Analysis of Accountability in Nutrition-Sensitive Policies and Programs in Burkina Faso ()
1. Introduction
For several years, the issue of accountability has been occupying an increasingly important place in the implementation of public policies. It remains a cornerstone of governance and public management because it is one of the principles by which those in charge of managing affairs must be accountable for what they do (Emanuel & Emanuel, 1996) . Thus, the mechanisms for implementing public policies and programs include mechanisms that hold all those responsible accountable for their management (Marty & Voisin, 2016) .
The term accountability covers three dimensions: accountability, responsibility and transparency. In the past, associated with accounting, the term “accountability” began to take on other meanings (Dubnick, 2002) . In political discourse, it has taken on the meaning of “rendering account” and is oriented toward transparent and fair management (Zumofen, 2016) . Accountability, or the principle of rendering account, contributes to participatory governance. The literature on accountability establishes that it is characterized by the obligation of public officials to inform about their activities and explain their actions, as well as the ability of competent agencies to impose sanctions on power holders who violate the principle of transparency (Schedler, Diamond, & Plattner, 1999) . The two driving forces behind accountability are, on the one hand, the citizens who are the beneficiaries of public services; on the other, the state, which is responsible for the provision of public goods and builds the space for citizen participation in governance. It is nowadays a concept closely linked to governance by politicians, development actors and civil society. Accountability is central to the 2005 Paris Declaration on Aid Effectiveness and the 2008 Accra Agenda for Action (Capron, 2016) . Both donors and recipients are increasingly accountable to a variety of actors. Viewed as an instrument of good governance, accountability tends to become an objective of governance and holds all those responsible for managing public affairs accountable. This raises questions about leadership, individual and collective responsibility, performance measurement systems, and the effects and impacts of interventions (Schedler, 1999; Fall et al., 2017) .
Since the adoption of democracy as a system of political governance, governments in African countries have been increasingly compelled to subject the management of public affairs to citizen criticism. The importance of accountability lies in the fact that it confers a certain legitimacy on the actors in charge of managing affairs (Dalton, 2004) . In the context of governance, civil servants are increasingly facing strong criticism from citizens; the exercise of public authority is no longer given (Wang, Medaglia, & Zheng, 2018; Papadopoulos, 2021) . Confidence in those in power remains very fragile. Efforts must be made to create a climate of trust between the actors indispensable to the implementation of development actions. The promotion of accountability is part of this dynamic of strengthening collaboration between the various development actors with a view to creating a favorable climate for the implementation of policies and programs to improve the living conditions of the population (Malhotra & Kennedy-Chouane, 2015; Nioche, 2016) .
In the nutrition sector, accountability is of particular importance. Indeed, the World Nutrition Report 2015 (Haddad et al., 2015) devotes an important section to the issue of measurement and accountability. The report states that “accountability mechanisms are essential to strengthen the effectiveness of all stakeholders in nutrition improvement efforts. They are necessary to increase corporate actions in support of nutrition at the expense of their harmful actions”. This paper aims to analyze the accountability mechanisms contained in nutrition policies and programs in Burkina Faso. It is an integral part of the Transform Nutrition West Africa study, led by the International Food Policy Research Institute (IFPRI) in collaboration with research institutions in Burkina Faso.
Importance of Nutrition-Sensitive Policies
Burkina Faso, like other West African countries, has the highest rates of acute and chronic malnutrition among children in the world. Thus, many children under the age of 3 suffer from malnutrition. Malnourished children are more likely to be sick, learn less well in school, and have less capacity as adults. Malnutrition also contributes to the chronic vulnerability of populations. Fighting malnutrition is therefore a priority issue for Burkina Faso. Thus, the government and its partners have been working for years to address all the determinants of malnutrition through the development of policies. Nutrition being a national priority is taken into account in all other sectors of activity. The importance of nutrition-sensitive policies is that they set orientations, formulate activities, mobilize resources and actors for their implementation.
