Health, Education & Labour Department, Institute of Policy Studies of Sri Lanka, Colombo, Sri Lanka.
Menzies Centre for Health Policy and Economics, The University of Sydney, Sydney, Australia.
Glob Health Action. 2023 Dec 31;16(1):2280339. doi: 10.1080/16549716.2023.2280339. Epub 2023 Nov 29.
Unhealthy dietary patterns significantly contribute to rising non-communicable diseases (NCDs) in Sri Lanka. The government has implemented policy measures to promote healthy dietary patterns, including the traffic light labelling (TLL) system for sugar-sweetened beverages (SSBs) in 2016 and taxation on SSBs in 2017.
To analyse how ideas, institutions, and power dynamics influence the formulation and implementation of these two interventions, and to identify strategies for public health actors to advocate for more effective food environment policies in Sri Lanka.
This study drew on Kingdon's theory of agenda-setting and Campbell's institutionalist approach to develop the theoretical framework. We examined the political economy at the policy development and implementation stages, adopting a deductive framework approach for data collection and analysis. Data were collected from documents and key informants.
NCDs and nutrition are recognised and framed as important policy issues in health-sector policy documents, and the SSB tax and TLL system are seen as means of improving diets and health. Sri Lanka's commitment to addressing NCDs and nutrition-related issues is evident through these policies. The Ministry of Health led policy development, and key stakeholders were involved. However, there are opportunities to learn and strengthen policy in Sri Lanka and elsewhere. Limited involvement and commitment of some stakeholders in developing national policies, industry interferences, and other gaps resulted in weaker policy design. Gender considerations were also given minimal attention in policy formulation and implementation.
To enhance the effectiveness of the policies and regulations to promote healthy diets in Sri Lanka, comprehensive policy coverage, multistakeholder involvement and commitment to national policies, balanced power dynamics, technical feasibility, government commitment backed with high-level political support, awareness, and knowledge creation, managing industry interferences, integrating gender considerations are crucial factors.
不健康的饮食模式是导致斯里兰卡非传染性疾病（NCDs）不断上升的主要原因。政府已经采取了政策措施来促进健康的饮食模式，包括 2016 年推出的含糖饮料（SSB）红绿灯标签（TLL）系统和 2017 年对 SSB 征税。
分析思想、制度和权力动态如何影响这两项干预措施的制定和实施，并确定公共卫生行为者在斯里兰卡倡导更有效的食品环境政策的策略。
本研究借鉴了 Kingdon 的议程设置理论和 Campbell 的制度主义方法来制定理论框架。我们在政策制定和实施阶段考察了政治经济，采用了演绎框架方法进行数据收集和分析。数据来自文件和主要知情人。
非传染性疾病和营养在卫生部门政策文件中被认为是重要的政策问题，SSB 税和 TLL 系统被视为改善饮食和健康的手段。斯里兰卡通过这些政策表明了其致力于解决非传染性疾病和与营养相关问题的承诺。卫生部主导了政策制定，关键利益相关者也参与其中。然而，斯里兰卡和其他地方有机会学习和加强政策。一些利益相关者在制定国家政策方面的参与度和承诺有限、行业干扰以及其他差距导致政策设计较弱。在政策制定和实施中，性别问题也没有得到足够的关注。
为了提高斯里兰卡促进健康饮食政策和法规的有效性，全面的政策覆盖、多利益攸关方的参与和对国家政策的承诺、平衡的权力动态、技术可行性、政府支持和高级别政治支持、提高认识和知识创造、管理行业干扰以及纳入性别考虑因素是至关重要的因素。
