The George Institute for Global Health, The University of New South Wales, Sydney, NSW 2042, Australia.
School of Public Health, Mekelle University, Mekelle 1871, Ethiopia.
Nutrients. 2023 Apr 3;15(7):1745. doi: 10.3390/nu15071745.
Despite the importance of salt reduction to health outcomes, relevant policy adoption in Ethiopia has been slow, and dietary consumption of sodium remains relatively high.
This analysis aims to understand the content and context of existing food-related policy, strategy, and guideline documents to identify gaps and potential opportunities for salt reduction in Ethiopia in the wider context of global evidence-informed best practice nutrition policy.
Policy documents relevant to food and noncommunicable diseases (NCDs), published between 2010 and December 2021, were identified through searches of government websites supplemented with experts' advice. Documentary analysis was conducted drawing on the 'policy cube' which incorporates three dimensions: (i) comprehensiveness of policy measures, which for this study included the extent to which the policy addressed the food-related WHO "Best Buys" for the prevention of NCDs; (ii) policy salience and implementation potential; and (iii) equity (including gender) and human rights orientation.
Thirty-two policy documents were retrieved from government ministries, of which 18 were deemed eligible for inclusion. A quarter of these documents address diet-related "Best Buys" through the promotion of healthy nutrition and decreasing consumption of excess sodium, sugar, saturated fat, and trans-fats. The remainder focuses on maternal and child health and micronutrient deficiencies. All documents lack detail relating to budget, monitoring and evaluation, equity, and rights.
This review demonstrates that the Government of Ethiopia has established policy frameworks highlighting its intention to address NCDs, but that there is an opportunity to strengthen these frameworks to improve the implementation of salt reduction programs. This includes a more holistic approach, enhanced clarification of implementation responsibilities, stipulation of budgetary allocations, and promoting a greater focus on inequities in exposure to nutrition interventions across population groups. While the analysis has identified gaps in the policy frameworks, further qualitative research is needed to understand why these gaps exist and to identify ways to fill these gaps.
尽管减少盐的摄入对健康结果至关重要，但埃塞俄比亚相关政策的采纳速度缓慢，饮食中钠的摄入量仍然相对较高。
本分析旨在了解现有与食品相关的政策、战略和指导方针文件的内容和背景，以确定在全球循证最佳实践营养政策背景下，埃塞俄比亚在减少盐方面的差距和潜在机会。
通过搜索政府网站并辅以专家建议，确定了 2010 年至 2021 年 12 月期间与食品和非传染性疾病相关的政策文件。通过借鉴“政策魔方”（policy cube）进行文件分析，该魔方包含三个维度：（i）政策措施的全面性，就本研究而言，包括政策在多大程度上解决了世界卫生组织预防非传染性疾病的“最佳购买”食品相关问题；（ii）政策的突出性和实施潜力；以及（iii）公平性（包括性别）和人权导向。
从政府各部门检索到 32 份政策文件，其中 18 份被认为符合纳入标准。其中四分之一的文件通过促进健康营养和减少过量摄入的钠、糖、饱和脂肪和反式脂肪来解决与饮食相关的“最佳购买”问题。其余的重点是母婴健康和微量营养素缺乏。所有文件都缺乏与预算、监测和评估、公平性和权利相关的细节。
本审查表明，埃塞俄比亚政府已经制定了强调其解决非传染性疾病意图的政策框架，但有机会加强这些框架，以改善减少盐计划的实施。这包括采取更全面的方法，更明确地阐明实施责任，规定预算拨款，并促进更加关注营养干预措施在不同人群中的不公平现象。虽然分析已经确定了政策框架中的差距，但需要进行进一步的定性研究，以了解为什么存在这些差距，并确定填补这些差距的方法。
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