Food Environment in Burkina Faso: Review of Public Policies and Government Actions Using the Food-EPI Tool.

BACKGROUND: Governments have a central role to play in creating a food environment that will enable people to have and maintain healthy eating practices. OBJECTIVES: This study analyzes public policies and government actions related to creating healthy food environments in Burkina Faso. METHODS: The Healthy Food Environment Policy Index tool used for this study has 2 components, 13 domains, and 56 indicators of good practice adapted to the Burkina Faso context. Official policy documents collected from data sources such as government and nongovernment websites, and through interviews with government and nongovernment resource persons, provided evidence of considerations of food environment in public policy documents in Burkina Faso. RESULTS: Policies documents show a lack of revision of old texts and administrative processes for new policies and government practices are very slow. Added to this is the absence of a regulatory document for some implemented actions. The analysis of the documents collected in relation to the indicators of Food-Epi tool shows that there is no evidence of consideration of food environments for the indicators concerning the regulation of nutrition and health claims, labeling, taxes on healthy and unhealthy foods, support systems for training for private structures on healthy diets, implementation of food guidelines, and food trade and investment. CONCLUSION: This study permits a review of public policies that take into account food environments through the various indicators and constitutes a starting point from which improvements can be made by the government.

Plain language titleOverview of Nutrition Policies, Taking Into Account All the Dimensions That Can Influence People's Food Choices Across Government, the Food Industry and SocietyPlain language summaryTo achieve healthy eating habits, governments need to be involved in creating a healthy food environment. This study analyzes public policies and government actions related to the creation of healthy food environments in Burkina Faso. The Healthy Food Environment Policy Index tool was used to carry out this study. Policy documents collected from data sources such as governmental and nongovernmental websites, and through interviews with governmental and nongovernmental resource persons, provided evidence of the consideration given to the food environment in Burkina Faso. Thus, policy documents show a lack of revision of older documents and a very slow administrative process. Added to this is the lack of regulatory documentation on concrete measures taken. An analysis of the documents collected according to the Food Epi-Tool indicators shows that food environments are not taken into account for indicators relating to nutrition and health claims, labeling and taxation of healthy and unhealthy foods, support systems for training private structures on healthy diets, implementation of food guidelines, and food trade and investment. In short, this research provides a starting point for evaluating and improving food-friendly public policies through a series of indicators.

Geographical and sociodemographic disparities in fruit and vegetables consumption among adults in Burkina Faso: baseline results from the 2013 WHO STEPS survey.

BACKGROUND: Evidence on sociodemographic determinants and spatial variations in the fruit and/or vegetable (FV) consumption was reported. This study aimed to explore geographical and sociodemographic disparities in the level of FV consumption among adults in Burkina Faso, using the national baseline data. METHODS: This was a cross-sectional secondary study of primary data obtained by the 2013 (September to October) World Health Organization Stepwise Approach to Surveillance survey conducted in Burkina Faso. The participants were 4402 women and men aged 25-64 years and living in all 13 Burkinabè Regions. Descriptive and analytical analyses were performed using Student's t test, ANOVA, the chi-square test, Fisher's exact test and logistic regressions. RESULTS: The prevalence of a typical daily consumption of at least three servings was 4.1% (95% CI: 3.6-4.8) for fruits and 6.6% (95% CI: 5.9-7.3) for vegetables. The national prevalence of adequate FV intake was 5.1% (95% CI: 4.4-5.8), and for two Regions ("Centre-Ouest" and "Nord") the pooled prevalence was 22.4%, while in the other eleven Regions its was significantly lower, 2.4% (p = 0.0001). Using quartiles derived from the national level of consumption, each of these two Regions had a higher proportion (about 50%) of their participants in the fourth quartile (the higher level). The associated sociodemographic factors with the adequate intake were being rural residents (aOR = 1.7, p = 0.011) and women (aOR = 1.3; p = 0.03). CONCLUSION: Except for the Regions of "Centre-Ouest" and "Nord" of Burkina Faso, the prevalence of adequate consumption of FV was very low in its other eleven Regions. Measures to increase consumption in urban people are urgent while women should be the key actor in the family-based approaches implementation and the nutrition education promoting FV consumption.

