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Burkina Faso Systematic Map to guide decision-making on the current landscape of research on World Health Assembly indicators in West Africa
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A new study by Transform Nutrition West Africa identifies the trends and gaps in research that cover the World Health Assembly indicators across West Africa. These are potentially valuable insights for nutrition decision makers in the region. This presentation is to be used as a freely accessible resource for decision-makers at all levels.
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Burkina Faso Systematic Map to guide decision-making on the current landscape of research on World Health Assembly indicators in West Africa
- The Current Landscape of Research on World Health Assembly Indicators in West Africa: A Systematic Map to Guide Decision-Making Burkina Faso International Food Policy Research Institute
- 2 The West Africa (WA) Region has been one of the slowest in reducing its many burdens of malnutrition. The World Health Assembly’s (WHA) 2025 nutrition targets were developed to track countries’ nutritional situations, and measure progress in reducing malnutrition. These indicators are therefore essential to guide decision making. Understanding the regional and in-country dynamics are an essential first step to highlight gaps and trends in evidence in the region. Introduction This study aimed to identify and catalogue peer-reviewed research on the WHA indicators in West Africa, and create a map of recent research evidence to inform decision-making for nutrition policies and programs in the region. Objective
- Data were extracted at abstract level. No quality appraisal of publications was undertaken. A systematic approach was applied to literature searches, developing inclusion criteria, screening, coding, taxonomy, data extraction, and study synthesis The MEDLINE database was searched for research published on World Health Assembly (WHA) indicators from 2010 to April 2018 Search terms were developed to capture evidence on the prevalence, drivers, programs (Randomized Controlled Trials), and policies relating to the WHA indicators. These include stunting, wasting and overweight in children under 5, low birth weight (LBW), exclusive breastfeeding (EBF) up to 6 months, and anemia in women of reproductive age (WRA) Methods
- References identified through systematic search (n=6,630) References excluded (n=2,581) - Not WA region (n=130) - Not target population (n=172) - Disease specific/not nutrition related (n=1729) - Nutrition related but not WHA specific (n=337) - Additional program studies (n=75) - RCT Protocol (n=9) - Other (n=129) Duplicates removed (n=3,669) References retrieved after title and abstract screening (n=380) - Primary studies (n=359) - Reviews (n=21) References retrieved for title and abstract screening (n=2,961) References included in mapping (n=363) Primary Studies (n=340) Reviews (n=23) Excluded at extraction level (n=17) Flow chart of search approach
- Results – Burkina Faso
- Analysis General characteristics Characteristics of WHA indicators Characteristics of focus of research
- 21 39 4 12 10 86 5 5 5 15 18 147 14 8 2 1 Benin Burkina Faso Cape Verde Cote d'Ivoire Gambia Ghana Guinea Guinea- Bassau Liberia Mali Niger Nigeria Senegal Sierre Leone Togo WA region Number of publications per country 11% of publications report on Burkina Faso 30 publications focus on Burkina Faso alone 9 publications are multi- country studies that include Burkina Faso
- Publications per year in focal countries 0 2 4 6 8 10 12 14 16 18 20 22 24 26 2010 2011 2012 2013 2014 2015 2016 2017 Nrofpublications Nigeria Ghana Burkina Faso Senegal
- Publications reporting on Burkina Faso by study setting 22 5 1 4 3 1 2 1 0 5 10 15 20 25 Not specified National District Village Community Hospital Health facility Primary health care centre Nr of publications
- Publications reporting on Burkina Faso by study design 5% 20% 5% 18% 3% 46% 3% Percent of publications per study design (n=39) Other Not specified Case-control Cross-sectional Cohort RCT Review 26% 46% Hierarchy of evidence
- Analysis General characteristics Characteristics of WHA indicators Characteristics of focus of research
- Publications per indicator category grouping for four focal countries 16 24 23 5 21 18 20 5 7 33 61 2 1 4 7 2 8 20 50 3 9 13 20 4 0 20 40 60 80 100 120 140 160 180 200 Burkina Faso Ghana Nigeria Senegal U5 Stunting U5 Wasting LBW U5 Overweight Anaemia WRA EBF
