Tracking Progress from Policy Development to Implementation: A Case Study on Adoption of Mandatory Regulation for Nutrition Labelling in Malaysia

Ng, See Hoe; Kelly, Barbara; Yeatman, Heather; Swinburn, Boyd; Karupaiah, Tilakavati

doi:10.3390/nu13020457

Cited by 8 publications

(15 citation statements)

References 45 publications

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“…Finally, the ability to explore or further implement front of pack labelling for Na in Mongolia and Malaysia, respectively, was limited by lack of back-of pack labelling of Na content. In Malaysia, a subsequent study identified further barriers such as lack of resources, governance complexity, industry resistance and lack of monitoring to regulations for nutrition labelling more broadly ( 21 ) .…”

Section: Discussionmentioning

confidence: 99%

Strengthening national salt reduction strategies using multiple methods process evaluations: case studies from Malaysia and Mongolia

McKenzie,

Mustapha,

Battumur

et al. 2024

Public Health Nutr.

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Objective: To understand the extent to which national salt reduction strategies in Malaysia and Mongolia were implemented and achieving their intended outcomes. Design: Multiple methods process evaluations conducted at the mid-point of strategy implementation, guided by theoretical frameworks. Setting: Malaysia (2018-19) and Mongolia (2020-21) Participants: Desk-based reviews of related documents, interviews with key stakeholders (n= 12 Malaysia, n= 10 Mongolia), focus group discussions with health professionals in Malaysia (n=43) and health provider surveys in Mongolia (n=12). Results: Both countries generated high-quality local evidence about salt intake and levels in foods, and culturally-specific education resources. In Malaysia education and reformulation activities were delivered with moderate dose (quantity) but reach among the population was low. Within 5 years, Mongolia implemented education among schools, health professionals and food producers on salt reduction with high reach, but with moderate dose (quantity) and reach among the general population. Both countries faced challenges in implementing legislative interventions (mandatory salt labelling and salt limits in packaged foods) and both could improve the scaling up of their reformulation and education activities. Conclusions: In the first half of Malaysia’s and Mongolia’s strategies, both countries generated necessary evidence and education materials, mobilised health professionals to deliver salt reduction education and achieved small-scale reformulation in foods. Both subsequently should focus on implementing regulatory policies and achieving population-wide reach and impact. Process evaluations of existing salt reduction strategies can help strengthen intervention delivery, aiding achievement of WHO’s 30% reduction in salt intake by 2025 target.

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Section: Discussionmentioning

confidence: 99%

Strengthening national salt reduction strategies using multiple methods process evaluations: case studies from Malaysia and Mongolia

McKenzie,

Mustapha,

Battumur

et al. 2024

Public Health Nutr.

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“…To address the increasing reach and impact of UCI, therefore, findings from this review suggest a need for governments to use frameworks building out from, but more comprehensive than those currently available. 2 , 22 - 27 …”

Section: Discussionmentioning

confidence: 99%

“…21 Evidence indicates that a strong regulatory framework, including monitoring, is needed to mitigate the negative health impacts of corporations. 2 , 22 - 27 There is also evidence that monitoring and accountability systems could better facilitate public health and private sector engagement on NCDs by ensuring safeguards are in place to define engagement and manage potential conflicts of interest. 25 Despite this, systematic monitoring of unhealthy corporate influence on health is largely absent at a national government level, and there is no established framework of surveillance that can be used across industries to monitor and evaluate these impacts.…”

Section: Rationalementioning

confidence: 99%

National Public Health Surveillance of Corporations in Key Unhealthy Commodity Industries – A Scoping Review and Framework Synthesis

