Mobilising innovative financing and domestic resources for nutrition: Progress and challenges in Burkina Faso
Ella Compaoré is the Technical Focal Point at the Technical Secretariat in the Ministry of Health in Burkina Faso1, responsible for improving the diet and nutrition of mothers and children, and the SUN country Focal Point.
Jean Kaboré is a research fellow at the Centre National de la Recherche Scientifique et Technologique, which is attached to the Ministry of Higher Education, Scientific Research and Innovation in Burkina Faso.
Moussa Ouédraogo is a nutritionist at the Technical Secretariat in the Ministry of Health, responsible for improving the diet and nutrition of mothers and children.
Nicolas Meda is a public health specialist and special advisor to the President of Burkina Faso on Human Capital development issues.
Leonie Claudine Sorgho is the current Minister of Health, a specialist in Radiology and Medical Imaging.
Introduction
It is well recognised that Scaling Up Nutrition (SUN) Movement countries will need additional financial resources, including domestic resource mobilisation (DRM), in order to meet the 2025 Global Nutrition targets. The lead-up to the Nutrition for Growth (N4G) Tokyo 2020 event to be held in December 2020 is an opportunity to stay on track through new partnership models and innovative financing. Burkina Faso, a landlocked country in the centre of west Africa with a population of approximately 19 million, is one of the countries that has benefitted from a number of financing facilities and mechanisms to tackle malnutrition.
The national prevalence of stunting in children under five years old (CU5) is 21%, having nearly halved in the previous decade (from 43% prevalence in 2005) and CU5 wasting prevalence is at 8.5%2. The country is on course to meet the global targets for CU5 stunting and infant exclusive breastfeeding, but is off course to meet other targets (although some progress has been made2. Between 2012 and 2018, prevalence of early breastfeeding increased from 29% to 59%, while that of exclusive breastfeeding rose from 38% to 55% and food diversity from 5% to 25% in the same period3.
Creating an enabling environment
Burkina Faso has strengthened its commitment to further reducing malnutrition at policy level by including the right to food in its new constitution and prioritising nutrition in the country’s national economic and social development plan. Moreover, the current President, Roch Marc Christian Kaboré, has been recognised as a nutrition champion for the African Leaders for Nutrition initiative, with four clear commitments in his roadmap: (i) to endorse the national nutrition policy and the multi-sector nutrition strategic plan (2020-2024), which has been costed at approximately USD463 million; ii) to upgrade the institutional anchorage of nutrition to the presidency of Burkina Faso; iii) to appoint a nutrition political point to his office in order to keep the president regularly informed of nutrition issues and progress; and iv) to increase domestic financing for nutrition.
Box 1 Nutrition financing options
SUN countries will need additional resources as well as domestic resource mobilisation (DRM) in order to meet 2025 Global Nutrition targets. The lead-up to the Nutrition for Growth (N4G) Tokyo Summit in December 2020 is an opportunity to stay on track through partnership models and innovative financing. The World Bank’s Global Investment Framework for Nutrition (2017) estimates that an additional USD7 billion per year (USD10 per child annually) is needed to reach four World Health Assembly Global Nutrition targets (USD70 billion over 10 years)4. This World Bank figure is only for nutrition-specific interventions.
Financing mechanisms such as the Global Financing Facility (GFF), the Global Agriculture and Food Security Programme (GAFSP) and the Power of Nutrition (PoN) catalyse domestic resources through match-funding and can act as a ‘defragmenter’, pulling resources together to invest in government plans and to enable working on a single platform.
For more information, visit https://scalingupnutrition.org/%20share-learn/financing-mechanisms-for-nutrition/
Domestic resource mobilisation
It was the president’s decision, following advocacy from civil society, to double government spending on nutrition from 0.5% to 1% of GDP between 2016 and 2018. In 2018, a tracking of the domestic budget for both nutrition-specific and nutrition-sensitive interventions showed that financial support for nutrition has increased to approximately USD101 million, the majority of which is allocated to the Ministry of Health (there are also plans to start tracking donor funding with the support of civil society). Key programmes currently being implemented with the increased resources include maternal and child nutrition, infant and young child feeding, immunisation programmes, and strengthening nutrition data collection. Even though a school feeding programme is already in place in Burkina Faso, a presidential initiative aims to provide better coverage with a multi-sector approach (including different ministries, such as agriculture, health and education).
When governments contribute financially to implementation of national nutrition plans with DRM, donors and other development partners are more likely to make financial commitments, as has been the case in Burkina Faso. The country has a number of innovative financing facilities and mechanisms in place. These include the GFF of USD20 million and PoN funding of USD10 million. Other funding comes from more traditional donors, such as the World Bank, the European Union and the Bill and Melinda Gates Foundation (BMGF), along with technical and financial support from UN agencies and non-governmental organisations (NGOs). Apart from BMGF support that is directed mainly towards NGOs, all financial support is provided to government through the Ministry of Health.
Challenges in domestic financing
To date, Burkina Faso has not made any N4G financial commitments. Despite progress, challenges remain in raising domestic financing; notably the creation of budget lines at national and sector level to support nutrition activities. In 2017 the government agreed to set up a budget line dedicated to purchasing ready-to-use therapeutic food (RUTF) for up to USD1.8 million. However, this line, which should see an increase of USD909,000 per year, has yet to be realised due to security issues and other factors.
Lessons learned and next steps
Engagement with parliamentarians has helped in advocacy for increased state budget allocations for nutrition in Burkina Faso, and for duty and tax exemption for imported fortificants used in local production of RUTFs and other products for treating acute malnutrition. However, there is a need for further advocacy with civil society, nutrition champions and the private sector for innovative strategies to fund nutrition in the country, including developing a rapid response to humanitarian needs caused by insecurity, which has increased financial demands.
In March 2020, the Technical Secretariat (STAN) is organising a national advocacy workshop with a range of stakeholders, including parliamentarians, to operationalise these commitments; in particular, the financing of specific interventions in the multi-sector nutrition strategic plan (2020-2024). In order to achieve the objectives of the nutrition agenda, the country, through the president, should commit to allocating resources to nutrition through the provision of budget lines for the purchase of nutritional inputs and to increase resources for both nutrition-specific and nutrition-sensitive interventions.
Footnotes
1 The Technical Secretariat responsible for improving the diet and nutrition of mothers and children (in French, ‘Secretariat technique chargé de l’amelioration de alimentation et de la nutrition des mères et des enfants’, or STAN) was created by decree in 2017 within the Ministry of Health to coordinate the implementation of the multi-sector nutrition policy via the National Council for Consultation in Nutrition.
3 Rapport de l’enquête nutrtionnelle selon la méthodologie SMART (2018). Ministère de la Santé.