Tensions and coalitions: A new trade agreement affects the policy space for nutrition in Vietnam

Harris, Jody; Hrynick, Tabitha; Thien, Thi My; Huynh, Tuyen; Huynh, Phuong; Nguyen, Phuong Hong; Thow, Anne-Marie

doi:10.1007/s12571-022-01264-1

Cited by 4 publications

(9 citation statements)

References 41 publications

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“…Studies aiming to assess the public policy environment (Adeyemi et al, Forthcoming ; Aryeetey et al, 2021 ; Avula et al, 2022 ; Drimie et al, Forthcoming ; Harris et al, 2022 ; Harris et al, 2021 ; Iruhiriye et al, 2022 ; Salm et al, Forthcoming ; Turowska et al, Forthcoming ) drew on multiple policy analysis frameworks and methods. Policy frameworks included the community readiness framework (Plested et al, 2007 ), the policy space (Grindle & Thomas, 1991 ), advocacy coalitions (Sabatier, 1988 ), and the nutrition-enabling environment (Gillespie et al, 2013 ).…”

Section: Methodsmentioning

confidence: 99%

“…Meat and milk consumption have increased significantly, and sweets and sweetened beverages have both increased; oils and fat consumption also more than quadrupled between 1985 and 2009. The retail environment in Vietnam is experiencing both continuity and change, with wet markets and (vegetable-rich) food eaten away from the home still common despite a policy of “supermarketization” (Harris et al, 2020 ) and a trade policy process that does not consider the nutrition and health implications of changes to trade (Harris et al, 2022 ).…”

Section: Synthesis Of Findingsmentioning

confidence: 99%

“…The trade policy space analysis in Vietnam found one policy coalition prioritising international trade to enhance economic development (a positive for nutrition) while the nutrition and health implications of specific trade policy provisions were not considered in policy negotiations (a negative for nutrition). This illustrates clear trade-offs even within a single policy process (Harris et al, 2022 ); further research is required to understand the net implications for different forms of malnutrition and in different population groups.…”

Section: Synthesis Of Findingsmentioning

confidence: 99%

“…Many of the studies undertake this as part of the triangulation between different methods, although some studies are focused only on the policy environment (Drimie et al, Forthcoming ). The studies use different policy analysis frameworks to help accomplish this aim – many opting to build on the 2013 Lancet series’ characterisation of an enabling environment (Gillespie et al, 2013 ), while others adapt political, policy science, or health policy frameworks to focus on specific questions such the role of advocacy coalitions in policy processes (Harris et al, 2022 ), or the status of implementation. We partly follow the 2017 synthesis of Stories of Change studies (Gillespie & van den Bold, 2017 ) in using a simplified framework which focuses on key areas of policy and political commitment to nutrition, coherence across sectors (including issues of vertical (implementation) and horizontal (multi-sectoral) co-ordination); and capacity .…”

Section: Synthesis Of Findingsmentioning

confidence: 99%

“…In Africa, studies took place in Ghana (Aberman et al, 2022 ; Aryeetey et al, 2021 ), Nigeria (Adeyemi et al, 2022 ; Adeyemi et al, Forthcoming ), Burkina Faso (Becquey et al, 2022 ; Turowska et al, Forthcoming ), Rwanda (Iruhiriye et al, 2022 ), Zambia (Harris et al, 2019 ) and South Africa (Drimie et al, Forthcoming ). In South-East and South Asia, studies took place in Vietnam (Harris et al, 2020 , 2021 , 2022 ) and across four states of India (Odisha, Tamil Nadu, Gujarat & Chhattisgarh) (Avula et al, 2022 ; Avula et al, Forthcoming ). In Europe, a city-level study took place in Brighton and Hove in the United Kingdom (Salm et al, Forthcoming ).…”

Section: Introductionmentioning

confidence: 99%

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Stories of change in nutrition: lessons from a new generation of studies from Africa, Asia and Europe

