1
|
Reeve E, Bell C, Sacks G, Mounsey S, Waqa G, Peeters A, Thow AM. Lessons for strengthening policymaking for obesity and diet-related noncommunicable disease prevention: A narrative synthesis of policy literature from the Western Pacific Region. Obes Rev 2024; 25:e13651. [PMID: 37905309 DOI: 10.1111/obr.13651] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 05/28/2023] [Accepted: 09/09/2023] [Indexed: 11/02/2023]
Abstract
Obesity and diet-related noncommunicable diseases (NCDs) have a profound impact on individuals, households, health care systems, and economies in low- and middle- income countries (LMICs), with the Western Pacific Region experiencing some of the highest impacts. Governments have committed to improving population diets; however, implementation challenges limit effective policy action. We undertook meta-narrative synthesis of the academic literature and used theories of policymaking and implementation to synthesize current knowledge of issues affecting the adoption and implementation of policies to prevent obesity and diet-related NCDs in LMICs in the Western Pacific Region. We found that political leadership and management of food and nutrition policies often diluted following policy adoption, and that nutrition and health advocates find it difficult to enforce policy compliance from actors outside their sectors. Opportunities for strengthening implementation of food and nutrition policies in the Western Pacific include (1) improved and earlier engagement between health policymakers and implementing agencies; (2) focusing on the need for increased accountability from governments, including through effective engagement and organization of actor networks, knowledge sharing, and in highlighting where stronger action is required; and (3) identifying and building the strategic capacities of policy actors in framing, advocacy, coalition-building, knowledge translation, and leadership.
Collapse
Affiliation(s)
- Erica Reeve
- Global Centre for Preventive Health and Nutrition (GLOBE), Institute for Health Transformation, Deakin University, Geelong, Victoria, Australia
| | - Colin Bell
- School of Medicine, Deakin University, Geelong, Victoria, Australia
| | - Gary Sacks
- Global Centre for Preventive Health and Nutrition (GLOBE), Institute for Health Transformation, Deakin University, Geelong, Victoria, Australia
| | - Sarah Mounsey
- Menzies Centre for Health Policy, School of Public Health, University of Sydney, Sydney, New South Wales, Australia
| | - Gade Waqa
- Pacific Research Centre for Prevention of Obesity and Non-Communicable Disease (C-POND), Fiji National University, Suva, Fiji
| | - Anna Peeters
- Institute for Health Transformation, Faculty of Health, Deakin University, Geelong, Victoria, Australia
| | - Anne Marie Thow
- Menzies Centre for Health Policy, School of Public Health, University of Sydney, Sydney, New South Wales, Australia
| |
Collapse
|
2
|
Thow AM, Phulkerd S, Ngqangashe Y, Ravuvu A, Zaruba L, Huckel Schneider C, Collin J, Schram A, Friel S. Protecting children from unhealthy food marketing: a comparative policy analysis in Australia, Fiji and Thailand. Health Promot Int 2023; 38:daad136. [PMID: 38011397 PMCID: PMC10681351 DOI: 10.1093/heapro/daad136] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2023] Open
Abstract
Restrictions on marketing of unhealthy foods and beverages to children is a globally recommended policy measure to improve diets and health. The aim of the analysis was to identify opportunities to enable policy learning and shift beliefs of relevant actors, to engender policy progress on restrictions on marketing of unhealthy foods to children. We drew on the Advocacy Coalition Framework to thematically analyse data from qualitative policy interviews conducted Australia (n = 24), Fiji (n = 10) and Thailand (n = 20). In all three countries two clear and opposing advocacy coalitions were evident within the policy subsystem related to regulation of unhealthy food marketing, which we termed the 'strengthen regulation' and 'minimal/self regulation' coalitions. Contributors to policy stasis on this issue were identified as tensions between public health and economic objectives of government, and limited formal and informal spaces for productive dialogue. The analysis also identified opportunities for policy learning that could enable policy progress on restrictions on marketing of unhealthy foods to children as: taking an incremental approach to policy change, defining permitted (rather than restricted) foods, investing in new public health expertise related to emerging marketing approaches and scaling up of monitoring of impacts. The insights from this study are likely to be relevant to many countries seeking to strengthen regulation of marketing to children, in response to recent global recommendations.
