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Senegal 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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Senegal Systematic Map to Guide decision-making on the current landscape of research on World Health Assembly indicators in West Africa
- Senegal International Food Policy Research Institute The Current Landscape of Research on World Health Assembly Indicators in West Africa: A Systematic Map to Guide Decision-Making
- 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 – Senegal
- Analysis General characteristics Characteristics of WHA indicators Characteristics of focus of research Results
- 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 4% of publications report on Senegal 8 publications focus on Senegal only and 6 publications are multi- country studies that include Senegal
- 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 Senegal by study setting 6 6 1 1 0 1 2 3 4 5 6 7 Not specified National Village Health facility Nr of publications
- Publications reporting on Senegal by study design 7% 29% 7% 43% 7% 7% Percent of publications per study design (n=14) Other Not specified Case-control Case series Cross-sectional Cohort Qualitative RCT 50% 7% Hierarchy of evidence
- Analysis General characteristics Characteristics of WHA indicators Characteristics of focus of research Results
- 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 Senegal per indicator category 43% 14% 14% 29% percent of publications per indicator category (n=14) U5NS EBF Anaemia WRA More than 1 indicator 50% 33% 0% 17% Breakdown of publications within U5NS (n=6) Stunting Wasting LBW Overweight
- Analysis General characteristics Characteristics of WHA indicators Characteristics of focus of research Results
- Publications per WHA indicator and research focus in Senegal 4 3 2 2 1 3 1 1 3 1 1 3 0 1 2 3 4 5 6 7 U5 Stunting U5 Wasting LBW U5 Overweight EBF Anaemia WRA Nrofpublications Policy Program Problem
- Program studies by intervention type and outcome 18 8 4 1 0 2 4 6 8 10 12 14 16 18 20 Burkina Faso Ghana Nigeria Senegal Nrofprogramstudies Intervention description U5NS (n=1) malaria intermittent preventive treatment 1 Senegal’s program
- Key Messages There is only 1 randomized controlled trial program in Senegal. This trial is a malaria prevention intervention which reports on under 5 stunting The majority of publications report on the prevalence and drivers of World Health Assembly indicators Senegal represents 4% of publications in the West Africa region
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. Senegal), as well as publications that report on multiple countries (Burkina Faso and Senegal and Ghana) We include all of these because we want to capture all evidence that incorporates that specific country (eg. Senegal). 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: There are only 14 publications reporting on Senegal (4%).
- Note: This graph includes publications that report on one specific focal country only (eg Senegal), 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 Key messages: Over all the volume of publications in these focal countries has increased over time. Senegal has the fewest publications compared to the other focal countries. In 2013 there were no publications reporting on Senegal. There is a positive tendency for 2016 and 2017
- Note: This graph includes publications that report on Senegal only, as well as publications that report on multiple countries, that include Senegal (14 studies in total). We include all of these because we want to capture all evidence that incorporates Senegal. Key message: Most of publications either do not report the setting (n=6) or report at a national level (n=6) at the abstract level.
- Note: This graph includes publications that report on Senegal only, as well as publications that report on multiple countries, that include Senegal (14 studies in total). We include all of these because we want to capture all evidence that incorporates Senegal Key message: The majority (50%) of studies reporting on Senegal are observational in design (cross-sectional, case-control) (n=7). There is only one experimental study (randomized control trial (RCT)). The remaining are either not specified at abstract level or are of an alternative design Majority of studies are towards the bottom 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 Senegal), 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 stunting). Therefore publications can be counted twice – Both in the EBF category and stunting category. This is why the total for Senegal is higher than 14 (total number of publication reporting on Senegal). Key Messages: Most of the studies among the four focal countries report on stunting, wasting, LBW and Anaemia WRA. In Senegal: Stunting and wasting represent the majority of studies (n=5 for each), followed by EBF (n=4) and Anaemia WRA (n=3). The less reported are LBW and U5 Overweight (n=2 for each)
- Note: These pie charts includes publications that report on Senegal only, as well as publications that report on multiple countries, that include Senegal. We include all of these because we want to capture all evidence that incorporates Senegal. U5NS (Under 5 nutritional status including stunting, wasting, LBW and overweight) 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=4) The right side pie chart includes studies that report on single indicators only (eg. Stunting). Studies reporting on more than one indicator (eg. Stunting and wasting) have not been included here. Key Messages: The majority of research publications report on U5NS (n=6), followed by Anaemia and EBF (n=2 each). There are 4 publications that report in more than 1 indicator. Within U5SN, most of the studies are reporting on stunting (n=3) and wasting (n=2). Only one reports on overweight. There is no study reporting exclusively on low birth weight.
- Note: This graph includes publications that report on Senegal only, as well as publications that report on multiple countries, that include Senegal (14 studies in total). We include all of these because we want to capture all evidence that incorporates Senegal Also, this graph includes publications reporting on one WHA indicator alone (Eg. EBF), as well as multi-indicator publications (eg. EBF and stunting). Therefore publications can be counted twice – Both in the EBF category and the stunting category. This is why the total is higher than 14 (total number of publication reporting on Senegal). Key message: The majority of publications across WHA indicators report on the problem (prevalence and drivers) of WHA indicators. There is only 1 program study. This reports on stunting. There is at least one policy study per WHA target, except for Anaemia WRA, for which only studies on the problem are available.
- Note: For each country, we included publications that report on that specific focal country only (eg Senegal), 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 Key message: Senegal has only 1 program (Randomized control trial) study (out of 42 in the region). This shows a very important research gap whereby the research on prevalence and drivers is not being translated to interventions. The program focus is on malaria preventative treatment The outcome reported is U5 stunting
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