Promoting Healthy Nutrition for Prevention and control of NCDs. Group II

Transcription

1 Promoting Healthy Nutrition for Prevention and control of NCDs Group II

2 Key Regional Targets related to Nutrition 30% relative reduction in mean population intake of salt/sodium Halt in the rise in prevalence of obesity and diabetes. The group however felt that it has to be seen in totality and should encompass F&V, sugar and fats.

3 Specific Questions Identify existing examples in the Region of good practices in policy response, public health legislation, and governance for reducing exposure of the population to diets high in salt, sugar and fat (including transfat) and low fruit and vegetable consumption. Identify additional opportunities and options for promoting healthy nutrition through multisectoral policies, legislative measures and governance in Member countries in the Region. Identify major challenges and barriers for widescale implementation of multisectoral policies and legislative measures for promoting healthy nutrition. Discuss the most useful strategies to address these challenges?

4 Specific Questions Identify key stakeholders needed for implementation of multi-sectoral policies and legislative measures for reducing exposure of the population to unhealthy diet. Discuss accountability measures to be instituted to ensure wide-scale implementation of diet-related multisectoral policies and legislations? Discuss gaps in country-level monitoring and surveillance mechanisms for measuring indicators and targets related to unhealthy diet. Summarize your specific recommendations for member states and for WHO/partners.

5 Good Practices in policy/legislation/governance Presence of Nutrition Policy/Plans Present For eg : Bangladesh/Maldives/Nepal/India/ Indonesia/Timor Leste These policies/plans are multi-sectoral but do not adequately address NCDs Some of the countries are reviewing these policies in the context of NCDs Presence of Food Safety legislation exists in many countries, the focus is on food adulteration & hygiene issues

6 Good Practices (Contd.) School Canteen/Lunch/Mid-day Meal Policy/Programs - in Many countries eg. Maldives, Timor Leste, India Regulation on nutrition labeling on sugar, salt and fats for both processed food and fast food restaurants. Very few countries eg. Indonesia Nutrition/Dietary guidelines exist in many countries. There is a focus on food security and malnutrition including micronutrients in the region. Incentives for Home gardening for Fertilizer organic free F & V Sri Lanka

7 Opportunities for healthy diet promotion Review Existing initiatives Food Safety and authority acts to address NCD related issues Relook at existing subsidy to food items Palm oil import and production; food items in public distribution systems. Setting based programs eg : Schools, works Availability of technology (Food processing and storage ; ICT) Increasing literacy levels Sugar sweetened beverages and processed food consumption is on the rise in the region and a cause of concern. Acting now would be important and opportunistic

8 Key Interventions - 1 Social and Behavioral change communication Identify Key and simple messages- avoid overload. Contextualize the message to the audience. Use multiple channels of communication

9 Key Interventions -2 Regulating food Industry Self-Regulation does not seem to work well, Group favored legislative approach. Set up standard and norms for nutrient content of foods Disseminate the standard and norms to food industry Capacity building of food manufacturers to adhere to the norms Establish certification/accreditation mechanism Regulate marketing/advertising of foods

10 Key Interventions - 3 Reduction in Salt intake Largely due to salt added at the time of cooking or on table. Consumer education should be the primary mode of intervention. Address salt content of processed/packaged food Evidence on Sodium substitute is not sufficient to advocate it at this stage.

11 Barriers and Challenges - 1 Taxation is a complicated process defining unhealthy food is not easy. Implementation is always a challenge no standardized of preparation of foods, number of establishments is large For some countries which largely import food items Timor Leste, Maldives and need to be addressed through cross-border talks International trade issues need to be addressed at global level. Affordability is a major issue making healthy choices cheaper. Availability across regions and seasons - Food transport and cold chain is not developed Lack of technical capacity to address nutrition issues effectively

12 Barriers and Challenges - 2 Food production is mostly by small and medium enterprises fragmented market Lack of human and laboratory resources for testing Aggressive marketing/ advertising by food industry, sometimes unethical Weak multisectoral co-ordination mechanisms Lack of public awareness on healthy foods Lack of Political commitment

13 Key Stakeholders Health is nodal agency 1. Agriculture increased quality and quantity of production, storage 2. Food technology, processing guidelines 3. Trade / commerce exim policies 4. Finance taxation/subsidy 5. livestock, fisheries, animal husbandry production 6. Education 7. Women and child development 8. Communication, Information and broadcasting 9. Consumer Forums/ NGOs 10. Food Industry 11. Law, justice and implementing agencies 12. Media 13. Academic institutions

14 Accountability measures Key is to develop a good Action plan that defines roles and responsibilities including indicators for each sector. Establishment of a Multi-sectoral executive committee/authority at different levels to oversee implementation Introduce social audit systems for consumers/ community level accountability. Better food safety testing procedures to be followed

15 Gaps in Monitoring and Surveillance There are significant gaps in nutrition related information in Member States. Many mechanisms exist (DHS/Nutrition surveys)in the countries but do not address the key indicators comprehensively While STEPs surveys done in countries gives us some information, information on salt intake is limited. The available information need to be better compiled and shared.

16 Recommendations for Member States While food security concerns are valid, approaches to address them should be aligned with NCD prevention approaches. Develop or review National nutrition policies/legislations/ /programs/plans in the context of NCDs. Review of existing policies /legislations in different sectors through NCDs lens. Establish multi-sectoral mechanisms for policy formulation and implementation Address issues related to availability and affordability of fruits and vegetable and other healthy food choices through a multi-pronged approach Address marketing by food industry effectively especially to that aimed at children. Identify an agency/organization for conducting monitoring and surveillance integrated with other NCDs.

17 Recommendations for WHO Develop a legislation tool kit to provide guidance to countries Build capacity on nutrition related issues expert group, knowledge sharing platforms Support member countries in developing food and nutrition related standards, guidelines and tools. Develop standard tools for nutrition surveillance and assist Member countries in its implementation