The case for metagovernance: The promises and pitfalls of multisectoral nutrition service delivery structures in low‐ and middle‐income countries

Fox, Ashley; Law, Jennie R.; Baker, Keith

doi:10.1002/pad.1974

Cited by 2 publications

(2 citation statements)

References 36 publications

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“…Although the Government of Zambia encourages multisectoral coordination for nutrition policy implementation in policy content—which is an important first step—achieving strong multisectoral cooperation is challenging. Evidence supports multisectoral approaches to addressing nutrition-related problems over traditional vertical programming as the latter has little success in effectively addressing the multifaceted drivers of the double burden of malnutrition [ 75 , 76 ]. Key lessons for successful integration from countries like Ethiopia include strong political will with national prioritization of nutrition coupled with strong governance structures that promote accountability among stakeholders [ 77 ].…”

Section: Discussionmentioning

confidence: 99%

Mapping of food environment policies in Zambia: a qualitative document analysis

Mukanu,

Thow,

Delobelle

et al. 2023

BMC Nutr

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Background The food environment in which people exercise food choices significantly impacts their dietary patterns. Policies that limit the availability, affordability, and access to unhealthy food while increasing that of healthier alternatives help build healthy food environments, which are required to address the double burden of malnutrition. This study aimed to assess the availability of food environment policies in Zambia. Method We applied a two-step qualitative document analysis to identify policy content relating to healthy food environments from global and Zambia-specific nutrition-related policy documents. In the first step, global policy documents were analyzed to develop a reference point for globally recommended policies for healthy food environments. In the second step, Zambia’s nutrition-related policies were analyzed to identify content relating to healthy food environments. The identified policy content was then mapped against the global reference point to identify food environment policy gaps. Results Our analysis of global policy recommendations identified five broad categories of policy provisions: information and education based; regulatory and legislative tools; strategies to promote production and access to healthy food production; social protection-based strategies and guiding principles for governments relating to multisectoral collaboration and governance. Our analysis found that Zambian Government policy documents in the health, agriculture, education, and national planning and development sectors have policy provisions for healthy food environments. While these policy provisions generally covered all five reference categories, we found policy gaps in the regulatory and legislative tools category relative to global recommendations. Conclusion Zambia’s food environment policy landscape must include globally recommended regulatory and legislative policy measures like restricting the marketing of unhealthy foods and non-alcoholic beverages to children. Nutrition policy reforms are required to facilitate the introduction of regulatory and legislative policy measures that effectively address the double burden of malnutrition in Zambia.

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Section: Discussionmentioning

confidence: 99%

Mapping of food environment policies in Zambia: a qualitative document analysis

Mukanu,

Thow,

Delobelle

et al. 2023

BMC Nutr

View full text Add to dashboard Cite

show abstract

“…In the adult population, 24% are overweight, while 90% do not meet the dietary requirement of consuming five portions of fruit and vegetables daily ( Mutale and Chilengi, 2018 ). Recent studies in the adolescent age group show that the snacking dietary pattern characterized by consuming processed food high in sugar, salt and fats is prevalent among urban school-going adolescents ( Mukanu et al. , 2022 ).…”

Section: Introductionmentioning

confidence: 99%

Nutrition policy reforms to address the double burden of malnutrition in Zambia: a prospective policy analysis

Mukanu

Mchiza

Delobelle

et al. 2023

Health Policy and Planning

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The evolution of nutrition patterns in Zambia has resulted in the coexistence of undernutrition and overnutrition in the same population, the double burden of malnutrition. While Zambia has strong policies addressing undernutrition and stunting, these do not adequately address food environment drivers of the double burden of malnutrition and the adolescent age group, hence the need for nutrition policy reforms. We conducted a theory-based qualitative prospective policy analysis involving in-depth interviews with nutrition policy stakeholders and policy documents review to examine the feasibility of introducing nutrition policy options that address the double burden of malnutrition among adolescents to identify barriers and facilitators to such policy reforms. Using the multiple streams theory, we categorized the barriers and facilitators to prospective policy reforms into those related to the problem, policy solutions, and politics stream. Using a life course approach in nutrition programming could facilitate policy reforms as adolescence is one of the critical invention points in a person’s lifecycle. Another key facilitator of policy reform was the availability of institutional infrastructure that could be leveraged to deliver adolescent-focused policies. However, the lack of evidence on the burden and long-term impacts of adolescent nutrition problems, the food industry’s strong influence over governments’ policy agenda setting, and the lack of public awareness to demand better nutrition were perceived as critical barriers to policy reforms. In addition, the use of the individual responsibility framing for nutrition problems was dominant among stakeholders. As a result, stakeholders did not perceive legislative nutrition policy options that effectively address food environment drivers of the double burden of malnutrition to be feasible for the Zambian context. Policy entrepreneurs are required to broker policy reforms that will get legislative policy options on the government’s agenda as they can help raise public support and re-engineer the framing of nutrition problems and their solutions in Zambia.

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The case for metagovernance: The promises and pitfalls of multisectoral nutrition service delivery structures in low‐ and middle‐income countries

Cited by 2 publications

References 36 publications

Mapping of food environment policies in Zambia: a qualitative document analysis

Mapping of food environment policies in Zambia: a qualitative document analysis

Nutrition policy reforms to address the double burden of malnutrition in Zambia: a prospective policy analysis

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