How well do national and local policies in England relevant to maternal and child health meet the international standard for non-communicable disease prevention? A policy analysis

Abstract

Objectives(1) To identify national policies for England and local policies for Southampton City that are relevant to maternal and child health. (2) To quantify the extent to which these policies meet the international standards for nutrition and physical activity initiatives set out in the WHO Global Action Plan for the Prevention and Control of Non-Communicable Diseases (WHO Action Plan).DesignThe policy appraisal process involved three steps: (1) identifying policy documents relevant to maternal and infant health, (2) developing a policy appraisal framework from the WHO Action Plan, and (3) analysing the policies using the framework.SettingEngland and Southampton City.Participants57 national and 10 local policies.ResultsAcross both national and local policies, priority areas supporting public health processes, such as evidence-based practice, were adopted more frequently than the action-oriented areas targeting maternal and child dietary and physical activity behaviours. However, the policy option managing conflicts of interest was rarely considered in the national policies (12%), particularly in white papers or evidence-based guidelines. For the action-oriented priority areas, maternal health policy options were more frequently considered than those related to child health or strengthening health systems. Complementary feeding guidance (9%) and workforce training in empowerment skills (14%) were the least frequent action-oriented policy options adopted among the national policies. The maternal nutrition-focused and workforce development policy options were least frequent among local policies adopted in 10% or fewer. Macroenvironmental policy options tended to have a lower priority than organisational or individual options among national policies (p=0.1) but had higher priority among local policies (p=0.02).ConclusionsFurther action is needed to manage conflicts of interest and adopt policy options that promote a system-wide approach to address non-communicable diseases caused by poor diet and physical inactivity.

Preconception health in England: a proposal for annual reporting with core metrics

“…The priority that government and food industry place on developing an environment supportive of preconception health and nutrition could be monitored through content analyses of national and local government policy documents and publicly available information from national food retailers and manufacturers (corporate social responsibility statements and company websites). The findings from these analyses would provide an overview of the commitment and leadership of these organisations to optimising preconception health and could provide impetus for generating future action through competition [16,17]. Progress on key environmental indicators can also be measured using national datasets.…”

Impact of Policies in Nutrition and Physical Activity on Diabetes and Its Risk Factors in the 28 Member States of the European Union

“…The more under-used categories of nutrition policies were the use of economic instruments for food affordability and restrictions on food advertising, reflecting the limited willingness of national governments to take regulatory action and their preference for educational strategies. This kind of legislative preference was already reported, e.g., by an analysis on maternal and child health policies from England and local policies for Southampton City [43]. Physical activity policies also show a wide variation across member states, ranging from 0 to 15; majority of countries were without implemented policies.…”

The development of the NOURISHING and MOVING benchmarking tools to monitor and evaluate national governments' nutrition and physical activity policies to address obesity in the European region

“…As such, they can be used in parallel with existing tools that focus on policy action at sub-national levels, 52 or to guide policy analysis at local levels. 53 Second, the benchmarking tools focus on government action and therefore exclude other types of policy such as plans or strategies. However, the full spectrum of policymaking could not feasibly be covered, and the tools focus specifically on policy actions within the wider range of public policy.…”

“…However, as these tools were designed to monitor government action at national level as well as to ensure comparability between countries, sub‐national level policy actions were excluded. As such, they can be used in parallel with existing tools that focus on policy action at sub‐national levels, 52 or to guide policy analysis at local levels 53 …”