- Publications reporting on Burkina Faso per indicator category 26% 15% 13% 46% % of publications per indicator category (n=39) U5NS EBF Anaemia WRA More than 1 indicator 20% 60% 20% % of publications within U5NS (n=10) U5 Stunting U5 Wasting LBW U5 Overweight U5NS = Under 5 nutritional status including U5 stunting, U5 wasting, LBW and U5 overweight
- Analysis General characteristics Characteristics of WHA indicators Characteristics of focus of research
- Publications reporting on Burkina Faso per indicator category and research focus 7 10 3 1 3 5 9 10 5 0 4 3 1 3 1 1 2 0 0 5 10 15 20 25 U5 Stunting U5 Wasting LBW U5 Overweight EBF Anaemia WRA Nrofpublications Policy Program Problem
- Program studies by intervention type and outcome Intervention description U5NS (n=15) EBF (n=4) Anaemia (n=3) Supplementation 8 0 1 Counseling/health promotion 4 4 0 Cash transfers 2 0 0 Malaria treatment/ screening 2 0 2 18 8 4 1 0 5 10 15 20 Burkina Faso Ghana Nigeria Senegal Nrofprogramstudies Burkina Faso’s programs
- Majority of programs deliver supplementation (n=9) or counselling/ health promotion (n=6) Burkina Faso has the highest amount of program publications in the region (n=18) The majority of publications report on under 5 nutritional status (stunting, wasting, low birth weight), but only 1 on under 5 overweight 11% of publications in the region report on Burkina Faso Key Messages
Editor's Notes
- Note: Only primary studies are included in the analysis (n=340) 23 reviews have been recorded for use at a later stage
- Note: Each bar in this graph includes publications that reports on one country only (eg. Burkina Faso), as well as publications that report on multiple countries (Burkina Faso and Nigeria and Ghana) We include all of these because we want to capture all evidence that incorporates that specific country (e.g. Burkina Faso). This is why the total is greater than 340 (the number of publications included in this study) because they may be counted twice if it reports on more than 1 country. There are 17 publications that report on more than 1 country Key Message: Burkina Faso has the third highest volume of publications (n=39), after Nigeria and Ghana
- Note: This graph includes publications that report on one specific focal country only (eg Burkina Faso), as well as publications that report on multiple countries, that include the focal country (eg. Ghana, Burkina Faso and Nigeria). We include all of these because we want to capture all evidence that incorporates each focal country Key messages: Over all the volume of publications in these focal countries had increased over time. Publications reporting on Burkina Faso have fluctuated over time, and peaked in 2017 (n=9).
- Note: This graph includes publications that repot on Burkina Faso only, as well as publications that report on multiple countries, that include Burkina Faso (39 studies in total). We include all of these because we want to capture all evidence that incorporates Burkina Faso. Key messages: Most of studies do not report the setting at abstract level (n=22). Of those that do, most are at a national coverage (n=5) and village or community coverage (village, n=4 and community, n=3)
- Note: This graph includes publications that report on Burkina Faso only, as well as publications that report on multiple countries, that include Burkina Faso (39 studies in total). We include all of these because we want to capture all evidence that incorporates Burkina Faso Key messages: Of the 39 studies reporting on Burkina Faso – 46 % are randomized control trial (RCT) (n=18). This is very high compared to other countries in the region (eg. Nigeria only has 4 RCTs among the 147 studies reporting on the country). Observational studies in design represent 26% (cross-sectional, cohort, case-control) (n= 10) The remaining studies are either not specified at abstract level or are of an alternative design Majority of studies are towards the top of the evidence pyramid in terms of evidence quality
- Note: Each bar in this graph includes publications that report on one specific focal country only (eg Burkina Faso), as well as publications that report on multiple countries, that include the focal country (eg. Ghana, Burkina Faso and Senegal). We include all of these because we want to capture all evidence that incorporates each focal country Also, this graph includes publications reporting on one indicator category alone (Eg. EBF), as well as multi-indicator publications (eg. EBF and U5 stunting). Therefore publications can be counted twice – Both in the EBF category and the U5 stunting category. This is why the total for Senegal is higher than 39 (total number of publication reporting on Burkina Faso). Key Message: Most of the studies among the four focal countries report on U5 stunting, U5 wasting, LBW and Anaemia WRA. In Burkina Faso The majority of studies report on wasting (n=21) followed by U5 stunting (n=16). A few number of studies report on EBF (n=9), Anaemia WRA (n=8) and LBW (n=7). Only one study report on U5 overweight
