Walls Helen, Johnston Deborah, Matita Mirriam, Kamwanja Tayamika, Smith Richard, Nanama Simeon
Department of Global Heath and Development, Faculty of Public Health & Policy, London School of Hygiene & Tropical Medicine, London, United Kingdom.
Department of Economics, SOAS University of London, London, United Kingdom.
PLOS Glob Public Health. 2023 Oct 11;3(10):e0002410. doi: 10.1371/journal.pgph.0002410. eCollection 2023.
The concept of food and nutrition policy has broadened from simply being an aspect of health policy, to policy interventions from across a wide range of sectors, but still with potentially important impact on nutritional outcomes. This wider and more complex conceptualisation involves policy with multiple objectives and stakeholder influences. Thus, it becomes particularly important to understand the dynamics of these policy processes, including policy design and implementation. To add to this literature, we apply the Kaleidoscope Model for understanding policy change in developing country contexts to the case-study of an agricultural input subsidy (AIS) programme in Malawi, the Farm Input Subsidy Programme (FISP), exploring the dynamics of the FISP policy process including nutritional impact. Over a three-month period between 2017 and 2019 we conducted in-depth interviews with key stakeholders at national and district levels, and focus groups with people from rural districts in Malawi. We also undertook a review of literature relating to the political economy of the FISP. We analysed the data thematically, as per the domains of the Kaleidoscope Model. The analysis across the FISP policy process including policy design and implementation highlights how stakeholders' ideas, interests and influence have shaped the evolution of FISP policy including constraints to policy improvement-and the nutritional impacts of this. This approach extends the literature on the tensions, contradictions and challenges in food and nutrition policy by examining the reasons that these occur in Malawi with the FISP. We also add to the political science and policy analysis literature on policy implementation, extending the concept of veto players to include those targeted by the policy. The findings are important for consideration by policymakers and other stakeholders seeking to address malnutrition in rural, food-insecure populations in Malawi and other low-income settings.
食品与营养政策的概念已从仅仅作为卫生政策的一个方面，扩展到涵盖广泛领域的政策干预，但这些干预仍可能对营养结果产生重要影响。这种更广泛、更复杂的概念化涉及具有多个目标和利益相关者影响的政策。因此，理解这些政策过程的动态，包括政策设计和实施，变得尤为重要。为丰富这方面的文献，我们将用于理解发展中国家政策变化的万花筒模型应用于马拉维农业投入补贴（AIS）计划——农业投入补贴计划（FISP）的案例研究，探讨FISP政策过程的动态，包括其营养影响。在2017年至2019年的三个月期间，我们对国家和地区层面的关键利益相关者进行了深入访谈，并与马拉维农村地区的民众进行了焦点小组讨论。我们还对与FISP政治经济相关的文献进行了综述。我们按照万花筒模型的领域对数据进行了主题分析。对包括政策设计和实施在内的FISP政策过程的分析突出了利益相关者的想法、利益和影响力如何塑造了FISP政策的演变，包括政策改进的制约因素以及由此产生的营养影响。这种方法通过研究在马拉维FISP中出现这些情况的原因，扩展了关于食品与营养政策中的紧张关系、矛盾和挑战的文献。我们还为关于政策实施的政治学和政策分析文献做出了贡献，将否决参与者的概念扩展到包括政策的目标对象。这些研究结果对于寻求解决马拉维和其他低收入地区农村粮食不安全人口营养不良问题的政策制定者和其他利益相关者具有重要的参考价值。
