Menzies Centre for Health Policy and Economics, Faculty of Medicine and Health, Charles Perkins Centre, The University of Sydney, City Road, Sydney, NSW, 2006, Australia.
Fiji National University, Suva, Fiji.
Global Health. 2022 Sep 1;18(1):79. doi: 10.1186/s12992-022-00859-9.
Noncommunicable diseases (NCDs) are the leading cause of death globally, and the World Health Organization (WHO) has recommended a comprehensive policy package for their prevention and control. However, implementing robust, best-practice policies remains a global challenge. In Fiji, despite political commitment to reducing the health and economic costs of NCDs, prevalence of diabetes and cardiovascular disease remain the highest in the region. The objective of this study was to describe the political and policy context for preventing diet-related NCDs in Fiji and policy alignment with WHO recommendations and global targets. We used a case study methodology and conducted (1) semi-structured key informant interviews with stakeholders relevant to diet-related NCD policy in Fiji (n = 18), (2) documentary policy analysis using policy theoretical frameworks (n = 11), (3) documentary stakeholder analysis (n = 7), and (4) corporate political activity analysis of Fiji's food and beverage industry (n = 12). Data were sourced through publicly available documents on government websites, internet searches and via in-country colleagues and analysed thematically.
Opportunities to strengthen and scale-up NCD policies in Fiji in line with WHO recommendations included (1) strengthening multisectoral policy engagement, (2) ensuring a nutrition- and health-in-all policy approach, (3) using a whole-of-society approach to tighten political action across sectors, and (4) identifying and countering food industry influence.
Diet-related NCD policy in Fiji will be strengthened with clearly defined partner roles, responsibilities and accountability mechanisms, clear budget allocation and strong institutional governance structures that can support and counter industry influence. Such initiatives will be needed to reduce the NCD burden in Fiji.
非传染性疾病（NCDs）是全球死亡的主要原因，世界卫生组织（WHO）已建议采取一整套综合政策来预防和控制 NCDs。然而，实施强有力的、最佳实践的政策仍然是一个全球性的挑战。在斐济，尽管有政治承诺来降低 NCD 对健康和经济的影响，但糖尿病和心血管疾病的患病率仍然是该地区最高的。本研究的目的是描述斐济预防与饮食相关的 NCD 的政治和政策背景，以及政策与 WHO 建议和全球目标的一致性。我们使用案例研究方法进行了以下研究：（1）对斐济与饮食相关的 NCD 政策相关的利益相关者进行半结构的关键人物访谈（n=18）；（2）使用政策理论框架进行政策文件分析（n=11）；（3）进行政策利益相关者分析（n=7）；（4）对斐济的食品和饮料行业的公司政治活动进行分析（n=12）。通过政府网站上的公开文件、互联网搜索以及通过国内同事，获取并分析了数据。
有机会加强和扩大斐济与 WHO 建议一致的 NCD 政策，包括：（1）加强多部门政策参与；（2）确保采取营养和健康综合政策方法；（3）利用全社会方法加强各部门的政治行动；（4）确定和抵制食品行业的影响。
通过明确界定合作伙伴的角色、责任和问责机制，明确预算分配以及支持和抵制行业影响的强大机构治理结构，斐济的饮食相关 NCD 政策将得到加强。这些举措将有助于减少斐济的 NCD 负担。