A comparison of unhealthy lifestyle practices among adults with hypertension aware and unaware of their hypertensive status: results from the 2013 WHO STEPS survey in Burkina Faso.

BACKGROUND: We compared the prevalence of unhealthy lifestyle factors between the hypertensive adults who were aware and unaware of their hypertensive status and assessed the factors associated with being aware of one's hypertension among adults in Burkina Faso. METHODS: We conducted a secondary analysis of data from the World Health Organization Stepwise approach to surveillance survey conducted in 2013 in Burkina Faso. Lifestyle factors analysed were fruits and vegetables (FV) consumption, tooth cleaning, alcohol and tobacco use, body mass index and physical activity. RESULTS: Among 774 adults living with hypertension, 84.9% (95% CI: 82.2-87.3) were unaware of their hypertensive status. The frequencies of unhealthy lifestyle practices in those aware vs. unaware were respectively: 92.3% vs. 96.3%, p = 0.07 for not eating, at least, five FV servings daily; 63.2% vs. 70.5%, p = 0.12 for not cleaning the teeth at least twice a day; 35.9% vs. 42.3%, p = 0.19 for tobacco and/or alcohol use; 53.9% vs. 25.4%, p = 0.0001 for overweight/obesity and 17.1% vs, 10.3%, p = 0.04 for physical inactivity. In logistic regression analysis, older age, primary or higher education, being overweight/obese [adjusted odds ratio (aOR) = 3.2; p < 0.0001], intake of adequate FV servings daily (aOR = 2.9; p = 0.023) and non-use of alcohol and tobacco (aOR = 0.6; p = 0.028) were associated with being aware of one's hypertensive status. CONCLUSION: Undiagnosed hypertension was very high among Burkinabè adults living with hypertension. Those aware of their hypertension diagnosis did not necessarily practise healthier lifestyles than those not previously aware of their hypertension. Current control programmes should aim to improve hypertension awareness and promote risk reduction behaviour.

Prevalence and factors associated with overweight and obesity among rural and urban women in Burkina Faso.

INTRODUCTION: Low- and middle-income countries, including Burkina Faso, are facing increasing urbanization with health challenges related to nutrition transition that impact body weight change. This study reported the prevalence and factors associated with overweight/obesity among women living in rural and urban Burkina Faso. METHODS: We conducted a secondary analysis using data from the Burkina Faso 2013 WHO STEPwise survey. Data included socio-demographic, clinical (anthropometric, systolic/diastolic blood pressure (SBP/DBP), oral/dental symptoms), biological (total and high-density lipoprotein cholesterol and fasting blood sugar), and alcohol and tobacco consumption data. A total of 2191 participants with complete data were considered in the analysis. We categorized the 13 Burkinabe regions by urbanization rate quartiles. We then performed Student's t, chi-squared, and Fisher's exact tests and backward stepwise regressions. RESULTS: The overall prevalence of overweight/obesity was 19.6% (13.1% and 44% in rural and urban women respectively, p=0.0001). Common factors positively associated with overweight/obesity in both rural and urban women were being a resident of a region in the highest urbanization rate quartile, having a high level of total cholesterol (alone or via an interaction with age) and having a high DBP. In urban women only, overweight/obesity was also associated with a high SBP. CONCLUSION: The prevalence of overweight/obesity in urban women in Burkina was among the highest levels in urban sub-Saharan Africa and roughly mimicked the urbanization profile of the country. In overweight/obesity conditions, cardiovascular concerns, such as increase in total cholesterol and blood pressure, were objective, and the blood pressure increase was more severe in urban women than in rural women.