2. Methodology
2.1. Conceptual Framework
Several conceptual frameworks exist and are used to analyze accountability. In this work, the framework developed by Mark Bovens will be used (Bovens, 2007) . This framework is built around four main components. The first refers to the actors to whom one is accountable. While noting that this list is not exhaustive, the author indicates that there are several types of actors to whom those responsible for implementing public policy could be accountable: representatives of voters, political parties, the media, the administration, courts of justice, communities, etc. The second component refers to the actors to whom the public is accountable. This paper will present and describe the actors identified in nutrition policy and program documents to whom one should be accountable. The second component of the framework focuses on the actor or actors who are accountable. Indeed, it is important to clearly indicate the profile and identity of those who, by virtue of their position, should be accountable for their responsibility. The author notes that this can be individual actors, collective actors, an administration, an ah’doc authority, etc. The author notes that the actors can be individual, collective, an administration, an ah’doc authority, etc. The various actors responsible for reporting on the implementation of nutrition policies and programs will be presented as mentioned in the documents. The third component concerns the aspects on which the actors involved in the implementation of policies and programs should be accountable. The literature informs that in the accountability process, several aspects, including financial, administrative, etc., are involved. The literature informs that in the accountability process, several aspects, including financial, administrative, etc. can be the subject of exchanges between those to whom one is accountable and those who are accountable. The article will present the aspects indicated in the nutrition policy documents on which the actors in charge are accountable. The fourth component is about the reasons that can make actors accountable. The aim here is to analyze the nature of the relationships between those who are accountable and those who receive accountability.
2.2. Data Collection and Processing
The data used in this article are exclusively qualitative. They were collected through two collection techniques: the individual interview and the review of policy documents. The individual interview was organized with public administration executives from the health and agriculture sectors, commune officials and civil society organizations involved in the implementation of nutrition programs in the Boulgou and Sissili provinces. In total, 32 people were interviewed, 12 at the provincial level and 20 at the central level (Ministry of Health, Ministry of Agriculture, technical and financial partners).
The data were collected by three research assistants (Bachelor’s degree in social sciences). These assistants were trained for three days on data collection techniques and the use of various data collection tools. The topics covered in the interviews ranged from prioritization of issues, implementation challenges, integration of nutrition and food security issues into programs at the local level, use of evidence in prioritizing nutrition issues, coordination between sectors in implementation, accountability mechanisms in place and their evolution over the last 30 years. Only data related to the issue of accountability were considered in this study.
For the literature review, several sources to collect policy documents were used: websites of ministries, consultation in document centers, consultation of national and international experts. Three main criteria were used to select the nutrition-sensitive policies used in this article: 1) the presence of a nutrition goal, a nutrition budget and/or a nutrition indicator, 2) being in use or in an advanced stage of drafting as of December 2018 3) being relevant at the national level.
For data processing and to minimize bias, the principal investigator first listened to all the soundtracks before having them transcribed literally. A coding template was developed around the main thematic areas. Subsequently, all interview files were imported into the NVIVO software and coded. Finally, a summary was produced for each of the coding keys and it is the set of summaries and information from the documentary review that constituted the material for the analysis. Portions of the speeches are used in the article (the italicized portions) to support and better substantiate the analyses. The words in brackets at the end of the italicized passages refer to the profile of the actor speaking.
3. Results
3.1. Nutrition-Sensitive Policies Selected
Sixteen nutrition-sensitive policy documents are analyzed in this article. Most of the selected policy documents address the issue of nutrition. In fact, as they fall under several sectors, each with its own specificity, these policies do not address nutrition in the same way. Although each document contains nutrition objectives or budgets allocated to nutrition, there is a variation in the nature of actions planned to promote nutrition.
3.2. The Term Accountability in Policy Documents
The first exercise performed was to search for the term accountability in each of the selected documents. The objective was first to identify all the passages containing the term accountability and then to see how it had been defined. However, at the end of the exercise, the term accountability was not found in any of the documents. However, most of the selected documents include a section on monitoring and evaluation, which some may consider to be a form of accountability.
3.3. Accountability According to the Actors Interviewed
Individual interviews were held with executives from the Ministries of Health and Agriculture at the central level and in the de concentrated structures (regional and provincial services). It is noted that these actors have variously appreciated the question of readability in nutrition-sensitive policy documents.