Collapse
Affiliation(s)
- Anne Marie Thow
- Faculty of Medicine and Health, Sydney School of Public Health, Menzies Centre for Health Policy and Economics, Charles Perkins Centre (D17), The University of Sydney, Sydney, NSW, 2006, Australia
| | - Sirinya Phulkerd
- Institute for Population and Social Research, Mahidol University, Phutthamonthon, Nakhon Pathom, Thailand
| | - Yandisa Ngqangashe
- Australian Research Centre for Health Equity, School of Regulation and Global Governance, Fellows Road, Australian National University, Canberra, ACT, 2600, Australia
| | - Amerita Ravuvu
- Non-Communicable Disease (NCD) Prevention and Control Programme, Public Health Division, Pacific Community (SPC), Private Mail Bag, Suva, Fiji
| | | | - Carmen Huckel Schneider
- Faculty of Medicine and Health, Sydney School of Public Health, Menzies Centre for Health Policy and Economics, Charles Perkins Centre (D17), The University of Sydney, Sydney, NSW, 2006, Australia
| | - Jeff Collin
- Global Health Policy Unit, Social Policy, School of Social and Political Science, University of Edinburgh, Edinburgh, EH8 9YL, UK
| | - Ashley Schram
- Australian Research Centre for Health Equity, School of Regulation and Global Governance, Fellows Road, Australian National University, Canberra, ACT, 2600, Australia
| | - Sharon Friel
- Australian Research Centre for Health Equity, School of Regulation and Global Governance, Fellows Road, Australian National University, Canberra, ACT, 2600, Australia
| |
Collapse
|
3
|
Patay D, Schram A, Friel S. The challenges in protecting public health interests in multisectoral governance in the context of small island developing states: the case of tobacco control in Fiji and Vanuatu. Global Health 2023; 19:31. [PMID: 37118741 PMCID: PMC10142426 DOI: 10.1186/s12992-023-00931-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Accepted: 04/19/2023] [Indexed: 04/30/2023] Open
Abstract
BACKGROUND The commercial determinants of health (CDoH) drive the rise of NCDs globally, and their regulation requires multisectoral governance. Despite existing recommendations to strengthen institutional structures, protecting public health interests can be challenging amidst industry interference and conflicting policy priorities, particularly in low and middle-income countries (LMICs) where the need for rapid economic development is pronounced. Small island developing states (SIDS) face even more challenges in regulating CDoH because their unique socioeconomic, political, and geographic vulnerabilities may weaken institutional conditions that could aid health sector actors in protecting health interests. This study aims to explore the institutional conditions that shape health sector actors' capability to protect public health interests in tobacco governance in Fiji and Vanuatu. METHODS We employed a qualitative, exploratory case study design. We applied the administrative process theory to inform data collection and analysis. Seventy interviews were completed in Fiji and Vanuatu from 2018 to 2019. RESULTS The findings show that the protection of health interests in tobacco governance were not supported by the institutional conditions in Fiji and Vanuatu. While the policy processes formally ensured a level playing field between actors, policies were often developed through informal mechanisms, and the safeguards to protect public interests from vested private interests were not implemented adequately. SIDS vulnerabilities and weak regulation of political parties contributed to the politicisation of government in both states, resulting in high-level government officials' questionable commitment to protect public health interests. The system of checks and balances usually embedded into democratic governments appeared to be muted, and policymakers had limited bureaucratic autonomy to elevate health interests in multisectoral policymaking amidst high-level government officials' frequent rotation. Finally, capacity constraints aggravated by SIDS vulnerabilities negatively impacted health sector actors' capability to analyse policy alternatives. CONCLUSIONS Health sector actors in Fiji and Vanuatu were not supported by institutional conditions that could help them protect public health interests in multisectoral governance to regulate CDoH originating from the tobacco industry. Institutional conditions in these states were shaped by SIDS vulnerabilities but could be improved by targeted capacity building, governance and political system strengthening.
