With the phase-out of the polio campaigns, Burkina Faso has developed a new strategy for routine community-based vitamin A supplementation (VAS) by institutionalising community-based health workers (CBHW) to sustain the gain of two decades of successful programming. Formative research was conducted soon after the strategy was introduced to solicit feedback on the acceptability of the new approach by the implementing actors while identifying the main implementation challenges for improving its effectiveness and sustainability.

This qualitative study was conducted in 2018 through (i) document review, (ii) individual interviews with key informants at the central, regional and district levels, and (iii) focus groups with CBHW and caregivers.

Data collection was carried out at six levels of sites covering the entire country and selected based on VAS coverage rates with the community routine. A total of six health districts were selected.

We conducted 46 individual interviews with health workers and 20 focus groups with 59 CBHW and 108 caregivers.

The study showed good acceptability of the strategy by all stakeholders. In the first 2 years of implementation, the national coverage of VAS was maintained at a high level (above 90 %) and there was a reduction in operational costs. The main challenges included delayed CBHW remuneration and weak communication and supervision

The acceptability of the community-based routine VAS was good and was perceived to have a high potential for sustainability. Addressing identified challenges will allow us to better manage the expectations of community stakeholders and maintain the initial results

To describe the living conditions of Senegalese adolescent girls according to their migration status, and to define the main socio-economic and biological determinants of their nutritional and growth status.

Health and living conditions, sexual maturation, and nutritional and growth status of adolescent girls were determined within the framework of a longitudinal study on growth.

The capital city of Senegal (Dakar) and a rural community (Niakhar), 120 km south-east of Dakar.

Three hundred and thirty-one girls, 14.5–16.6 years of age, were recruited from the same villages. Thirty-six per cent of the sample remained in the villages to attend school and/or to help with household subsistence tasks (non-migrants). The remaining (64%) migrated to cities to work as maids (migrants) and lived in two different socio-economic environments: at the home of a guardian during the night and in the house of the employer during the daytime.

Family rural environment and guardian and employer urban environments were socio-economically different (P < 0.001). Living conditions in urban areas were better than in rural areas and the employer's environment was socio-economically more favourable. Migrants had more advanced sexual maturation and higher body mass index (BMI), fat mass index (FMI) and mid-upper arm circumference than non-migrants. However, migrants were smaller than non-migrants. BMI, FMI and weight-for-age were related to socio-economic levels and duration of migration. Schooling was positively related to height and negatively related to BMI.

Migrants enjoyed better living conditions than non-migrants. This could be partly due to the better socio-economic environment of the employer. It was associated with earlier puberty and better nutritional status, but not with a better growth.

To stress the importance of social and environment (nutritional) factors in determining the growth spurt during puberty and the risk of excessive adiposity, two contrasting adolescent populations, one from a rural area of Senegal (West Africa) and the other from Martinique (French West Indies), were compared.

Cross-cultural comparison of contrasting populations. Adolescents from Senegal belonged to a cohort followed up since 1995. Adolescents from Martinique participated in a cross-sectional nutritional survey that covered the entire island.

A total of 507 adolescents (mean age: 14.3 ± 0.7 years) from Senegal (319 girls and 188 boys) and 703 adolescents from Martinique (351 boys and 352 girls) were surveyed.

Differences in growth and maturation were striking: boys in Martinique were 22.7 kg heavier and 20.1 cm taller than boys in Senegal. Differences were less important for girls but still evident: 12.6 kg in weight and 10.5 cm in stature. In Senegal, there were virtually no overweight adolescents, but 18% of girls and 50% of boys could be considered as malnourished. In Martinique, 19% of girls and 23% of boys were overweight or obese. Adolescent girls from Martinique were also sexually more mature than adolescent girls from Senegal. When comparisons were repeated after Senegalese girls reached menarche, differences in weight and body mass index disappeared, but Senegalese girls were still shorter than girls from Martinique.

Adolescents are extremely susceptible to nutritional changes and their particular situation needs to be incorporated into nutritional prevention programmes.