July 2017

Country Profile on Nutrition Burkina Faso

The European Commission (EC) is continuing to work government of Burkina Faso in mobilizing actors and resources strategically to secure traction on its commitments to reduce around the nutrition objective by taking the role of SUN donor stunting and to allocate EUR 3.5 billion (2014–20) for this convenor in the country. The EU also adopted a multi-sectoral purpose1. Preliminary results for 2016 indicate a three-fold approach to nutrition and mobilized no less than 260 million increase in the EC’s commitments to nutrition since 2014. euros for the 2014–2020 period to reinforce the health, water This is a significant development, but this pace of investment and sanitation and food security, nutrition and sustainable needs to be maintained in order to reach the pledge by agriculture sectors. 2020. The scope to achieve this lies in the strategic design of programmes that are still to be funded – especially in the focal Number of stunted children under 5 sectors of Food & Nutrition Security, Sustainable Agriculture, Current Health and Education – so that nutrition is integrated alongside other objectives. This approach is particularly relevant to the new EU Consensus on Development which places emphasis 2016 0.86 million on human development and dignity as well as partnership, National target prosperity, peace and the planet itself.

In Burkina Faso, one child out of three is affected by stunting 2020 0.87 million leading to serious consequences on his/her mental and WHA Target physical development. With the high population growth, despite reduction in prevalence, it is expected that almost one

million children under five will still be affected in 2025, i.e. 2025 more than today. Under-nutrition has dire consequences on 0.61 million the Burkinabe population and economy. The economic losses Expected according to current trend associated to under-nutrition in the country are estimated at 409 billion Fcfa annually, i.e. 7,7% of GDP. It is also estimated that under-nutrition underlies 38% of infant and 2025 child mortality cases. The EU is committed to support the 0.95 million

Progress against the World Health Assembly targets2 Data last referenced by EU

GNR 2016 analysis of progress WHA (and SDG) nutrition indicators Prevalence Number Year Off course – Some progress Stunting of children U5 years of age (SDG2) 27.3% 859 766 20163 Off course Wasting of children U5 years of age (SDG2) 7.6% 239 349 20163 Off course – At risk Overweight of children U5 years of age 1.2% 37 792 20163 Currently off course Anaemia of women of reproductive age 48.8% 3 473 769 20104 NA Low birth weight 13.9% – 20104 On course Exclusive breastfeeding of infants U6 months 55.0% – 20163

International Cooperation and Development Profile on Nutrition in Burkina Faso July 2017

Trend, projection and targets in the prevalence and number of children (under-five) stunted

80

70

0.96 60 1.02 0.73 1.08 50 0.96 2.01% 0.94 0.86 0.96 40 1.42% 0.95

30

20 0.98 Prevalence of stunting (%) The rate of stunting 0.88 reduction has accelerated 10 0.87 between 2012 and 2016 Government target: 0.61 WHA target 25% stunting by 2020 by 2025 0 1985 1990 1995 2000 2005 2010 2015 2020 2025

Number of stunted children estimated by surveys (million) Average annual rate of reduction in stunting estimated in 2016 Projected number of stunted children calculated in 2016 (million) Average annual rate of reduction in stunting estimated in 2012

Implications for development planners

Burkina Faso has experienced a decline in prevalence of stunting since the 1990s; a decline that accelerated between 2012 and 2016. Yet, with the population growth, the number of stunted children is only decreasing marginally. Recent projects anticipate that Burkina Faso will neither meet the government’s own target in 2020, nor the World Health Assembly (WHA) target by 2025. The rate of stunting reduction has marginally accelerated from 1.42% in 2012 to 2.01% in 2016; even if this maintained, then nearly one million children are expected to be stunted in 2025. This is considerably higher than the WHA target, and by extension, that of the principal indicator for Sustainable Development Goal 2 (SDG 2). Consequently, additional efforts are urgently required by the government and development partners to change Burkina Faso’s course and secure the level of stunting reduction required.

Nutrition governance

Yes/No Comment Member of SUN Movement Yes Since 2011; the EUD is donor convenor since 2017. Government’s commitment Yes Burkina Faso committed to reduce stunting to 25% by 2020 at the N4G event (June 2013) to nutrition (including N4G and also set new objectives in a national common framework including reduction of stunting event) below 20% by 2025. Multi-sectoral policy Yes A multi-sectoral National Nutrition Policy (PNN) has been revised in 2016. It will be framework nutrition operationalised through a costed Strategic Multi-Sectoral Plan for Nutrition 2016–2020 which is currently under preparation. Multi-sectoral platform for Yes The National Nutrition Collaborative Council (CNCN), set up in 2008, is the nutrition nutrition coordination convening body. Profile on Nutrition in Burkina Faso July 2017

EU financial commitments to nutrition 2008–2016

Data collected March 2017

The EU commitments to nutrition in Burkina Faso through Preliminary results for 2016 indicate a 3-fold increase in DEVCO from 2008 to 2016 are illustrated below in Figure the EU’s global funding commitments to nutrition since 1. Under the 11th EDF National Indicative Programme (NIP) 2014 as illustrated in Figure 2. The total amount of funding 2014–2020 for Burkina Faso nutrition is prioritised through commitments for nutrition globally in the last three years the Food and Nutrition Security and Sustainable Agriculture is EUR 1.8 billion, which represents 51 % of the EU overall (FNSSA) focal sector and the health focal sector. The NIP financial commitment for the period 2014–2020. In 2016 allocations to these sectors are, respectively, EUR 190 alone, the EU’s financial commitments to nutrition have million and EUR 80 million. By the end of 2016, a total of reached EUR 790 million. This is a significant development, EUR 242 million is committed under both sectors of which but this pace of investment needs to be maintained in order to EUR 50 million5 is for nutrition (as per the SUN methodology). reach the EUR 3.5 billion target by 2020. Additional nutrition sensitive commitments are identified under the EU Emergency Trust Fund for Africa but are not yet officially reported.