Collapse
Affiliation(s)
- Dori Patay
- School of Regulation and Global Governance, College of Asia and the Pacific, The Australian National University, Canberra, Australia.
- The George Institute for Global Health, Sydney, Australia.
- Menzies Centre for Health Policy and Economy, Sydney School of Public Health, The University of Sydney, Camperdown, NSW, 2006, Australia.
| | - Ashley Schram
- School of Regulation and Global Governance, College of Asia and the Pacific, The Australian National University, Canberra, Australia
| | - Sharon Friel
- School of Regulation and Global Governance, College of Asia and the Pacific, The Australian National University, Canberra, Australia
| |
Collapse
|
4
|
The role of trade in pacific food security and nutrition. GLOBAL FOOD SECURITY 2023. [DOI: 10.1016/j.gfs.2022.100670] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
|
5
|
Patay D, Trieu K, McKenzie B, Ramanathan S, Hure A, Bell C, Thow AM, Allender S, Reeve E, Palu A, Woodward M, Waqa G, Webster J. Research protocol for impact assessment of a project to scale up food policies in the Pacific. Health Res Policy Syst 2022; 20:117. [PMID: 36309749 PMCID: PMC9617745 DOI: 10.1186/s12961-022-00927-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Accepted: 10/12/2022] [Indexed: 11/29/2022] Open
Abstract
Background One of the challenges for countries implementing food policy measures has been the difficulty in demonstrating impact and retaining stakeholder support. Consequently, research funded to help countries overcome these challenges should assess impact and translation into practice, particularly in low-resource settings. However, there are still few attempts to prospectively, and comprehensively, assess research impact. This protocol describes a study co-created with project implementers, collaborative investigators and key stakeholders to optimize and monitor the impact of a research project on scaling up food policies in Fiji. Methods To develop this protocol, our team of researchers prospectively applied the Framework to Assess the Impact from Translational health research (FAIT). Activities included (i) developing a logic model to map the pathway to impact and establish domains of benefit; (ii) identifying process and impact indicators for each of these domains; (iii) identifying relevant data for impact indicators and a cost–consequence analysis; and (iv) establishing a process for collecting quantitative and qualitative data to measure progress. Impact assessment data will be collected between September 2022 and December 2024, through reports, routine monitoring activities, group discussions and semi-structured interviews with key implementers and stakeholders. The prospective application of the protocol, and interim and final research impact assessments of each project stream and the project as a whole, will optimize and enable robust measurement of research impact. Discussion By applying this protocol, we aim to increase understanding of pathways to impact and processes that need to be put in place to achieve this. This impact evaluation will inform future projects with a similar scope and will identify transferable and/or translatable lessons for other Pacific Island states and low- and middle-income countries. Supplementary Information The online version contains supplementary material available at 10.1186/s12961-022-00927-x.