- Note: These pie charts includes publications that report on Burkina Faso only, as well as publications that report on multiple countries, that include Burkina Faso. We include all of these because we want to capture all evidence that incorporates Burkina Faso The left pie chart includes publications reporting on one indicator alone (Eg. EBF). Studies that report on more that one indicator have been brought together into the ‘more than 1 indicator’ category (n=18) The right side pie chart includes studies that report on single indicators only (eg. U5 Stunting). Studies reporting on more than one indicator (eg. U5 Stunting and U5 wasting) have not been included here. Key Messages: The majority of publications report on U5NS (n=10), followed by EBF (n=6) and Anaemia WRA (n=5). Most of studies report on more than one indicator category (n=18) Within U5NS there is a big disparity. The majority of studies report on wasting (n=6) versus few reporting on U5 stunting and LBW (n=2 each). There is no study reporting exclusively on Overweight.
- Note: This graph includes publications that report on Burkina Faso only, as well as publications that report on multiple countries, that include Burkina Faso (39 studies in total). We include all of these because we want to capture all evidence that incorporates Burkina Faso Also, this graph includes publications reporting on one indicator category alone (Eg. EBF), as well as multi-indicator publications (eg. EBF and U5 stunting). Therefore publications can be counted twice – Both in the EBF category and the U5 stunting category. This is why the total for Burkina Faso is higher than 39 (total number of publications reporting on Burkina Faso). This graph includes publications reporting on one area of research only (eg. Policy) as well as multi-areas of research (eg. Policy and problem), therefore publications can be counted twice (when reporting for instance on two research areas, Problem and Program); and this is why the total number of publications on indicator category can be higher than the number of publications for that indicator category. Key Messages: Burkina Faso has nearly an even distribution of publuications reporting on nutrition problems (n= 29) (prevalence and drivers) and programs (n=31); and fewer reporting on policy (n=8). Wasting has the most amount of publications in all areas of research (n=23). The majority of publications across indicator categories in Burkina Faso report on programs. Of these program studies, most are programs reporting on U5 wasting (n=10) and U5 stunting (n=9). Very few on LBW (n=5), EBF (n=4) and anaemia WRA (n=3); and no one program report on U5 overweight
- Note: For each country, we included publications that report on that specific focal country only (eg Burkina Faso), as well as publications that report on multiple countries, that include the focal country (eg. Ghana, Burkina Faso and Senegal). We include all of these because we want to capture all evidence that incorporates each focal country In the table we includes program publications reporting on one indicator category alone (Eg. EBF), as well as multi-indicator publications (eg. EBF and U5 stunting). Therefore publications can be counted twice – Both in the EBF category and the U5NS category. This is why the total for Burkina Faso is higher than 18 (total number of publications reporting on programs). This table includes program studies reporting program type only (eg. Supplementation to address U5NS) as well as multi-program types (eg. Supplementation and counseling to address U5NS), therefore programs can be counted twice (when reporting for instance on more than one intervention); and this is why the total number of programs can be higher than the number of program publications for specific WHA indicators Key messages: Almost half of programs (n=8) deliver supplementation to address U5NS related outcomes, followed by counselling/ health promotion to address EBF and U5NS related outcomes.
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