Some feel that this important aspect of governance is not reflected in policy documents. They question the process of developing these documents, such as this framework operating at the regional level:
“It’s easy to see how most policy documents are written in our context to see how difficult it is to address the issue of accountability. It is always the technical and financial partners who push the government to develop these documents. As a result, there is not always a strong incentive for some to do so. Others (often the majority) do not have sufficient skills to participate in such an activity. Typically, people come together without really contributing to the discussion. It is often up to the consultants to do the work. They are free to do whatever they want. This is the reality of our context” (Regional Level Manager_1).
A similarly pointed view is that governance at the level of the public administration in general. It points out that it will be difficult to promote accountability in the nutrition sector if other sectors do not move in the same direction. He continued:
“Before talking about the evolution of something, it must first exist. That’s it! So I think there is no accountability. I don’t know of any accountability mechanisms that have been put in place in the implementation of nutrition programs and policies. Things work the same as they do everywhere else. Managers do what they want and you can’t say anything about it because there are no frameworks for it. Those in charge of managing programs are not accountable to their staff. There are no binding functional arrangements” (Central level manager_ 3).
Some interviewees questioned the behavior of some donors in the absence of accountability mechanisms to effectively monitor the implementation of nutrition actions. They find that this is even convenient for some partners. A former Ministry of Health official who had worked in the nutrition directorate and who was working in a Non-Governmental Organization (NGO) at the time of the survey stated that “the lack of accountability is a major obstacle to the implementation of nutrition activities:
“....it’s disappointing because everyone comes, they put their flag up, they run their program, they collect the information and they go and defend it in front of their partners to get more money. We don’t care about the other actors at the national level. As there is no authority that obliges them, everyone does what they want. It is perhaps at the level of the national assembly that all the actors could be made accountable, but it is not simple. In our countries, those who finance our programs do what they want. They don’t report to anyone and that’s the way it’s been working for years” (Responsible at the central level_6).
Opinions on the issue of accountability in nutrition-sensitive public policy do not seem to be unanimous among the respondents. Contrary to the ideas expressed in the section above, it appears from the data collected and according to some study participants that the issue of accountability is relatively well taken care of, as the following passage indicates:
“Personally, I think that nutrition-sensitive policies take into account the issue of accountability. Well, maybe it’s not clearly stated that it’s about accountability. But let’s assume that there are frameworks that allow for accountability to actors. It’s true that it’s not expressly stated or that these frameworks don’t work as well. If I take the case of the common results framework put in place by nutrition actors, it remains an instrument of accountability. The fact that a certain number of multisectoral indicators have been defined and are filled in by everyone makes it possible to report on the progress made but also on the difficulties. Today, there are several frameworks for exchange between nutrition actors in Burkina Faso. In my opinion, all of this contributes to accountability” (Responsible NGO_2).
The question of the relationship between accountability and monitoring evaluation was discussed at length during this study. Indeed, a number of participants consider accountability as a sub-component of monitoring evaluation, which is in itself the most widespread and common form of accountability in policy and program management practices. In doing so, these actors indicate that there are many accountability mechanisms in the implementation of nutrition policies and programs. One study participant working in a health district notes:
“I think that formally there are accountability mechanisms in place for managing nutrition issues. All major projects have monitoring and evaluation departments whose role is to collect information on everything that is happening and share it with all the players. This is the way of reporting that most of the actors are familiar with. Reports are regularly produced to inform about what is happening. At the district level here, we have a monitoring and evaluation and planning department that does this work. In addition, there are meetings that are organized and that bring together actors from the various sectors, from civil society to present the results and assessments of the activities of nutrition programs and projects. Personally, I think that there are accountability mechanisms, even if we don’t call them that” (Regional Officer_3).
Other opinions focused on who benefits from accountability in the implementation of nutrition-sensitive policies. Participants in the study felt that accountability is essentially administrative and institutional. Those responsible for implementing policies and programs simply report to superiors and donors through reports. In doing so, other actors outside the chain of command are not involved. And the biggest losers in this system remain the beneficiaries, the communities. A participant states:
“We can say that there are accountability mechanisms if we look at the administrative organization. For example, those responsible for policies and programs are accountable to their supervisors, either directly to the minister or to directorates, the state’s control structures. But what is regrettable is that they are rarely accountable to the communities. It is difficult, for example, to find a framework in which nutrition program managers report directly to the beneficiary village populations, or to mothers of children, for example. It is at this level that efforts will have to be made” (Central level manager_7).
