Instituto Nacional de Salud Pública, Cuernavaca, Morelos 62100, México.
Centro de Investigación en Nutrición y Salud, Instituto Nacional de Salud Pública, Cuernavaca, Morelos 62100, México.
Nutrients. 2019 Mar 12;11(3):594. doi: 10.3390/nu11030594.
Malnutrition and poor diet are the largest risk factors responsible for the global burden of disease. Therefore, ending all forms of malnutrition by 2030 is a global priority. To achieve this goal, a key element is to design and implement nutrition policies based on the best available scientific evidence. The demand for evidence-based nutrition policies may originate directly from policymakers or through social actors. In both cases, the role of research institutions is to generate relevant evidence for public policy. The two key objects of analysis for the design of an effective policy are the nutrition conditions of the population and the policies and programs available, including the identification of delivery platforms and competencies required by personnel in charge of the provision of services (social response). In addition, systematic literature reviews about risk factors of malnutrition, as well as the efficacy and effectiveness of policy actions, lead to evidence-based policy recommendations. Given the multifactorial nature of malnutrition, the drivers and risk factors operate in several sectors (food and agriculture, health, education, and social development) and may be immediate, underlying or basic causes. This multilevel complexity should be considered when developing nutrition policy. In this article, we show two models for the evidence-based design of nutrition policies and programs that may be useful to academia and decision makers demonstrated by two examples of policy design, implementation and evaluation in Mexico.
营养不良和饮食不良是导致全球疾病负担的最大风险因素。因此,到 2030 年消除所有形式的营养不良是全球的优先事项。为了实现这一目标,一个关键要素是根据最佳现有科学证据设计和实施营养政策。对循证营养政策的需求可能直接来自政策制定者,也可能来自社会行为者。在这两种情况下,研究机构的作用都是为公共政策提供相关证据。设计有效政策的两个关键分析对象是人口的营养状况和现有的政策和方案,包括确定服务提供人员(社会响应)所需的交付平台和能力。此外,关于营养不良风险因素以及政策行动的效果和有效性的系统文献综述可导致循证政策建议。鉴于营养不良的多因素性质,驱动因素和风险因素在多个部门(食品和农业、卫生、教育和社会发展)中起作用,可能是直接、潜在或基本原因。在制定营养政策时应考虑到这种多层次的复杂性。本文通过两个政策设计、实施和评估的墨西哥实例,展示了两种可能对学术界和决策者有用的循证营养政策和方案设计模型。