The state of diet-related NCD policies in Afghanistan, Bangladesh, Nepal, Pakistan, Tunisia and Vietnam: a comparative assessment that introduces a 'policy cube' approach.

Autor:	Buse K; UNAIDS, Avenue Appia 20, 1211 Genève, Switzerland., Aftab W; Department of Community Health Sciences, Aga Khan University, Stadium Road, P. O. Box 3500, Karachi 74800, Pakistan., Akhter S; Health System and Population Studies Division, icddrb, GPO Box 128, Dhaka 1000, Bangladesh., Phuong LB; Center for Population Health Sciences, Hanoi University of Public Health, No. 1A, Duc Thang Street, Duc Thang Ward, Bac Tu Liem District, Hanoi City, Vietnam., Chemli H; SURVEN (Nutrition Surveillance and Epidemiology in Tunisia) Research Laboratory, 11 Rue Jebel Lakhdar, Bab Saadoun, 1007, Tunis, Tunisia., Dahal M; Center for Research on Environment, Health and Population Activities (CREHPA), P.O.Box. 9626, Kusunti (near Yatayat office), Lalitpur, Nepal., Feroz A; Department of Community Health Sciences, Aga Khan University, Stadium Road, P. O. Box 3500, Karachi 74800, Pakistan., Hofiani S; Ministry of Public Health, Fifth Floor, Central Blood Bank Building, Cinema Pamir Area, Kabul, Afghanistan., Pradhan NA; Department of Community Health Sciences, Aga Khan University, Stadium Road, P. O. Box 3500, Karachi 74800, Pakistan., Anwar I; Health System and Population Studies Division, icddrb, GPO Box 128, Dhaka 1000, Bangladesh., Skhiri HA; Faculty of Medicine of Tunis, University of Tunis El-Manar, Rue de la Faculte de Medecine, Tunis, Tunisia.; National Health Institute, Ministry of Health, 5/7 Rue El Khartoum, Diplomat, Bloc IV, 10ème étage, le Belvédère 1002 Tunis, Tunisia., El Ati J; National Institute of Nutrition and Food Technology, SURVEN (Nutrition Surveillance and Epidemiology in Tunisia) Research Laboratory, 11 Rue Jebel Lakhdar, Bab Saadoun, 1007 Tunis, Tunisia., Giang KB; Institute of Preventive Medicine and Public Health, Hanoi Medical University, No 1 Ton That Tung, Dong da District, Hanoi, Vietnam., Puri M; Center for Research on Environment, Health and Population Activities (CREHPA), P.O.Box. 9626, Kusunti (near Yatayat office), Lalitpur, Nepal., Noormal B; Ministry of Public Health, Fifth Floor, Central Blood Bank Building, Cinema Pamir Area, Kabul, Afghanistan., Rabbani F; Department of Community Health Sciences, Aga Khan University, Stadium Road, P. O. Box 3500, Karachi 74800, Pakistan., Hawkes S; Institute for Global Health, University College London, 30 Guilford Street, London WC1N 1EH5, UK.
Jazyk:	angličtina
Zdroj:	Health policy and planning [Health Policy Plan] 2020 Jun 01; Vol. 35 (5), pp. 503-521.
DOI:	10.1093/heapol/czz175
Abstrakt:	We assessed the technical content of sugar, salt and trans-fats policies in six countries in relation to the World Health Organization 'Best Buys' guidelines for the prevention and control of non-communicable diseases (NCDs). National research teams identified policies and strategies related to promoting healthy diets and restricting unhealthy consumption, including national legislation, development plans and strategies and health sector-related policies and plans. We identified relevant text in relation to the issuing agency, overarching aims, goals, targets and timeframes, specific policy measures and actions, accountability systems, budgets, responsiveness to inequitable vulnerabilities across population groups (including gender) and human rights. We captured findings in a 'policy cube' incorporating three dimensions: policy comprehensiveness, political salience and effectiveness of means of implementation, and equity/rights. We compared diet-related NCD policies to human immunodeficiency virus policies in relation to rights, gender and health equity. All six countries have made high-level commitments to address NCDs, but dietary NCDs policies vary and tend to be underdeveloped in terms of the specificity of targets and means of achieving them. There is patchwork reference to internationally recognized, evidence-informed technical interventions and a tendency to focus on interventions that will encounter least resistance, e.g. behaviour change communication in contrast to addressing food reformulation, taxation, subsidies and promotion/marketing. Policies are frequently at the lower end of the authoritativeness spectrum and have few identified budgetary commitments or clear accountability mechanisms. Of concern is the limited recognition of equity and rights-based approaches. Healthy diet policies in these countries do not match the severity of the NCDs burden nor are they designed in such a way that government action will focus on the most critical dietary drivers and population groups at risk. We propose a series of recommendations to expand policy cubes in each of the countries by re-orienting diet-related policies so as to ensure healthy diets for all. (© The Author(s) 2020. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine.)
Databáze:	MEDLINE
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