Advancing the use of evidence in bouillon fortification policy discussions: Burkina Faso, Nigeria, and Senegal.

Policy changes require stakeholder buy-in, therefore, the timely delivery of tailored evidence provided to all stakeholders involved in policy discussions is important. This paper reports the evidence generation and delivery processes undertaken in Burkina Faso, Nigeria, and Senegal in support of bouillon fortification discussions. We identified stakeholder-specific evidence needs, tapped existing data and new data to generate that evidence, and packaged and delivered it to stakeholders. Evidence needs included the levels of micronutrient inadequacy (with/without existing and other hypothetical fortification programs), the potential contributions of bouillon fortification to reduce micronutrient inadequacy and (for some micronutrients) child mortality, the cost and cost-effectiveness of bouillon fortification programs, and the contribution of bouillon to total sodium intake. Evidence on technical and commercial issues was also required. Stakeholder-specific understanding and ownership of evidence was essential; achieving both required continual interaction and trust. New bouillon evidence delivery channels were developed in each country and linked to existing decision-making bodies. A shared vocabulary and understanding of issues and evidence, and the continual innovative redelivery of evidence, were critical to success; persistence and innovations in evidence delivery paid dividends. Concrete policy changes regarding bouillon fortification were secured in Nigeria; policy discussions continue in Burkina Faso and Senegal.