Bennett

Topp

Moodie

2023

Int J Health Policy Manag

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Background: Corporations in unhealthy commodity industries (UCI) have growing influence on the health of national populations through practices that lead to increased consumption of unhealthy products. The use of government-led public health surveillance is best practice to better understand any emerging public health threat. However, there is minimal systematic evidence, generated and monitored by national governments, regarding the scope of UCI corporate practices and their impacts. This study aims to synthesise current frameworks that exist to identify and monitor UCI influence on health to highlight the range of practices deployed by corporations and inform future surveillance efforts in key unhealthy commodity industries. Methods: Seven biomedical, business and scientific databases were searched to identify literature focused on corporate practices that impact human health and frameworks for monitoring or assessment of the way unhealthy commodity industries impact health. Content analysis occurred in three phases, involving 1) the identification of framework documents in the literature and extraction of all corporate practices from the frameworks; 2) initial inductive grouping and synthesis followed by deductive synthesis using Lima & Galea’s ‘vehicles of power’ as a heuristic; and 3) scoping for potential indicators linked to each corporate practice and development of an integrated framework. Results: Fourteen frameworks were identified with thirty-seven individual corporate practices which were coded into five different themes according the Lima & Galea ‘Corporate Practices and Health’ framework. We proposed a summary framework to inform the public health surveillance of unhealthy commodity industries which outlines key actors, corporate practices and outcomes that should be considered. The proposed framework draws from the health policy triangle framework and synthesises key features of existing frameworks. Conclusion: Systematic monitoring of the practices of unhealthy commodity industries is likely to enable governments to mitigate the negative health impacts of corporate practices. The proposed synthesised framework highlights the range of practices deployed by corporations for public health surveillance at a national government level. We argue there is significant precedent and great need for monitoring of these practices and the operationalisation of a UCI monitoring system should be the object of future research.

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“…‘Stakeholder relations’ posed a critical barrier to both policy development and implementation, which we identified in this case study but not prevalent in the previous studies relating to food marketing policies [ 36 , 37 , 85 ]. Another case study covering mandatory nutrition labelling in Malaysia, also identified ‘stakeholder relations’ as a barrier [ 33 ]. Therefore, with reference to Malaysia, systemic influences to progress local policy reforms are required to halt inherent policy inertia.…”

Section: Discussionmentioning

confidence: 99%

“…This framework comprised key components of the Advocacy Coalition Framework [ 29 ], the Model of Agenda Building [ 30 ] and the Theory of Coalition Structuring [ 31 , 32 ]. The interview guide has been described in another case study [ 33 ] and included as Supplementary Material S1 .…”

Section: Methodsmentioning

confidence: 99%

Policy Inertia on Regulating Food Marketing to Children: A Case Study of Malaysia

Kelly

Yeatman

et al. 2021

IJERPH

Self Cite

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Unhealthy food marketing shapes children’s preference towards obesogenic foods. In Malaysia, policies regulating this food marketing were rated as poor compared to global standards, justifying the need to explore barriers and facilitators during policy development and implementation processes. The case study incorporated qualitative methods, including historical mapping, semi-structured interviews with key informants and a search of cited documents. Nine participants were interviewed, representing the Federal government (n = 5), food industry (n = 2) and civil society (n = 2). Even though the mandatory approach to government-led regulation of food marketing to children was the benchmark, more barriers than facilitators in the policy process led to industry self-regulations in Malaysia. Cited barriers were the lack of political will, industry resistance, complexity of legislation, technical challenges, and lack of resources, particularly professional skills. The adoption of industry self-regulation created further barriers to subsequent policy advancement. These included implementer indifference (industry), lack of monitoring, poor stakeholder relations, and policy characteristics linked to weak criteria and voluntary uptake. These underlying barriers, together with a lack of sustained public health advocacy, exacerbated policy inertia. Key recommendations include strengthening pro-public health stakeholder partnerships, applying sustained efforts in policy advocacy to overcome policy inertia, and conducting monitoring for policy compliance and accountability. These form the key lessons for advocating policy reforms.

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Tracking Progress from Policy Development to Implementation: A Case Study on Adoption of Mandatory Regulation for Nutrition Labelling in Malaysia

Cited by 8 publications

References 45 publications

Strengthening national salt reduction strategies using multiple methods process evaluations: case studies from Malaysia and Mongolia

Strengthening national salt reduction strategies using multiple methods process evaluations: case studies from Malaysia and Mongolia

National Public Health Surveillance of Corporations in Key Unhealthy Commodity Industries – A Scoping Review and Framework Synthesis

Policy Inertia on Regulating Food Marketing to Children: A Case Study of Malaysia

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