Collapse
|
6
|
Patay D, Schram A, Collin J, Sell S, Friel S. Authority in tobacco control in Pacific Small Island Developing States: a qualitative study of multisectoral tobacco governance in Fiji and Vanuatu. Tob Control 2022:tobaccocontrol-2022-057404. [PMID: 35882520 DOI: 10.1136/tc-2022-057404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Accepted: 07/16/2022] [Indexed: 11/03/2022]
Abstract
OBJECTIVE Small Island Developing States (SIDS) struggle with implementing multisectoral tobacco control measures, and health sector actors often lack capacity to forge multisectoral commitment. This study aims to explore the sources and dynamics of authority that can enable multisectoral collaboration despite the divergence of policy agendas in tobacco control. METHODS We applied a qualitative, explorative case study design, with data collection and analysis guided by an analytical framework that identifies sources and dynamics of authority. Seventy interviews were conducted in Fiji and Vanuatu between 2018 and 2019. RESULTS The key features shaping multisectoral coordination for tobacco control in Fiji and Vanuatu are the expert, institutional, capacity-based and legal authority that state and non-state actors have in tobacco governance. The amount of authority actors can secure from these sources was shown to be influenced by their performance (perceived or real), the discourse around tobacco control, the existing legal tools and their strategic alliances. SIDS vulnerabilities, arising from small size, isolation and developing economies, facilitate an economic growth discourse that reduces health sector actors' authority and empowers protobacco actors to drive tobacco governance. CONCLUSIONS Our results highlight the need for terms of engagement with the tobacco industry to enable governments to implement multisectoral tobacco control measures. Expanding assistance on tobacco control among government and civil society actors and increasing messaging about the impact of economic, trade and agricultural practices on health are essential to help SIDS implement the Framework Convention on Tobacco Control.
Collapse
Affiliation(s)
- Dori Patay
- Menzies Centre for Health Governance, School of Regulation and Global Governance, The Australian National University, Canberra, Australian Capital Territory, Australia
- Public Health Advocacy and Policy Impact team, Food Policy Division, The George Institute for Global Health, Sydney, New South Wales, Australia
| | - Ashley Schram
- Menzies Centre for Health Governance, School of Regulation and Global Governance, The Australian National University, Canberra, Australian Capital Territory, Australia
| | - Jeff Collin
- Global Health Policy Unit, University of Edinburgh, Edinburgh, UK
| | - Susan Sell
- Menzies Centre for Health Governance, School of Regulation and Global Governance, The Australian National University, Canberra, Australian Capital Territory, Australia
| | - Sharon Friel
- Menzies Centre for Health Governance, School of Regulation and Global Governance, The Australian National University, Canberra, Australian Capital Territory, Australia
| |
Collapse
|
7
|
Ares G, Antúnez L, de León C, Alcaire F, Vidal L, Natero V, Otterbring T. 'Even if you don't pay attention to it, you know it's there': A qualitative exploration of adolescents' experiences with digital food marketing. Appetite 2022; 176:106128. [PMID: 35718311 DOI: 10.1016/j.appet.2022.106128] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Revised: 06/07/2022] [Accepted: 06/08/2022] [Indexed: 11/02/2022]
Abstract
Adolescents are particularly vulnerable to digital food marketing. However, research on adolescents' recall, awareness, and opinions of this type of marketing is still scarce. Accordingly, the present study aimed to conduct an in-depth examination of adolescents' experiences with digital food marketing. A convenience sample of 209 adolescents was recruited at two private educational institutions and a public health facility in Montevideo, the capital city of Uruguay. Semi-structured group interviews were conducted, recorded in audio and transcribed. The transcripts were analyzed using content analysis based on a deductive-inductive approach. Results showed that participants were highly exposed to digital food marketing, as they all remembered having seen advertisements, with those of fast-food restaurants and food-ordering apps being the most frequently mentioned. According to the adolescents' accounts, images, colors, music, oversized portions, product novelty, price promotions and celebrities were the most memorable aspects of food advertisements. Participants recognized the effect of advertisements on product awareness and wanting, and, to a lesser extent, on actual purchase and consumption behavior. Factors that were thought to mediate the impact of digital marketing on food choice were also identified. In the final part of the interviews, participants proposed strategies to reduce the effect of digital marketing on their food choices, which included both regulatory approaches to reduce exposure to digital marketing of unhealthy foods and behavior change communication. Together, the current findings provide insights for the development of multifaceted strategies to reduce the effects of digital food marketing on the eating habits of adolescents.
