African Regional Health Education Centre, Department of Health Promotion and Education, Faculty of Public Health, College of Medicine, University of Ibadan, Queen Elizabeth Road, Mokola, Ibadan, Nigeria.
Health Promot Int. 2020 Dec 1;35(6):1383-1393. doi: 10.1093/heapro/daaa009.
Unhealthy diet and physical inactivity are modifiable risk factors for non-communicable diseases. Policies formulated in line with international guidelines are required for the implementation of population-level interventions to reduce the risks. This study describes the utilization of multisectoral approach (MSA) for the formulation of nutrition and physical activity policies and the extent to which they align with the WHO 'Best Buy Interventions'. The research utilized a descriptive case study design and the theoretical model guiding the study was the Walt and Gilson framework for policy analysis. Data were obtained through the interview of 44 key informants using pre-tested guides and document review of 17 policies and articles obtained from government institutions or through the search of electronic databases. Data were integrated and analysed using thematic analysis. Between 2000 and 2016, Nigeria had formulated 10 nutrition-related policies and 5 guidelines with actions to promote physical activity. Only three nutrition and two physical activity policies adopted a high level of MSA. In line with the WHO best buy interventions, educational interventions for the general population are proposed to reduce sugar and salt intake and replace transfat with polyunsaturated fats but there are no legal regulatory acts to support these actions. Policy documents with actions to reduce physical inactivity do not include the WHO best buys. The country should adopt a wider range of actors to formulate and review policies, integrate all the WHO best buy interventions and develop effective legislation to regulate the salt and sugar content of processed foods.
不健康的饮食和缺乏身体活动是非传染性疾病的可改变风险因素。需要制定符合国际准则的政策,以实施人群干预措施,降低风险。本研究描述了多部门办法(MSA)在制定营养和身体活动政策中的应用,以及这些政策在多大程度上符合世卫组织的“最佳购买干预措施”。本研究采用描述性案例研究设计,指导研究的理论模型是 Walt 和 Gilson 政策分析框架。通过对 44 名关键知情者进行访谈,利用预先测试的指南获取数据,并对来自政府机构的 17 项政策和文章以及通过电子数据库搜索获取的政策和文章进行文件审查。通过主题分析对数据进行整合和分析。2000 年至 2016 年期间,尼日利亚制定了 10 项营养相关政策和 5 项促进身体活动的准则,其中只有 3 项营养政策和 2 项身体活动政策采用了高水平的 MSA。根据世卫组织的最佳购买干预措施,建议开展针对普通民众的教育干预措施,以减少糖和盐的摄入量,并以多不饱和脂肪替代反式脂肪,但没有法律监管措施来支持这些行动。减少身体活动不足的政策文件没有包括世卫组织的最佳购买干预措施。该国应扩大参与制定和审查政策的行动者范围,整合所有世卫组织的最佳购买干预措施,并制定有效的立法,以规范加工食品的盐和糖含量。