Damari Behzad, Abdollahi Zahra, Pourghaderi Mona, Mohammadi-Nasrabadi Fatemeh
Department of Governance and Health, Brain and Spinal Cord Injury Research Center, Neuroscience Institute, Tehran University of Medical Science and Health Services, Tehran, Islamic Republic of Iran.
Department of Community Nutrition, Deputy of Health, Iran Ministry of Health Treatment and Medical Education, Tehran, Islamic Republic of Iran.
Int J Prev Med. 2020 Oct 17;11:173. doi: 10.4103/ijpvm.IJPVM_405_19. eCollection 2020.
National Nutrition and Food Security Policy of Iran was developed and ordered by Office of Community Nutrition Improvement, in cooperation with National Nutrition and Food Technology Research Institute and National Institute of Health Research in 2012. This study was aimed at evaluating the success of the operationalization of the Policy between 2012 and 2015 and using the lessons learned in future policies.
The participatory evaluation was conducted by taking part of all main partners including trustee organizations involved in implementation of the document, specialists and academic researchers, people's deputies, health service, headquarters experts at Ministry of Health. Three qualitative methods including reviewing evidences, interviews, and focus group discussions have been used to gather information. The degree of achievement of the document's strategic objectives, as well as the degree of adaptation of the document implementation to the desired state, has been determined.
The mean percentage of progress in achieving outcomes and adaptation of the deployment method to ideal criteria (for 2016) of the National Document on Food and Nutrition Security from 2013 to 2017 are 52.6% and 41%, respectively. The best success was found in the existence of an evidence-based program (70%), a coalition of policy implementation (66.1%), and indicators for monitoring the progress of the document (61.1%). The least success was related to the weakness of public justification and public participation (20%) and lack of ranking and encouraging partners' function (24%). Lack of approval of the national document at the High Council for Health and Food Security of the country (HCHFS) was the important factor which led to less progress of the document.
It is recommended to target avoiding structural changes while saving time, strengthening intersectoral capacity for collaboration, encouraging partners, and empowering the environment of the provinces in the coming years.
伊朗国家营养与食品安全政策由社区营养改善办公室与国家营养与食品技术研究所及国家卫生研究院合作制定并于2012年颁布。本研究旨在评估该政策在2012年至2015年期间实施的成效,并汲取经验教训以用于未来政策。
参与式评估由所有主要合作伙伴参与进行,包括参与文件实施的受托组织、专家和学术研究人员、人民代表、卫生服务机构、卫生部总部专家。采用了三种定性方法,包括审查证据、访谈和焦点小组讨论来收集信息。确定了文件战略目标的实现程度以及文件实施与预期状态的适配程度。
2013年至2017年期间,国家食品与营养安全文件在实现成果方面的平均进展百分比以及部署方法与理想标准(2016年)的适配度分别为52.6%和41%。在基于证据的项目(70%)、政策实施联盟(66.1%)以及文件进展监测指标(61.1%)方面取得的成功最佳。最不成功的方面是公众宣传和公众参与薄弱(20%)以及缺乏对合作伙伴职能的排名和激励(24%)。国家卫生与食品安全高级委员会(HCHFS)未批准国家文件是导致该文件进展较少的重要因素。
建议在未来几年避免进行结构性变革的同时节省时间,加强跨部门协作能力,激励合作伙伴,并增强各省的环境力量。