In 2008, the commercial cultivation of Genetically Modified (GM) cotton (Bollgard II) started in Burkina Faso. The adoption rate increased rapidly in subsequent years to reach around 70% in 2014. Although some criticisms were raised concerning the suitability of the technology for the farming system in Burkina Faso, the introduction of transgenic cotton in the country was generally regarded as a great success. Despite this, during the 2016-2017 agricultural campaign, the government of Burkina Faso decided to suspend the cultivation of Bollgard II. In this context, this paper investigates farmers' knowledge, perceptions, opinions and attitudes towards Bollgard II as well as their views on the recent decision to suspend its cultivation. Data was collected from 324 cotton farmers, both growers of conventional and Bollgard II. The results showed that the farmers surveyed had a poor knowledge concerning the core concepts of biotechnology and Bollgard II in particular. Moreover, the regulatory oversight of the implementation of the technology was found insufficient, as illustrated by the lack of compliance with prescriptions concerning refuge areas and pesticide treatments. Nevertheless, overall, the farmers interviewed had a slightly positive opinion about the effects on yield, income and their wellbeing. In particular the reduction in pesticide treatments was perceived very positively by all respondents. Although the study finds that the majority of farmers disagreed with the recent suspension of Bt cotton cultivation by the government, it also makes clear that a thorough debate on the technology and its implementation is necessary.

BackgroundIn several countries, attempts are made to improve health promotion by centrally rating the effectiveness of health promotion interventions. The Dutch Effectiveness Rating System (ERS) for health promotion interventions is an improvement-oriented approach in which multi-disciplinary expert committees rate available health promotion interventions as ‘theoretically sound’, ‘probably effective’ or ‘proven effective’. The aim of this study is to explore the functioning of the ERS and the perspective of researchers, policy-makers and practitioners regarding its contribution to improvement.MethodsWe interviewed 53 selected key informants from research, policy and practice in the Netherlands and observed the assessment of 12 interventions.ResultsBetween 2008 and 2012, a total of 94 interventions were submitted to the ERS, of which 23 were rejected, 58 were rated as ‘theoretically sound’, 10 were rated as ‘probably effective’ and 3 were rated as ‘proven effective’. According to participants, the ERS was intended to facilitate both the improvement of available interventions and the improvement of health promotion in practice. While participants expected that describing and rating interventions promoted learning and enhanced the transferability of interventions, they were concerned that the ERS approach was not suitable for guiding intervention development and improving health promotion in practice. The expert committees that assessed the interventions struggled with a lack of norms for the relevance of effects and questions about how effects should be studied and rated. Health promotion practitioners were concerned that the ERS neglected the local adaptation of interventions and did not encourage the improvement of aspects like applicability and costs. Policy-makers and practitioners were worried that the lack of proven effectiveness legitimised cutbacks rather than learning and advancing health promotion.ConclusionWhile measuring and centrally rating the effectiveness of interventions can be beneficial, the evidence based-inspired ERS approach is too limited to guide both intervention development and the improvement of health promotion in practice. To better contribute to improving health promotion, a more reflexive and responsive guidance approach is required, namely one which stimulates the improvement of different intervention aspects, provides targeted recommendations to practitioners and provides feedback to those who develop and rate interventions.

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