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How does nutrition improve? We need to understand better what drives both positive and negative change in different contexts, and what more can be done to reduce malnutrition. Since 2015, the Stories of Change in Nutrition studies have analysed and documented experiences in many different African and Asian countries, to foster empirically-grounded experiential learning across contexts. This article provides an overview of findings from 14 studies undertaken in nine countries in South Asia, sub-Saharan Africa, and Europe between 2017 and 2021. The studies used a combination of methods, including regression-decomposition analyses of national datasets to assess determinants of nutritional change; policy process and food environment analyses; and community-level research assessing attitudes to change. This article takes a narrative synthesis approach to identify key themes across the studies, paying particular attention to multisectoral determinants, changes in the food environment, the role of structural factors (including longstanding social inequities), and changes in political commitment, cross-sectoral coherence and capacity. Given the inherent multisectoral nature of nutrition, many countries are experimenting with different models of ensuring coherence across sectors that are captured in this body of work. The relative immaturity of the policy sector in dealing with issues such as obesity and overweight, and associated influences in the wider food environment, adds a further challenge. To address these interrelated issues, policy must simultaneously tackle nutrition’s upstream (social/economic/equity) and downstream (health and dietary) determinants. Studies synthesised here provide empirically-driven inspiration for action.

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Section: Methodsmentioning

confidence: 99%

Section: Synthesis Of Findingsmentioning

confidence: 99%

Section: Synthesis Of Findingsmentioning

confidence: 99%

Section: Synthesis Of Findingsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Stories of change in nutrition: lessons from a new generation of studies from Africa, Asia and Europe

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Protecting children from unhealthy food marketing: a comparative policy analysis in Australia, Fiji and Thailand

Thow,

Phulkerd,

Ngqangashe

et al. 2023

Health Promotion International

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Restrictions on marketing of unhealthy foods and beverages to children is a globally recommended policy measure to improve diets and health. The aim of the analysis was to identify opportunities to enable policy learning and shift beliefs of relevant actors, to engender policy progress on restrictions on marketing of unhealthy foods to children. We drew on the Advocacy Coalition Framework to thematically analyse data from qualitative policy interviews conducted Australia (n = 24), Fiji (n = 10) and Thailand (n = 20). In all three countries two clear and opposing advocacy coalitions were evident within the policy subsystem related to regulation of unhealthy food marketing, which we termed the ‘strengthen regulation’ and ‘minimal/self regulation’ coalitions. Contributors to policy stasis on this issue were identified as tensions between public health and economic objectives of government, and limited formal and informal spaces for productive dialogue. The analysis also identified opportunities for policy learning that could enable policy progress on restrictions on marketing of unhealthy foods to children as: taking an incremental approach to policy change, defining permitted (rather than restricted) foods, investing in new public health expertise related to emerging marketing approaches and scaling up of monitoring of impacts. The insights from this study are likely to be relevant to many countries seeking to strengthen regulation of marketing to children, in response to recent global recommendations.

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Dietary patterns and child, parental, and societal factors associated with being overweight and obesity in Vietnamese children living in Ho Chi Minh city

Thien

Trần

Nambiar

et al. 2023

Maternal & Child Nutrition

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Childhood overweight and obesity are rapidly increasing in urban Vietnam. Dietary patterns are understudied for their association with obesity risk in these children, and it is unclear which parental and societal factors should be targeted in prevention efforts. The study assessed child characteristics, dietary patterns, parental and societal factors for associations with childhood overweight and obesity status in Ho Chi Minh City, Vietnam. A sample of 221 children aged 9–11 years was randomly selected from four Ho Chi Minh City primary schools. Weight, height and waist circumference were measured using standardized methods. Three 24‐h dietary recalls were collected from 124 children, which were used to assess dietary patterns using principal component analysis (PCA). Parents completed a questionnaire about child, parental and societal factors. The overall prevalence of obesity was 31.7% and of combined overweight and obesity 59.3%. Three main dietary patterns from 10 food groups were identified by PCA: traditional (grains, vegetables, meat and meat alternatives), discretionary (snacks and sweetened beverages), and industrialized (fast food and processed meat). Children with higher discretionary diet scores had higher odds of being overweight. Being a boy, screen time over 2 h/day, parental underestimation of child weight status, father's obesity, and household income in the lowest quintile were positively associated with childhood obesity. Future intervention programmes in Vietnam need to consider targeting children's unhealthy diets and parental perceptions of child weight status, as well as focusing on upstream approaches that reduce inequities contributing to childhood obesity and concomitant dietary patterns.

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Tensions and coalitions: A new trade agreement affects the policy space for nutrition in Vietnam

Cited by 4 publications

References 41 publications

Stories of change in nutrition: lessons from a new generation of studies from Africa, Asia and Europe

Stories of change in nutrition: lessons from a new generation of studies from Africa, Asia and Europe

Protecting children from unhealthy food marketing: a comparative policy analysis in Australia, Fiji and Thailand

Dietary patterns and child, parental, and societal factors associated with being overweight and obesity in Vietnamese children living in Ho Chi Minh city

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