Institute for Population and Social Research, Mahidol University, 999 Phutthamonthon 4 Road, Phutthamonthon, Nakhon Pathom, 73170, Thailand.
School of Regulation and Global Governance, Australian National University, Canberra, Australia.
Global Health. 2022 Mar 9;18(1):29. doi: 10.1186/s12992-022-00825-5.
Governance processes play an important role in shaping the formulation and implementation of policy measures such as restrictions on marketing of ultra-processed foods. However, there is limited analysis of the factors that affect governance for nutrition, especially in low- and middle-income countries such as Thailand and the Southeast Asia region. This study aimed to examine governance factors that create opportunities and challenges for the introduction of policy to restrict food marketing in Thailand, in line with the WHO recommendations to restrict food marketing to children.
A qualitative study design was used. Interviews were conducted with 20 actors with experience and in depth knowledge of food marketing in Thailand, including government, civil society, industry and international organisations. Open questions were asked about experiences and perceptions of the governance processes related to policies for restricting food marketing in Thailand. Themes were derived from the 3-i Framework which relates to interests, ideas and institutions influencing the introduction of food marketing policy were identified and analysed using abductive methods.
Actors viewed institutional challenges as a significant barrier to advancing effective regulation of food marketing. Three major clusters emerged from the data: interests (priorities, relationships), institutions (formal structures, informal structures, broader institutional strategies), and ideas (norms). The study has three major findings in relation to these factors, highlighting the influence of formal structures, institutional interests in food marketing issues, and ideas in promoting multisectoralism. The siloed nature of policymaking was reflected in the government failing to stimulate engagement among key actors, posing challenges for implementation of effective policy change. Contested interests led to disagreements between actors over food marketing agenda and thus competing policy priorities. Consistent with these findings, the lack of effective mechanisms to promote multisectoral coordination across diverse actors reinforced barriers to policy change.
The findings highlight ongoing challenges to the government's aim to strengthen policy to restrict food marketing which, without greater coordination in governance mechanisms, will hinder effective regulation and the achievement of public health goals. This analysis suggests that the Government should prioritise the development of a holistic, multisectoral approach to improve governance for better nutrition outcomes by overcoming policy silos.
治理过程在制定和实施政策措施（如限制超加工食品营销）方面发挥着重要作用。然而，对于影响营养治理的因素，特别是在泰国和东南亚等中低收入国家，分析有限。本研究旨在考察为适应世卫组织限制向儿童推销食品的建议而在泰国引入限制食品营销政策的治理因素。
采用定性研究设计。对 20 名在泰国食品营销方面有经验和深入了解的行为者进行了访谈，包括政府、民间社会、行业和国际组织。就泰国与限制食品营销相关的政策的治理过程的经验和看法提出了开放式问题。使用归纳法从 3-i 框架中得出主题，该框架涉及影响食品营销政策引入的利益、理念和制度。
行为者认为体制挑战是有效监管食品营销的重大障碍。数据中出现了三个主要聚类：利益（优先事项、关系）、制度（正式结构、非正式结构、更广泛的制度战略）和理念（规范）。该研究在这些因素方面有三个主要发现，强调了正式结构、食品营销问题的机构利益以及促进多部门主义的理念的影响。政策制定的分散性质反映在政府未能激发关键行为者之间的参与，这对有效政策变革的实施构成了挑战。有争议的利益导致行为者之间在食品营销议程上存在分歧，从而导致竞争政策优先事项。与这些发现一致的是，缺乏促进不同行为者之间多部门协调的有效机制，加剧了政策变革的障碍。
研究结果突出了政府加强限制食品营销政策的目标所面临的持续挑战，如果没有治理机制的更大协调，将阻碍有效监管和实现公共卫生目标。这项分析表明，政府应优先制定全面的多部门办法，通过克服政策分散，改善治理以实现更好的营养成果。
