Starting date: May 2022 Duration: 22 month(s) Type: Research
Undernutrition remains a significant public health challenge in the Sahel, despite decades of interventions supported by national authorities and international organisations. The study reviewed existing literature to identify drivers of stunting, wasting and anaemia among children and women in the Sahel. Using the "best-fit" framework-synthesis approach, findings were contextualised within the UNICEF conceptual framework, adapted to the region’s environment and systemic challenges. The results revealed a broad spectrum of 76 identified drivers of undernutrition across immediate, underlying, and systemic causes.
The Nutrition Research Facility (NRF) conducted a series of consultations with decision-makers in EU Member States, EU partner countries, within Delegations of the EU in partner countries and within the European Commission, in order to identify their current concerns in relation to nutrition issues in development contexts. This question arose from a consultation workshop focusing on African countries. (NRF, 2022).
A systematic mapping review was conducted to assess drivers of undernutrition in the region (Burkina Faso, Cameroon, Chad, Côte d’Ivoire, Ghana, Guinea, Mali, Mauritania, Niger, Nigeria, Senegal, The Gambia, Ethiopia, Sudan, Eritrea and Djibouti) , focusing on children and women of reproductive age. Academic and grey literature was analysed using the "best-fit" framework-synthesis approach, drawing from the "Acute malnutrition in Africa’s drylands" framework by Young et al. and based on the UNICEF conceptual framework. Out of 72 publications, most addressed drivers of child undernutrition, with only limited focus on women’s nutritional challenges.
Young, H., & Marshak, A. (2020). Nutrition in Africa’s Drylands: A Conceptual Framework for Addressing Acute Malnutrition. Boston, MA : Feinstein International Center, Friedman School of Nutrition Science and Policy, Tufts University.
The study identified 76 drivers of undernutrition in the Sahel spanning immediate, underlying, and basic/systemic causes. Immediate drivers were most frequently documented, while underlying drivers were underrepresented. The main findings indicate a limited evidence base for categories of drivers such as dietary intake, household food security and environment & seasonality, while disease, health & care environments, and the arrangement of formal and informal institutions are emphasised. This may reflect a higher attention given to the region by the health research community and the lack of local capacities to conduct research addressing broader drivers of malnutrition, particularly the interlinked effects across long causal pathways.
Addressing undernutrition in the Sahel requires a multisectoral and integrated approach that tackles systemic and underlying drivers alongside immediate causes. Strengthening local research capacity is essential to generate context-specific insights and inform targeted actions. Adapting the UNICEF framework to the region’s context could enhance the effectiveness of interventions and ensure alignment with regional needs.
The study highlights gaps in research on underlying and systemic drivers of undernutrition particularly in less economically developed countries where data is scarce. Future efforts should focus on exploring interlinked causes, diversifying data sources, and prioritising country-specific studies.
Nutrition is a key determinant of health, particularly for women and children. Tackling systemic drivers through region-specific approach could provide valuable insights to guide and enhance programming.
Main contact: Luis Goulao
Organisation: ISA – School of Agriculture, University of Lisbon
Email address: goulao@isa.utl.pt
University of Lisboa