Swiss Tropical and Public Health Institute, Basel, Switzerland.
University of Basel, Basel, Switzerland.
Int J Health Policy Manag. 2022 Jul 1;11(7):1158-1171. doi: 10.34172/ijhpm.2021.18. Epub 2021 Mar 15.
Food systems affect nutritional and other health outcomes. Recent literature from India has described policy aspects addressing nutritional implications of specific foods (eg, fruits, vegetables, and trans-fats), and identified opportunities to tackle the double burden of malnutrition. This paper attempts to deepen the understanding on how health concerns and the role of the health sector are addressed across food systems policies in India.
This qualitative study used two approaches; namely (i) the framework method and (ii) manifest content analysis, to investigate national-level policy documents from relevant sectors (ie, food security, agriculture, biodiversity, food processing, trade, and waste management, besides health and nutrition). The documents were selected purposively. The textual data were coded and compared, from which themes were identified, described, and interpreted. Additionally, mentions of various health concerns and of the health ministry in the included documents were recorded and collated.
A total of 35 policy documents were included in the analysis. A variety of health concerns spanning nutritional, communicable and non-communicable diseases (NCDs) were mentioned. Undernutrition received specific attention even beyond nutrition policies. Only few policies mentioned NCDs, infectious diseases, and injuries. Governing and advisory bodies were instituted by 17 of the analysed policies (eg, food safety, agriculture, and food processing), and often included representation from the health ministry (9 of the 17 identified inter-ministerial bodies).
We found some evidence of concern for health, and inclusion of health ministry in food policy documents in India. The ongoing and planned intersectoral coordination to tackle undernutrition could inform actions to address other relevant but currently underappreciated concerns such as NCDs. Our study demonstrated a method for analysis of health consideration and intersectoral coordination in food policy documents, which could be applied to studies in other settings and policy domains.
食品系统会影响营养和其他健康结果。印度最近的文献描述了针对特定食品（如水果、蔬菜和反式脂肪）的营养影响的政策方面，并确定了应对营养双重负担的机会。本文试图深入了解印度食品系统政策如何解决健康问题和卫生部门的作用。
本定性研究采用了两种方法；即（i）框架方法和（ii）明显内容分析，以调查来自相关部门（即粮食安全、农业、生物多样性、食品加工、贸易和废物管理，以及卫生和营养）的国家层面政策文件。这些文件是有针对性选择的。对文本数据进行编码和比较，从中确定、描述和解释主题。此外，还记录和整理了所包括文件中提到的各种健康问题和卫生部。
共纳入 35 份政策文件进行分析。提到了各种健康问题，包括营养、传染病和非传染性疾病（NCD）。即使在营养政策之外，也特别关注营养不良问题。只有少数政策提到 NCD、传染病和伤害。分析的 17 项政策（如食品安全、农业和食品加工）制定了治理和咨询机构，并且通常包括卫生部的代表（17 个确定的部际机构中有 9 个）。
我们发现印度对健康的关注和卫生部门在食品政策文件中的参与有一些证据。为解决营养不良问题而进行的正在进行和计划中的部门间协调，可以为解决其他目前被低估的相关问题（如非传染性疾病）提供行动方案。我们的研究展示了一种分析食品政策文件中健康考虑因素和部门间协调的方法，可应用于其他环境和政策领域的研究。
