Burkina Faso. Design: A qualitative study was conducted in 2019 through (i) individual interviews with key informants from five different sectors (health, agriculture, environment, livestock and education) and association staff, agents and community leaders and (ii) focus groups with mothers of children under the age of 2 years. Setting: Three health districts in the northern region of Burkina Faso implemented a multisectoral community nutrition programme to improve IYCF practices. Participants: Forty-seven implementing actors and twenty-four beneficiary mothers. Results: Factors influencing successful implementation include community participation; sector commitment and involvement; the existence of nutrition champions; capacity building; the integration of interventions; micronutrient powder distribution; the introduction of nutrition-sensitive interventions, such as the promotion of the consumption of orange-fleshed sweet potatoes; improved food production and small livestock rearing and the effective coordination of actors and complementary funding. The main challenges of the implementation of multisectorality are low participation among nutrition-sensitive sectors, a tendency for siloed work among sectors, scheduling conflicts, high actor mobility, differences in the target population by sector, a lack of technical skills among community workers, insufficient financial resources, low geographic convergence and coverage of beneficiaries, a lack of a multisectoral monitoring mechanism and accountability and insecurity. Conclusions: Strengthening sector participation, identifying a common targeting strategy and mobilising financial resources have the potential to significantly reduce barriers and improve the quality of implementation.

Factors driving and inhibiting stunting reduction acceleration programs at district level: A qualitative study in West Sumatra

“…In other words, each sector tended to work independently. The lack of cross-sectoral cooperation is reflected at the central level, where each sector focuses on its sectoral priorities [27]. Such circumstances certainly hinder the implementation of multi-sectoral activities.…”

“…The results show that limited funding has become an inhibiting factor in stunting reduction programs in many government agencies in the failed district. Other studies have also found that insufficient internal funding is a major obstacle to the program's sustainability [27]. Several programs, such as sanitation, PMT (Supplementary Food Provision), and counseling services, received limited funding.…”

Implementation of two policies to extend maternity leave and further restrict marketing of breast milk substitutes in Vietnam: a qualitative study

“…, 2017 ). It is possible that the loss of technical support and general finances to sustain Alive and Thrive Initiative activities ( Ouedraogo et al. , 2021 ; Sanghvi et al.…”

Evidence-based strategies needed to combat malnutrition in Sub-Saharan countries facing different stages of nutrition transition

“…Interestingly, ten papers report on qualitative studies, whereas publications using quantitative research are usually predominant. Four qualitative studies looked at community solutions to malnutrition in a novel and participatory approach with the population (13)(14)(15)(16) , while one study looked at factors influencing the implementation of a multisectoral, community-level nutrition programme aimed at improving infant and young child feeding practices (17) . The other qualitative studies explored nutritionrelated behaviours of mothers (18,19) , women outside of their maternal role (20) , parents (21) , and adolescents (22) .…”

“…None of the studies included in this issue applied implementation research methods and tools even if one study examined the facilitating factors and challenges of implementing multisectoral nutrition programmes (17) . This is an area where further research should be advocated.…”