Research Initiative for Cities Health and Equity (RICHE), Division of Public Health Medicine, School of Public Health and Family Medicine, University of Cape Town, Cape Town 7925, South Africa.
African Centre for Cities, University of Cape Town, Cape Town 7701, South Africa.
Int J Environ Res Public Health. 2021 Oct 26;18(21):11246. doi: 10.3390/ijerph182111246.
Noncommunicable diseases contribute the greatest to global mortality. Unhealthy diet-a prominent risk factor-is intricately linked to urban built and food environments and requires intersectoral efforts to address. Framings of the noncommunicable disease problem and proposed solutions within global and African regional diet-related policy documents can reveal how amenable the policy landscape is for supporting intersectoral action for health in low-income to middle-income countries. This study applied a document analysis approach to undertake policy analysis on global and African regional policies related to noncommunicable disease and diet. A total of 62 global and 29 African regional policy documents were analysed. Three problem frames relating to noncommunicable disease and diet were identified at the global and regional level, namely evidence-based, development, and socioeconomic frames. Health promotion, intersectoral and multisectoral action, and evidence-based monitoring and assessment underpinned proposed interventions to improve education and awareness, support structural changes, and improve disease surveillance and monitoring. African policies insufficiently considered associations between food security and noncommunicable disease. In order to effectively address the noncommunicable disease burden, a paradigm shift from 'health for development' to 'development for health' is required across non-health sectors. Noncommunicable disease considerations should be included within African food security agendas, using malnutrition as a possible intermediary concept to motivate intersectoral action to improve access to nutritious food in African low-income to middle-income countries.
非传染性疾病对全球死亡率的影响最大。不健康的饮食——一个突出的风险因素——与城市建设和食品环境密切相关，需要跨部门努力来解决。从全球和非洲区域与饮食有关的政策文件中对非传染性疾病问题的表述和提出的解决方案，可以揭示政策环境在多大程度上有利于支持低收入和中等收入国家的跨部门健康行动。本研究采用文件分析方法，对与非传染性疾病和饮食有关的全球和非洲区域政策进行了政策分析。共分析了 62 份全球政策文件和 29 份非洲区域政策文件。在全球和区域层面确定了与非传染性疾病和饮食有关的三个问题框架，即基于证据的框架、发展框架和社会经济框架。健康促进、跨部门和多部门行动以及基于证据的监测和评估是改善教育和提高认识、支持结构改革以及改善疾病监测和监测的拟议干预措施的基础。非洲政策没有充分考虑粮食安全与非传染性疾病之间的关系。为了有效应对非传染性疾病负担，需要在非卫生部门实现从“发展促进健康”到“健康促进发展”的范式转变。应将非传染性疾病问题纳入非洲粮食安全议程，利用营养不良作为一个可能的中间概念，推动跨部门行动，改善非洲低收入和中等收入国家获得营养食品的机会。