Respondents’ perceptions of accountability in the implementation of nutrition-sensitive policies and programs indicate that populations are the actors to whom the least accountability rests. The functioning of mechanisms and other procedures put in place to inform stakeholders on the status of implementation and results do not facilitate their involvement. Thus, many programs are implemented without the beneficiary communities being able to provide any insight into the management process of the actions. According to the interviewees, the current accountability mechanisms are not to the advantage of the communities. They are powerless to witness nutrition promotion actions without being able to hold those who manage the programs accountable.
4. Discussion
It was noted that the issue of accountability is weakly developed in nutrition-sensitive policy documents. The consistent finding from the documents used in this article is that policy makers give very little attention to this important issue in the formulation phases. Based on the basic elements of Bovens’ conceptual framework (Bovens, 2014) , it can be seen that the aspects that can facilitate consideration of the issue of accountability are not developed in nutrition-sensitive policy documents, namely: 1) to whom should one be accountable, 2) who should be accountable, 3) what aspects should be reported on, 4) why should one be accountable. The conceptual framework used shows that nutrition-sensitive policies in Burkina Faso are not very explicit on the issue of accountability.
4.1. Accountability Instruments
It is noted that the most commonly used accountability instruments remain for the moment the reports produced by the different bodies implementing nutrition programs and policies. It is generally through this channel that information is made available to stakeholders on the state of operation of interventions and the results achieved. In order to have information that can be used by the different actors involved in the promotion of nutrition, it is necessary to obtain the progress or completion reports produced by the different actors involved in the interventions. In addition to reports, feedback workshops are also widely used in the development world to report on the actions implemented. Depending on the specificity of each policy or program, several forms of meetings are regularly used to communicate with the other actors. In the specific case of Burkina Faso, program or policy reviews are forms of meetings organized to report on the nature of the activities carried out, the results achieved and the difficulties encountered in order to benefit from the criticism and proposals for solutions from the other actors. For the moment, it can be said that these two instruments are the most commonly used.
These instruments are important sources of information and have important limitations that need to be mentioned. In terms of form, it is noted that program or policy reports are still not easy to read and understand for those outside the intervention team. It is frequent that the reporting framework is designed by the financial partners, which means that the information needs expressed often do not correspond to those of the other actors. In addition, some reports use a lot of technical terms and remain very synthetic, which contributes to making it difficult for third parties to exploit them. With regard to substance, it is noted that the reports are not prepared taking into account national nutrition priorities. The information in the reports does not provide a clear picture of the links between the current intervention and the major orientations of the national nutrition priorities.
4.2. Promoting Social Accountability
In order to accelerate the performance of nutrition policies and programs, greater emphasis needs to be placed on social accountability (Bennett et al., 2020) . The voices of communities and other actors must be heard and their opinions and views are taken into account in the implementation of public policies (Kirk, 2017; Hamal et al., 2018; Bennett et al., 2020) . This will undoubtedly enable actions to benefit from public support and, above all, acceptance of the changes promoted. This promotion should emphasize democratic accountability (Courville, 2003; Malena & McNeil, 2010; Fox, 2015; Bennett et al., 2020) , and citizen participation in decision-making in order to guarantee the transparency and equity that are essential to the establishment of trust in those who govern and those who are governed (Mohanan et al., 2020) . It is worth noting that efforts have generally been made to put in place financial accountability and performance mechanisms, as Brinkerhoff put it, with very little attention paid to real citizen participation (Pantoja et al., 2017) . It is only at this price that nutrition policies and programs in particular, and development policies and programs in general, will be able to contribute to a consequent improvement in the living conditions of the population.
5. Conclusion
Accountability is weakly addressed and developed in nutrition-sensitive policies. During the elaboration of these documents, the actors do not give themselves the necessary time to develop the part devoted to accountability mechanisms which occupy an important place in the promotion of good governance and the improvement of the performance of the actions undertaken. The actors interviewed during the study mentioned this in their speeches. In the years to come, efforts will have to be made to better formulate and describe accountability mechanisms capable of promoting real consideration of the opinions of the communities and the beneficiaries of the policies.
Availability of Data and Material
We used publicly available policy documents. Primary qualitative data (interviews) cannot be de-identified, and therefore cannot be made publicly available for ethical considerations.