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将多部门的食品和营养相关政策付诸实施,以遏制加纳肥胖率的上升。

Operationalising multi-sectoral food- and nutrition-related policies to curb the rise in obesity in Ghana.

机构信息

Department of Dietetics, School of Biomedical and Allied Health Sciences, College of Health Sciences, University of Ghana, P.O. Box KB143, Accra, Ghana.

Department of Biochemistry and Biotechnology, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.

出版信息

Public Health Nutr. 2023 Dec;26(12):3230-3238. doi: 10.1017/S136898002300037X. Epub 2023 Feb 27.

Abstract

OBJECTIVE

To examine the governance of the food and nutrition policy space with particular reference to interests and power among stakeholders.

DESIGN

We followed a case study research design to conduct a nutrition policy analysis. We triangulated three sources of data: key-informant interviews, learning journey and relevant policy documents (2010-2020). This study is grounded in a conceptual framework focused on power.

SETTING

Ghana.

PARTICIPANTS

Key informants ( 28) drawn from policy stakeholders from government (Health, Agriculture, Trade and Industry), academia, civil society, development partners, civil society organisation (CSO) and private sector in Accra and Kumasi.

RESULTS

Power relations generated tensions, leading to weak multi-sectoral coordination among actors within the nutrition policy space. Governance and funding issues were identified as reasons for the weak multi-sectoral coordination. Formal power rested with government institutions while the private sector and CSO pushed to be invited during policy formulation. Visible stakeholders from industry were trade oriented and held a common interest of profit-making; they sought to receive support from government in order to be more competitive. There were no observed structures at the subnational levels for effective link with the national level.

CONCLUSION

Formal responsibility for decision making within the nutrition and food policy space rested with the health sector and bringing on board nutrition-related sectors remained a challenge due to power tensions. Establishing a National Nutrition Council, with structures at the subnational level, will strengthen policy coordination and implementation. Taxation of sugar-sweetened beverages could provide a fund generation avenue for coordination of programmes to curb obesity.

摘要

目的

特别关注利益相关者之间的利益和权力,考察食品和营养政策领域的治理。

设计

我们采用案例研究设计进行营养政策分析。我们对三种数据来源进行了三角分析:关键知情者访谈、学习之旅和相关政策文件(2010-2020 年)。本研究基于一个关注权力的概念框架。

地点

加纳。

参与者

来自政府(卫生、农业、贸易和工业)、学术界、民间社会、发展伙伴、民间社会组织(CSO)和私营部门的利益相关者中的关键知情者(28 人),来自阿克拉和库马西的营养政策领域。

结果

权力关系产生了紧张局势,导致营养政策领域内各行为者之间的多部门协调不力。治理和供资问题被确定为多部门协调不力的原因。正式权力属于政府机构,而私营部门和 CSO 则争取在政策制定过程中被邀请参与。来自工业界的明显利益相关者以贸易为导向,有着共同的盈利利益;他们寻求从政府获得支持,以提高竞争力。在国家以下各级没有观察到与国家一级有效联系的结构。

结论

营养和食品政策领域的决策正式责任在于卫生部门,由于权力紧张,让与营养相关的部门参与进来仍然是一个挑战。建立一个国家营养理事会,并在国家以下各级建立结构,将加强政策协调和执行。对含糖饮料征税可以为遏制肥胖症的方案协调提供资金来源。

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