Collapse
Affiliation(s)
- Gastón Ares
- Sensometrics & Consumer Science, Instituto Polo Tecnológico de Pando, Facultad de Química, Universidad de la República, By Pass de Rutas 8 y 101 s/n. CP 91000. Pando, Canelones, Uruguay.
| | - Lucía Antúnez
- Sensometrics & Consumer Science, Instituto Polo Tecnológico de Pando, Facultad de Química, Universidad de la República, By Pass de Rutas 8 y 101 s/n. CP 91000. Pando, Canelones, Uruguay
| | | | - Florencia Alcaire
- Sensometrics & Consumer Science, Instituto Polo Tecnológico de Pando, Facultad de Química, Universidad de la República, By Pass de Rutas 8 y 101 s/n. CP 91000. Pando, Canelones, Uruguay
| | - Leticia Vidal
- Sensometrics & Consumer Science, Instituto Polo Tecnológico de Pando, Facultad de Química, Universidad de la República, By Pass de Rutas 8 y 101 s/n. CP 91000. Pando, Canelones, Uruguay
| | - Virginia Natero
- Departamento de Alimentos, Escuela de Nutrición, Universidad de la República, Montevideo, Uruguay
| | - Tobias Otterbring
- School of Business and Law, Department of Management, University of Agder, Universitetsveien 17, 4630 Kristiansand, Norway; Institute of Retail Economics, Regeringsgatan 60, 103 29, Stockholm, Sweden
| |
Collapse
|
8
|
Phulkerd S, Ngqangashe Y, Collin J, Thow AM, Schram A, Schneider CH, Friel S. Moving from silos to synergies: strengthening governance of food marketing policy in Thailand. Global Health 2022; 18:29. [PMID: 35264200 PMCID: PMC8905862 DOI: 10.1186/s12992-022-00825-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Accepted: 02/17/2022] [Indexed: 11/25/2022] Open
Abstract
Background Governance processes play an important role in shaping the formulation and implementation of policy measures such as restrictions on marketing of ultra-processed foods. However, there is limited analysis of the factors that affect governance for nutrition, especially in low- and middle-income countries such as Thailand and the Southeast Asia region. This study aimed to examine governance factors that create opportunities and challenges for the introduction of policy to restrict food marketing in Thailand, in line with the WHO recommendations to restrict food marketing to children. Methods A qualitative study design was used. Interviews were conducted with 20 actors with experience and in depth knowledge of food marketing in Thailand, including government, civil society, industry and international organisations. Open questions were asked about experiences and perceptions of the governance processes related to policies for restricting food marketing in Thailand. Themes were derived from the 3-i Framework which relates to interests, ideas and institutions influencing the introduction of food marketing policy were identified and analysed using abductive methods. Results Actors viewed institutional challenges as a significant barrier to advancing effective regulation of food marketing. Three major clusters emerged from the data: interests (priorities, relationships), institutions (formal structures, informal structures, broader institutional strategies), and ideas (norms). The study has three major findings in relation to these factors, highlighting the influence of formal structures, institutional interests in food marketing issues, and ideas in promoting multisectoralism. The siloed nature of policymaking was reflected in the government failing to stimulate engagement among key actors, posing challenges for implementation of effective policy change. Contested interests led to disagreements between actors over food marketing agenda and thus competing policy priorities. Consistent with these findings, the lack of effective mechanisms to promote multisectoral coordination across diverse actors reinforced barriers to policy change. Conclusion The findings highlight ongoing challenges to the government’s aim to strengthen policy to restrict food marketing which, without greater coordination in governance mechanisms, will hinder effective regulation and the achievement of public health goals. This analysis suggests that the Government should prioritise the development of a holistic, multisectoral approach to improve governance for better nutrition outcomes by overcoming policy silos.
