The synergy effect of multi-country policy actions announced in reaction to global risk: A network structure perspective

The policy actions of countries reflect adaptive responses of local components within the system to the dynamic global risk landscape. These responses can generate interactions and synergy effects on alleviating the evolution of global risks. Adopting a network perspective, the study proposes a theoretical framework that connects three structural characteristics of policy synergy, namely, synergy scale, alignment intensity, and timing synchronization. Focusing on the Covid-19 pandemic as a typical global risk context, the study finds that policy synergy with a larger scale, stronger alignment intensity, and more synchronized timing has a positive impact on mitigating global risks. The effect of alignment intensity is particularly pronounced when polycentric governance involves 20 countries facing severe risks, whereas the effect of timing synchronization is more significant when the multicenter group comprises more countries. Building upon the concept of an efficient scale of polycentric governance in various dimensions, this study develops a policy synergy index model. Through multiple empirical analyses, this study validates the causal relationship between policy synergy and the future evolution of global pandemic risk. Policymakers can leverage the dynamic changes in the policy synergy to predict future risk situations and implement well-rounded and appropriate policy actions, thereby enhancing the efficacy of the synergy effect of multi-country policy actions for risk governance.

Reducing Sodium Consumption in Mexico: A Strategy to Decrease the Morbidity and Mortality of Cardiovascular Diseases

Hypertension (HTN) and cardiovascular diseases (CVD) are important public health problems in Mexico. High sodium intake is linked to high blood pressure and increased risk of developing CVD. International organizations suggest consuming <2 g of sodium/day; however, the Mexican population consumes amounts above what is recommended: 3.1 g/day. Although efforts have been made to mitigate this problem, interventions are needed to improve cardiovascular health. This policy brief offers a short review of the current sodium consumption situation in Mexico and the importance of why decision makers should consider actions to reduce consumption. Recommendations to reduce sodium/salt intake include: Reformulation of ultra-processed-foods, promote the use warning labels, communication campaign, reduce the use of table salt, and monitor sodium intake.

Promoting Physical Activity Policy: The Development of the MOVING Framework

BACKGROUND

Considering the large health burden of physical inactivity, effective physical activity promotion is a "best buy" for noncommunicable disease and obesity prevention. The MOVING policy framework was developed to promote and monitor government policy actions to increase physical activity as part of the EU Horizon 2020 project "Confronting Obesity: Co-creating policy with youth (CO-CREATE)."

METHOD

A scanning exercise, documentary review of key international policy documents, and thematic analysis of main recommendations were conducted. Themes were reviewed as part of a consultation with physical activity experts.

RESULTS

There were 6 overarching policy framework areas: M-make opportunities and initiatives that promote physical activity in schools, the community, and sport and recreation; O-offer physical activity opportunities in the workplace and training in physical activity promotion across multiple professions; V-visualize and enact structures and surroundings that promote physical activity; I-implement transport infrastructure and opportunities that support active societies; N-normalize and increase physical activity through public communication that motivates and builds behavior change skills; and G-give physical activity training, assessment, and counseling in health care settings.

CONCLUSIONS

The MOVING framework can identify policy actions needed, tailor options suitable for populations, and assess whether approaches are sufficiently comprehensive.

The magnitude of intimate partner violence during pregnancy in Eldoret, Kenya: exigency for policy action

Intimate partner violence (IPV) is sexual, psychological and physical coercive acts used against persons by intimate partners. When IPV occurs during pregnancy (IPVp), it can result in adverse maternal and pregnancy outcomes. No policy nor practice direction exists to address the rates and risk factors of IPVp in Kenya. Determining the prevalence, types and determinants of IPVp in Western Kenya would aid in the identification of pregnant women affected by and/or at risk of IPVp, as well as informing the development of policy, practices and programmes to support preventive interventions. In this cross-sectional study of 369 women who had given birth at Moi Teaching and Referral Hospital, participants were recruited using systematic sampling and data collected via structured questionnaires adopted from the WHO Violence Against Women Instrument. Associations were made in relation to physical or sexual violence and psychological violence. Logistic regression was used to assess the association between determinants and occurrence of IPVp. The overall prevalence of IPVp was 34.1%. Prevalence of physical or sexual violence was 22.8%. Psychological violence emerged as the most common (27.4%) form of IPVp. A lower than tertiary level of education and previous experience of IPV were individually associated with physical/sexual IPVp, whereas psychological IPVp was associated with previous experience of IPV and was prevented by the intimate partner having formal employment. Preterm birth rates were found to be higher than the country's rates. The prevalence rates of IPVp are high in Western Kenya. Strategies that address the promotion of respectful, nonviolent relationships and that interrupt the development of risk factors are required. Policies (clinical guidelines) targeting prevention of IPVp and screening and the identification of at-risk women and survivors of IPVp are needed urgently. Primary prevention through interrupting the occurrence of predisposing factors is key in addressing IPVp.