DIYASU Community Development Centre, Biratnagar, Morang, Nepal.
Massey University, Wellington, Wellington Region, New Zealand.
PLoS One. 2023 Feb 6;18(2):e0281355. doi: 10.1371/journal.pone.0281355. eCollection 2023.
Unhealthy dietary habits and physical inactivity are major risk factors of non-communicable diseases (NCDs) globally. The objective of this paper was to describe the role of dietary practices and physical activity in the interaction of the social determinants of NCDs in Nepal, a developing economy. The study was a qualitative study design involving two districts in Nepal, whereby data was collected via key informant interviews (n = 63) and focus group discussions (n = 12). Thematic analysis of the qualitative data was performed, and a causal loop diagram was built to illustrate the dynamic interactions of the social determinants of NCDs based on the themes. The study also involved sense-making sessions with policy level and local stakeholders. Four key interacting themes emerged from the study describing current dietary and physical activity practices, influence of junk food, role of health system and socio-economic factors as root causes. While the current dietary and physical activity-related practices within communities were unhealthy, the broader determinants such as socio-economic circumstances and gender further fuelled such practices. The health system has potential to play a more effective role in the prevention of the behavioural and social determinants of NCDs.
不健康的饮食习惯和缺乏身体活动是非传染性疾病（NCDs）在全球范围内的主要危险因素。本文旨在描述尼泊尔这样一个发展中经济体中，饮食实践和身体活动在 NCD 社会决定因素相互作用中的作用。本研究采用定性研究设计，涉及尼泊尔的两个地区，通过关键知情人访谈（n=63）和焦点小组讨论（n=12）收集数据。对定性数据进行了主题分析，并根据主题构建了一个因果关系图，以说明 NCD 社会决定因素的动态相互作用。该研究还涉及与政策层面和当地利益相关者的意义建构会议。研究中出现了四个关键的相互作用主题，描述了当前的饮食和身体活动实践、垃圾食品的影响、卫生系统的作用以及社会经济因素作为根本原因。虽然社区内当前的饮食和与身体活动相关的实践是不健康的，但更广泛的决定因素，如社会经济情况和性别，进一步加剧了这些实践。卫生系统有可能在预防 NCD 的行为和社会决定因素方面发挥更有效的作用。