Collapse
Affiliation(s)
- Sirinya Phulkerd
- Institute for Population and Social Research, Mahidol University, 999 Phutthamonthon 4 Road, Phutthamonthon, Nakhon Pathom, 73170, Thailand.
| | - Yandisa Ngqangashe
- School of Regulation and Global Governance, Australian National University, Canberra, Australia
| | - Jeff Collin
- Global Health Policy Unit, School of Social & Political Science, University of Edinburgh, Edinburgh, UK
| | - Anne-Marie Thow
- Menzies Centre for Health Policy and Economics, School of Public Health, University of Sydney, Sydney, Australia
| | - Ashley Schram
- School of Regulation and Global Governance, Australian National University, Canberra, Australia
| | - Carmen Huckel Schneider
- Menzies Centre for Health Policy and Economics, School of Public Health, University of Sydney, Sydney, Australia
| | - Sharon Friel
- School of Regulation and Global Governance, Australian National University, Canberra, Australia
| |
Collapse
|
9
|
Mulcahy G, Boelsen-Robinson T, Hart AC, Pesantes MA, Sameeha MJ, Phulkerd S, Alsukait RF, Thow AM. A Comparative Policy Analysis of the Adoption and Implementation of Sugar-Sweetened Beverage Taxes (2016-2019) in 16 Countries. Health Policy Plan 2022; 37:543-564. [PMID: 35244693 PMCID: PMC9113088 DOI: 10.1093/heapol/czac004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Revised: 12/23/2021] [Accepted: 02/02/2022] [Indexed: 11/13/2022] Open
Abstract
Taxes on sugar-sweetened beverages (SSBs) are recommended as part of comprehensive policy action to prevent diet-related non-communicable diseases (NCDs), but have been adopted by only one quarter of World Health Organization (WHO) Member States. This paper presents a comparative policy analysis of recent SSB taxes (2016–19) in 16 countries. This study aimed to analyse the characteristics and patterns of factors influencing adoption and implementation of SSB taxes and policy learning between countries, to draw lessons for future SSB taxes. The data collection and analysis were informed by an analytical framework that drew on ‘diffusion of innovation’ and theories of policy learning. Qualitative data were collected from policy documents and media, in addition to national statistics. Qualitative data were thematically analysed and a narrative synthesis approach was used for integrated case study analysis. We found adaptation and heterogeneity in the approaches used for SSB taxation with a majority of countries adopting excise taxes, and consistent health framing in media and policy documents. Common public frames supporting the taxes included reducing obesity/NCDs and raising revenue (government actors) and subsequent health system savings (non-government actors). Opposing frames focused on regressivity and incoherence with other economic policy (government actors) and posited that taxes have limited health benefits and negative economic impacts on the food industry (industry). Evident ‘diffusion networks’ included the WHO, predominantly in middle-income countries, and some regional economic bodies. We found indications of policy learning in the form of reference to other countries’ taxes, particularly countries with membership in the same economic bodies and with shared borders. The study suggests that adoption of SSB taxation could be enhanced through strategic engagement by health actors with the policy-making process, consideration of the economic context, use of consistent health frames by cross-sector coalitions, and robust evaluation and reporting of SSB taxation.
