Fox Ashley M, Balarajan Yarlini, Cheng Chloe, Reich Michael R
Department of Health Evidence and Policy, Mount Sinai School of Medicine, One Gustave L. Levy Place, New York, NY 10029, USA and Nutrition Section, Programme Division, United Nations Children's Fund (UNICEF), Three United Nations Plaza, New York, NY 10017, USA, Department of Health Evidence and Policy, Mount Sinai School of Medicine, One Gustave L. Levy Place, New York, NY 10029, USA, Department of Global Health and Population, Harvard School of Public Health, 665 Huntington Avenue, Boston, MA 02115, USA
Department of Health Evidence and Policy, Mount Sinai School of Medicine, One Gustave L. Levy Place, New York, NY 10029, USA and Nutrition Section, Programme Division, United Nations Children's Fund (UNICEF), Three United Nations Plaza, New York, NY 10017, USA, Department of Health Evidence and Policy, Mount Sinai School of Medicine, One Gustave L. Levy Place, New York, NY 10029, USA, Department of Global Health and Population, Harvard School of Public Health, 665 Huntington Avenue, Boston, MA 02115, USA.
Health Policy Plan. 2015 Jun;30(5):566-78. doi: 10.1093/heapol/czu035. Epub 2014 Jun 5.
Lack of political commitment has been identified as a primary reason for the low priority that food and nutrition interventions receive from national governments relative to the high disease burden caused by malnutrition. Researchers have identified a number of factors that contribute to food and nutrition's 'low-priority cycle' on national policy agendas, but few tools exist to rapidly measure political commitment and identify opportunities to advance food and nutrition on the policy agenda. This article presents a theory-based rapid assessment approach to gauging countries' level of political commitment to food and nutrition security and identifying opportunities to advance food and nutrition on the policy agenda. The rapid assessment tool was piloted among food and nutrition policymakers and planners in 10 low- and middle-income countries in April to June 2013. Food and nutrition commitment and policy opportunity scores were calculated for each country and strategies to advance food and nutrition on policy agendas were designed for each country. The article finds that, in a majority of countries, political leaders had verbally and symbolically committed to addressing food and nutrition, but adequate financial resources were not allocated to implement specific programmes. In addition, whereas the low cohesion of the policy community has been viewed a major underlying cause of the low-priority status of food and nutrition, the analysis finds that policy community cohesion and having a well thought-out policy alternative were present in most countries. This tool may be useful to policymakers and planners providing information that can be used to benchmark and/or evaluate advocacy efforts to advance reforms in the food and nutrition sector; furthermore, the results can help identify specific strategies that can be employed to move the food and nutrition agenda forward. This tool complements others that have been recently developed to measure national commitment to advancing food and nutrition security.
缺乏政治承诺已被视为国家政府对粮食和营养干预措施重视程度较低的主要原因,而营养不良造成的疾病负担却很高。研究人员已经确定了一些导致粮食和营养在国家政策议程上处于“低优先级循环”的因素,但几乎没有工具可以快速衡量政治承诺并确定在政策议程上推进粮食和营养的机会。本文提出了一种基于理论的快速评估方法,以衡量各国对粮食和营养安全的政治承诺水平,并确定在政策议程上推进粮食和营养的机会。2013年4月至6月,在10个低收入和中等收入国家的粮食和营养政策制定者及规划者中试用了该快速评估工具。计算了每个国家的粮食和营养承诺及政策机会得分,并为每个国家设计了在政策议程上推进粮食和营养的战略。文章发现,在大多数国家,政治领导人在口头上和象征性地承诺解决粮食和营养问题,但没有分配足够的财政资源来实施具体方案。此外,虽然政策群体的低凝聚力被视为粮食和营养处于低优先级地位的一个主要潜在原因,但分析发现,大多数国家都存在政策群体凝聚力和经过深思熟虑的政策选择。该工具可能对政策制定者和规划者有用,提供可用于衡量和/或评估推进粮食和营养部门改革的宣传努力的信息;此外,结果有助于确定可用于推动粮食和营养议程前进的具体战略。该工具补充了最近开发的其他用于衡量国家对推进粮食和营养安全承诺的工具。