School of Public Health, Université Libre de Bruxelles (ULB), Brussels, Belgium.
Université Privée Africaine pour le Développement (UPAD), Niamey, Niger.
Public Health Nutr. 2021 Aug;24(12):3756-3767. doi: 10.1017/S136898002000347X. Epub 2020 Sep 30.
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.
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.
Three health districts in the northern region of Burkina Faso implemented a multisectoral community nutrition programme to improve IYCF practices.
Forty-seven implementing actors and twenty-four beneficiary mothers.
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.
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.
在多部门社区层面方法中确定成功实施营养方案的驱动因素和挑战，以改善布基纳法索北部婴幼儿喂养（IYCF）实践。
2019 年进行了一项定性研究，方法包括：（i）对来自五个不同部门（卫生、农业、环境、牲畜和教育）的主要信息提供者和协会工作人员、代理人和社区领袖进行个人访谈；（ii）与 2 岁以下儿童的母亲进行焦点小组讨论。
布基纳法索北部的三个卫生区实施了多部门社区营养方案，以改善 IYCF 实践。
47 名实施行为者和 24 名受益母亲。
影响成功实施的因素包括社区参与；部门承诺和参与；营养冠军的存在；能力建设；干预措施的整合；微量营养素粉的分配；引入营养敏感干预措施，如促进食用橙色果肉甘薯；改善粮食生产和小牲畜养殖；以及协调行为者和补充资金的有效协调。多部门实施的主要挑战是营养敏感部门参与度低、部门之间倾向于孤立工作、日程安排冲突、行为者流动性高、社区工作者技术技能不足、财政资源不足、地理融合度和受益覆盖面低、缺乏多部门监测机制和问责制以及不安全。
加强部门参与、确定共同的目标战略和调动财政资源有可能显著减少障碍并提高实施质量。