Collapse
Affiliation(s)
- Georgina Mulcahy
- Menzies Centre for Health Policy, Sydney School of Public Health, University of Sydney, Australia
| | - Tara Boelsen-Robinson
- Menzies Centre for Health Policy, Sydney School of Public Health, University of Sydney, Australia.,Global Obesity Centre (GLOBE), Institute for Health Transformation, Deakin University, Geelong, Australia
| | | | - Maria Amalia Pesantes
- CRONICAS Centro de Excelencia en Enfermedades Crónicas, Universidad Peruana Cayetano Heredia, Peru.,Department of Anthropology and Archaeology, Dickinson College, USA
| | - Mohd Jamil Sameeha
- Centre for Community Health Studies (ReaCH), Faculty of Health Sciences, Universiti Kebangsaan Malaysia (UKM), Kuala Lumpur, Malaysia
| | - Sirinya Phulkerd
- Institute for Population and Social Research, Mahidol University, Thailand
| | - Reem F Alsukait
- Department of Community Health Sciences, King Saud University, Saudi Arabia
| | - Anne Marie Thow
- Menzies Centre for Health Policy, Sydney School of Public Health, University of Sydney, Australia
| |
Collapse
|
10
|
Ares G, Velázquez AL, Vidal L, Curutchet MR, Varela P. The role of food packaging on children's diet: Insights for the design of comprehensive regulations to encourage healthier eating habits in childhood and beyond. Food Qual Prefer 2022. [DOI: 10.1016/j.foodqual.2021.104366] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
|
11
|
Abstract
Context Policy-specific actions to improve food environments will support healthy population diets. Objective To identify cited barriers and facilitators to food environment policy (FEP) processes reported in the literature, exploring these according to the nature of the policy (voluntary or mandatory) and country development status. Data sources A systematic search was conducted of 10 academic and 7 grey-literature databases, national websites, and manual searches of publication references. Data extraction Data on government-led FEPs, barriers, and facilitators from key informants were collected. Data synthesis The constant-comparison approach generated core themes for barriers and facilitators. The appraisal tool developed by Hawker et al. was adopted to determine the quality of qualitative and quantitative studies. Results A total of 142 eligible studies were identified. Industry resistance or disincentive was the most cited barrier in policy development. Technical challenges were most frequently a barrier for policy implementation. Frequently cited facilitators included resource availability or maximization, strategies in policy process, and stakeholder partnership or support. Conclusions The findings from this study will strategically inform health-reform stakeholders about key elements of public health policy processes. More evidence is required from countries with human development indices ranging from low to high and on voluntary policies. Systematic Review Registration PROSPERO registration no. CRD42018115034.
Collapse
Affiliation(s)
- SeeHoe Ng
- Early Start, School of Health and Society, University of Wollongong, Wollongong, New South Wales, Australia
- School of Biosciences, Faculty of Health and Medical Sciences, Taylor's University, Subang Jaya, Selangor, Malaysia
| | - Heather Yeatman
- Early Start, School of Health and Society, University of Wollongong, Wollongong, New South Wales, Australia
| | - Bridget Kelly
- Early Start, School of Health and Society, University of Wollongong, Wollongong, New South Wales, Australia
| | - Sreelakshmi Sankaranarayanan
- School of Biosciences, Faculty of Health and Medical Sciences, Taylor's University, Subang Jaya, Selangor, Malaysia
| | - Tilakavati Karupaiah
- T. Karupaiah, School of Biosciences, Faculty of Health and Medical Sciences, Taylor's University, 47500 Subang Jaya, Selangor, Malaysia. E-mail:
| |
Collapse
|
12
|
Analysis of the policy process for the implementation of nutritional warning labels in Uruguay. Public Health Nutr 2021; 24:5927-5940. [PMID: 34313211 DOI: 10.1017/s1368980021002469] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
OBJECTIVE To analyse the process for the development and implementation of mandatory nutritional warning labels in Uruguay, in order to inform future nutrition policy making and strategic engagement by public health actors. DESIGN The study design drew on policy analysis methodology and case study research methodology. Two main sources of information were selected and analysed for the current study: eighteen official documents from the Uruguayan government and 259 news reports, published between June 2017 and February 2021. SETTING Uruguay, Latin America. RESULTS The Uruguayan Ministry of Public Health led a cross-sectoral working group composed of diverse governmental stakeholders, international organisations and the academia to develop the front-of-package nutrition labelling policy. A robust evidence-based approach, based on rigorous scientific knowledge generated in the country, was followed. However, changes in the systemic governing coalition as a consequence of a change in government led to a delay in the entry into force and changes in the regulation. The food industry was the main opponent to the warning label regulation and relied on widely reported corporate political activities to influence the policy process: information and messaging, legal action, policy substitution, opposition, fragmentation and destabilisation. CONCLUSIONS Key insights to inform future policy action in Uruguay and other jurisdictions were derived. Results stressed the importance of an evidence-based approach for policy design and the early engagement with actors from all the political system.
Collapse
|