Department of Community Nutrition, Faculty of Nutrition, Tabriz University of Medical Sciences, Tabriz, Iran.
Department of Health Policy and Management, School of Management and Medical Informatics, Tabriz University of Medical Sciences, Tabriz, Iran.
BMC Pediatr. 2021 May 27;21(1):250. doi: 10.1186/s12887-021-02731-y.
Pediatric obesity is one of the most important health challenges of the twenty-first century. Primary prevention of childhood obesity, can lessen its consequences. This study aims to assess childhood obesity prevention policies in Iran through a policy analysis of agenda-setting using Kingdon's multiple streams.
A qualitative study was conducted using in-depth interviews with 39 key informants and document review from different stages of the policymaking process of childhood and adolescent obesity prevention programs in Iran. The analysis of documents and interviews were guided based on Kingdon's multiple streams (problem, policy and political streams).
The important factors of the problem stream were the high prevalence of childhood and adolescent obesity and its risk factors in Iran. In the policy stream, a focus on preventing non-communicable diseases in the health system, increasing the workforce in health centers, promoting health school programs, and creating healthy eating buffets in schools was identified. Under the political stream, the impact of the WHO ECHO program in 2015 and the implementation of the health system transformation plan in Iran in the new government took place after 2013, caused the Iran ECHO program entered the agenda and implemented from 2016.
Now that a window of opportunity for childhood and adolescent obesity prevention policymaking has been created, the problems such as the therapeutic approach in the health system, the existence of sanctions against Iran and outbreak of coronavirus disease-19 (COVID-19), have hindered the successful implementation of this policy and the opportunity window has not been well used. However, actors need political support from the high levels of government to keep this policy on the agenda.
儿科肥胖是 21 世纪最重要的健康挑战之一。对儿童肥胖进行初级预防可以减轻其后果。本研究旨在通过使用 Kingdon 的多流分析来评估议程设置中的伊朗儿童肥胖预防政策。
采用定性研究方法，对 39 名关键知情者进行深入访谈，并对伊朗儿童和青少年肥胖预防计划制定过程的不同阶段进行文件审查。根据 Kingdon 的多流（问题、政策和政治流）对文件和访谈进行分析。
问题流的重要因素是伊朗儿童和青少年肥胖及其危险因素的高患病率。在政策流中，重点是在卫生系统中预防非传染性疾病，增加卫生中心的工作人员，促进健康学校计划，并在学校设立健康饮食自助餐。在政治流中，2015 年世卫组织 ECHO 计划的影响以及 2013 年后伊朗新政府实施卫生系统转型计划，导致伊朗 ECHO 计划进入议程并于 2016 年实施。
既然已经为儿童和青少年肥胖预防政策制定创造了机会之窗，但诸如卫生系统中的治疗方法、对伊朗的制裁以及冠状病毒病-19（COVID-19）的爆发等问题，阻碍了这一政策的成功实施，机会之窗也没有得到很好地利用。然而，行为者需要政府高层的政治支持，以使这一政策继续列入议程。
