Evaluating the Process and Extent of Institutionalization: A Case Study of a Rapid Response Unit for Health Policy in Burkina Faso

Abstract Background: Good decision-making requires gathering and using sufficient information. Several knowledge translation platforms have been introduced in Burkina Faso to support evidence-informed decision-making. One of these is the rapid response service for health. This platform aims to provide quick access for policy-makers in Burkina Faso to highquality research evidence about health systems. The purpose of this study is to describe the process and extent of the institutionalization of the rapid response service. Methods: A qualitative case study design was used, drawing on interviews with policy-makers, together with documentary analysis. Previously used institutionalization frameworks were combined to guide the analysis. Results: Burkina Faso’s rapid response service has largely reached the consolidation phase of the institutionalization process but not yet the final phase of maturity. The impetus for the project came from designated project leaders, who convinced policy-makers of the importance of the rapid response service, and obtained resources to run a pilot. During the expansion stage, additional policy-makers at national and sub-national levels began to use the service. Unit staff also tried to improve the way it was delivered, based on lessons learned during the pilot stage. The service has, however, stagnated at the consolidation stage, and not moved into the final phase of maturity. Conclusion: The institutionalization process for the rapid response service in Burkina Faso has been fluid rather than linear, with some areas developing faster than others. The service has reached the consolidation stage, but now requires additional efforts to reach maturit

Multiplication végétative par bouturage et marcottage aérien de trois espèces agroforestières au Burkina Faso

L’insuffisance de connaissances sur la régénération des ligneux fruitiers sauvages est une contrainte majeure à la domestication de ceux-ci dans les pays sahéliens soumis à une longue saison sèche. Des essais de marcottage aérien et de bouturage racinaire et caulinaire, suivis de transplantation ont été conduits sur Balanites aegyptiaca, Sclerocarya birrea et Diospyros mespiliformis. Les résultats montrent, après 4 mois d’essais, que l’essai de bouturage de segments de racine de S. birrea donne des taux d’enracinement de 12 % pour les boutures disposées verticalement contre 8 % pour les boutures horizontales. Cependant les différences observées entre traitements ne sont pas significatives (P< 0,05). Le marcottage aérien a été positif pour les trois espèces, principalement pour B. aegyptiaca avec 65 % et 72 % de réussite respectivement pour les marcottes médianes et basales. Les différences observées entre les traitements sont significatives (P< 0,05). Les taux moyens de réussite de S. birrea sont de 48 % et 45 % respectivement pour les marcottes médianes et basales. Aucune différence significative n’a été observée (P< 0,05). D. mespiliformis enregistre des taux de réussite de 28 % pour les parties basales contre 12 % pour les parties médianes. Les différences d’enracinement entre les traitements sont hautement significatives (P< 0,001). À deux ans, le taux moyen de survie en station des plants issus des marcottes est de 52,5 % pour B. aegyptiaca, 92 % pour S. birrea.The insufficient knowledge on the regeneration of wild fruit trees is a major constraint to the domestication of these in the Sahelian countries subjected to a long dry season. Stem cuttings, root cuttings and air layering trials were carried out on Balanites aegyptiaca, Sclerocarya birrea and Diospyros mespiliformis specie. The results show, after 4 months of trials, that the root cutting test of S. birrea gives rooting rates of 12 % for cuttings planted vertically and 8 % rooting rates for cuttings planted horizontally in soil substrate. However, differences observed between treatments are not significant (P <0.05). Air layering test was given a positive result for all three species, mainly for B. aegyptiaca with 65 % and 72 % success rate respectively for plant marcotted at the medial and basal level of the stem. The differences observed between treatments are significant (P <0.05). The success rates on S. birrea are 48 % and 45 % respectively for plant marcotted at the medial and basal level of the stem. However, no significant differences were observed between the two treatment (P <0.05). D. mespiliformis recorded success rates of 28 % for plant marcotted at the basal level and 12 % success rate for the plant marcotted at the medial level of stem. The differences in rooting between treatments are highly significant (P <0.001) for this species. The rooted layers planted at the research station present a survival rate of 52.5 % for B. aegyptiaca and 92 % for S. birrea after 2 years monitoring

Evaluating the Process and Extent of Institutionalization: A Case Study of a Rapid Response Unit for Health Policy in Burkina Faso

Background Good decision-making requires gathering and using sufficient information. Several knowledge translation platforms have been introduced in Burkina Faso to support evidence-informed decision-making. One of these is the rapid response service for health. This platform aims to provide quick access for policy-makers in Burkina Faso to highquality research evidence about health systems. The purpose of this study is to describe the process and extent of the institutionalization of the rapid response service. Methods A qualitative case study design was used, drawing on interviews with policy-makers, together with documentary analysis. Previously used institutionalization frameworks were combined to guide the analysis. Results Burkina Faso’s rapid response service has largely reached the consolidation phase of the institutionalization process but not yet the final phase of maturity. The impetus for the project came from designated project leaders, who convinced policy-makers of the importance of the rapid response service, and obtained resources to run a pilot. During the expansion stage, additional policy-makers at national and sub-national levels began to use the service. Unit staff also tried to improve the way it was delivered, based on lessons learned during the pilot stage. The service has, however, stagnated at the consolidation stage, and not moved into the final phase of maturity. Conclusion The institutionalization process for the rapid response service in Burkina Faso has been fluid rather than linear, with some areas developing faster than others. The service has reached the consolidation stage, but now requires additional efforts to reach maturity

The factors affecting the institutionalisation of two policy units in Burkina Faso’s health system: a case study

Abstract Background This paper is one of three linked studies that attempts to understand the process of institutionalisation of policy units within Burkina Faso’s health system. It examines the relationships between the existence of an institutional framework, data production capacity and other resource availability in the institutionalisation of policy units in health systems. It therefore contributes to our understanding of the dynamics linking the key drivers and indicators of institutionalisation. Additionally, it examines how factors within the managerial setting, including workplace environment, and budgetary and human resource availability, may influence the institutionalisation process. Methods The study used an explanatory qualitative case study approach, examining two policy units in Burkina Faso’s Ministry of Health, the first of which had been institutionalised successfully and the other less so. Data were collected from key policymakers, including 13 connected with the first policy unit and 10 with the second, plus two funders. We also conducted a documentary analysis of the National Program for Health Development, two mid-term strategic plans, 230 action plans, eight Ministry of Health state budgets, eight Ministry of Health annual statistics reports, 16 policy unit budgets and published literature. Results The framework within which the government gave the policy unit its mandate and policy focus had the strongest effect on the institutionalisation process. Institutionalisation depended on political will, in both the host government and any donors, and the priority given to the policy unit’s focus. It was also affected by the leadership of the policy unit managers. These factors were influenced by human resource capacity, and our findings suggest that, for successful institutionalisation in Burkina Faso’s health system, policy units need to be given sufficient human resources to achieve their objectives. Conclusion Policy units’ institutionalisation in Burkina Faso’s health system depend on the leadership of the unit managers to implement relevant activities, mobilise funding, and recruit and maintain enough human resources, as well as the mandate given by the government