Progress against the EU’s financial pledge to reduce stunting 2014–2020:

Commitment of Allocation of €1.8 €3.5 BILLION BILLION

over the last 3 years 2014–2016 total global pledge 2014–2020 51%

Figure 1 Figure 2

DEVCO Nutrition commitments in Burkina Faso DEVCO and ECHO global commitments 2014–2016 to (In EUR million) 2008-2016 the EU pledge of EUR 3.5 billion to nutrition 2014–2020

80 4000 EU pledge of 70 EUR 3.5 billion 2014–2020 3500 60 EU pledge for Nutrition 50 commitments between 3000 2014–2020 40

30 DEVCO and ECHO 2500 Nutrition commitments 20 2014–2016

Nutrition in EUR million 2000 DEVCO commitments for commitments for DEVCO 10 DEVCO Nutrition

0 EUR million DEVCO and ECHO Commitments 1500 contributions 2014–2016 2008 2009 2010 2011 2012 2013 2014 2015 2016 Commitment year 1000 DEVCO contribution

500

0 Profile on Nutrition in Burkina Faso July 2017

Support of the EU and Member States

NIP Focal sector(s) for nutrition 2014–2020 • Food and nutrition security, sustainable agriculture • Health and water (lead)

Enhance mobilisation and political commitment for nutrition

The EU assumes the presidency of the donors group of the including the revision of the National Nutrition Policy SUN movement (donor convenor). In this capacity, the EU and capacity strengthening of multi-sectoral coordination supports the government to draw attention to the nutrition at the decentralised level. problem and to mobilise actors and resources on tackling Budget support in the sectors of health, food and nutrition the issues. security and sustainable agriculture sustain projects Through the Africa Nutrition Security Partnership (ANSP) that were previously funded through other development and in partnership with UNICEF, the EU supported the partners. development of a multi-sectoral approach to nutrition,

Scaling-up actions

In 2016 the EU renewed its commitment to the rural is inclusively part of the free access to healthcare program development sector through the “Programme d’Appui that was established by the government last year. à la Sécurité Alimentaire et Nutritionelle, à l’Agriculture The EU also supports the “Programme d’Appui à la Politique Durable” au Burkina Faso (PASANAD) €118 million from Sectorielle Santé II “(PAPS II) €80 million from 2017–2020 2017–2020 including €100 million for budget support. including €70 million for budget support through the This enables the government to respond to essential needs health sector. This intervention includes key measures to of food and nutrition security, prevention of malnutrition, improve health care of those most affected by malnutrition. improvement of incomes and resilience of the most At national level, it aims to reduce diseases associated vulnerable groups to shocks, including those related to with undernutrition, to improve access to prenatal care and climate change. PASANAD also includes nutrition-specific to improve child care practices (including breastfeeding). interventions to prevent stunting (€10 million). It also includes more efficient treatment of severe acute In the framework of the EU Trust Fund (EUTF) €30 million is malnutrition through the health system and funding of committed from 2017–2020 to support resilience building therapeutic products through the health budget. and improved nutrition in areas of most vulnerability to The EU supports the implementation of the water and food and nutrition insecurity. sanitation sector policy with €54 million allocated to DG ECHO has been a key donor and actor in funding the improve access to potable water, hygiene and sanitation scaling up of treatment of severe acute malnutrition in rural areas and prevent malnutrition. since 2007. Coming from a substitional approach, today The EU and DG ECHO has for many years supported the all treatments are provided by the government (MoH) implementation of social transfers in emergency and of Burkina Faso. Therapeutic food for treatment is even recovery contexts to enable the poorest to access food. produced in Burkina, distribution is for the majority done by These transfers are often combined with fortified flour to CAMEG since 2016 and not by partners and the treatment improve the nutritional impact on children.

Strengthen expertise and knowledge-base

Support to the development of nutrition modules in the Co-funding of SMART surveys. (DG ECHO) agriculture and health curricula. Potential establishment of a National Information Platform Funding of pilot projects evaluating the impact of health for Nutrition (NIPN). care fee exemptions on stunting. (DG ECHO)

1 The EU stunting reduction target is embodied in the EU’s Communication on Enhancing Maternal and Child Nutrition and the Action Plan on Nutrition to operationalise that policy 2 http://www.who.int/nutrition/topics/nutrition_globaltargets2025/en/ 3 Enquête Nutritionnelle SMART-résultats préliminaires 4 Enquête Démographique et de Santé 2010–11 5 CRIS number: 38564 – focal sector: Health – EU contribution amount: EUR 84 million – nutrition score: partial – nutrition amount: EUR 21 million. CRIS number: 38575 – focal sector FNSSA – EU contribution amount: EUR 117 million – nutrition score: partial – nutrition amount: EUR 29 million.