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非洲超重和肥胖预防与控制相关政策的范围综述

A Scoping Review of Policies Related to the Prevention and Control of Overweight and Obesity in Africa.

机构信息

Nutrition Research Centre, Radiological and Medical Sciences Research Institute, Ghana Atomic Energy Commission, Accra LG80, Ghana.

Division of Health Systems and Public Health, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town 7505, South Africa.

出版信息

Nutrients. 2021 Nov 11;13(11):4028. doi: 10.3390/nu13114028.

Abstract

To address the issue of obesity, the World Health Organization (WHO) recommends a set of comprehensive programmes aimed at changing the obesogenic environments to provide opportunities for healthy food options and increased physical activity in the school, home, and at the population level. The objectives of this study were to examine the nature and range of policies related to overweight and obesity prevention in Africa, and to assess how they align with international guidelines. An existing methodological framework was adapted for this scoping review. A search of publicly available national documents on overweight/obesity, general health, and non-communicable diseases (NCDs) was undertaken from relevant websites, including WHO, ministries, and Google Scholar. Additional requests were sent to key contacts at relevant ministries about existing policy documents. The documents were reviewed, and the policies were categorised, using the Analysis Grid for Environments Linked to Obesity (ANGELO) framework. The framework categorises the environmental drivers of obesity into four domains (physical, economic, legislative, and socio-cultural) and two scales: macro (national, regional, sectors, food industries, media, etc.) and micro (household, institutional, and community). This review included documents from 41 African countries. The policy initiatives to prevent overweight/obesity target the school, family and community settings, and macro environments, and broadly align with global recommendations. The NCD documents were in the majority, with only two on obesity. The majority of the documents detailed strategies and key interventions on unhealthy diets and physical inactivity. The physical, legislative, and sociocultural domains were largely featured, with less emphasis on the economic domain. Additionally, nutrition- and diet-related policies were in the majority. Overlaps and interactions of policies were observed in the application of the ANGELO framework. This study has provided information on national policies and programmes in Africa and can be useful as a first point of call for policymakers. The overlapping and interaction in the initiatives demonstrate the importance of multi-sectoral partnerships in providing supportive environments for healthy behaviours.

摘要

为了解决肥胖问题,世界卫生组织(WHO)建议制定一套综合计划,旨在改变致肥胖环境,为学校、家庭和人群层面提供健康食品选择和增加身体活动的机会。本研究的目的是考察非洲与超重和肥胖预防相关的政策的性质和范围,并评估其与国际准则的一致性。本研究采用现有的方法框架进行了这一范围界定审查。从相关网站(包括世卫组织、部委和谷歌学术)搜索了有关超重/肥胖、一般健康和非传染性疾病(NCD)的公开国家文件。向相关部委的主要联系人额外请求了现有政策文件。使用肥胖相关环境分析网格(ANGELO)框架审查了这些文件并对政策进行了分类。该框架将肥胖的环境驱动因素分为四个领域(物理、经济、立法和社会文化)和两个尺度:宏观(国家、区域、部门、食品工业、媒体等)和微观(家庭、机构和社区)。本审查包括来自 41 个非洲国家的文件。预防超重/肥胖的政策举措针对学校、家庭和社区环境以及宏观环境,并广泛符合全球建议。NCD 文件占多数,仅有两份关于肥胖的文件。大多数文件详细说明了不健康饮食和缺乏身体活动的战略和关键干预措施。物理、立法和社会文化领域得到了广泛关注,而经济领域则关注较少。此外,营养和饮食相关政策占多数。在应用 ANGELO 框架时观察到政策的重叠和相互作用。本研究提供了非洲国家政策和计划的信息,可作为政策制定者的首要参考。倡议中的重叠和相互作用表明了多部门伙伴关系在提供支持健康行为的环境方面的重要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ace2/8625107/713286532682/nutrients-13-04028-g001.jpg

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