Evaluating policy responses to noncommunicable diseases in seven Caribbean countries: challenges to addressing unhealthy diets and physical inactivity
Objective. To identify, assess, and compare existing policies on noncommunicable diseases (NCDs) in the Caribbean, gaps in policy responses, and the factors influencing successful policy development and implementation following the Port of Spain Declaration of 2007. Specifically, to examine policies...
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2018-12-01
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doaj-947596a3c0a445c494a5c465d61c6e142020-11-25T01:30:13ZengPan American Health OrganizationRevista Panamericana de Salud Pública1020-49891680-53482018-12-01421810.26633/RPSP.2018.174e174Evaluating policy responses to noncommunicable diseases in seven Caribbean countries: challenges to addressing unhealthy diets and physical inactivityMadhuvanti M. Murphy0Nigel Unwin1T. Alafia Samuels2Trevor A. Hassel3Lisa Bishop4Cornelia Guell5Faculty of Medical Sciences, University of the West Indies, Cave Hill Campus, BarbadosMedical Research Council Epidemiology Unit and Centre for Diet and Activity Research, University of Cambridge, Cambridge, United KingdomGeorge Alleyne Chronic Disease Research Centre, University of the West Indies, Bridgetown, BarbadosHealthy Caribbean Coalition, Bridgetown, BarbadosFaculty of Medical Sciences, University of the West Indies, Cave Hill Campus, BarbadosEuropean Centre for Environment & Human Health, University of Exeter Medical School, Truro, United KingdomObjective. To identify, assess, and compare existing policies on noncommunicable diseases (NCDs) in the Caribbean, gaps in policy responses, and the factors influencing successful policy development and implementation following the Port of Spain Declaration of 2007. Specifically, to examine policies that target the upstream determinants of two NCD risk factors—unhealthy diets and physical inactivity. Methods. A total of 76 semi-structured interviews with 80 relevant stakeholders in government, the private sector, and civil society were complemented by policy document analysis. Interviews were analyzed pragmatically, framed by the CARICOM government commitments, the WHO NCD Action Plan, a Multiple Streams framework approach, and realist evaluation ideas. Results. The most widely-reported policy successes involved health promotion activities (e.g., school meal programs) that leveraged multisectoral collaboration among government ministries, such as Health, Education, and Agriculture. Large policy gaps still exist around creating legislative, physical, and social environments to support healthy eating and physical activity at the population level. Multisectoral NCD commissions successfully reached across sectors, but had limited influence on policy development. Different policy levels emerged with national-level policies considered a lengthy process, while “On-the-ground” programming was considered faster to implement than national policies. External barriers included a reliance on food imports enabled by international trade agreements limited availability, quality, and affordability of healthy foods. International pushback limited legislation to reduce food imports and the absence of an international/regional framework, similar to the Framework Convention on Tobacco Control, further impedes efforts. Conclusions. Regional collaboration and political support across sectors are essential to accelerating the pace of action to support healthy eating and active living environments. Policy “blueprints” could accelerate the process of development. Regional “NCD champions” could spearhead such responses and approaches.http://iris.paho.org/xmlui/handle/123456789/49573Noncommunicable diseasespolicy makinghealth policyexercisenutritionpublic healthCaribbean region |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Madhuvanti M. Murphy Nigel Unwin T. Alafia Samuels Trevor A. Hassel Lisa Bishop Cornelia Guell |
spellingShingle |
Madhuvanti M. Murphy Nigel Unwin T. Alafia Samuels Trevor A. Hassel Lisa Bishop Cornelia Guell Evaluating policy responses to noncommunicable diseases in seven Caribbean countries: challenges to addressing unhealthy diets and physical inactivity Revista Panamericana de Salud Pública Noncommunicable diseases policy making health policy exercise nutrition public health Caribbean region |
author_facet |
Madhuvanti M. Murphy Nigel Unwin T. Alafia Samuels Trevor A. Hassel Lisa Bishop Cornelia Guell |
author_sort |
Madhuvanti M. Murphy |
title |
Evaluating policy responses to noncommunicable diseases in seven Caribbean countries: challenges to addressing unhealthy diets and physical inactivity |
title_short |
Evaluating policy responses to noncommunicable diseases in seven Caribbean countries: challenges to addressing unhealthy diets and physical inactivity |
title_full |
Evaluating policy responses to noncommunicable diseases in seven Caribbean countries: challenges to addressing unhealthy diets and physical inactivity |
title_fullStr |
Evaluating policy responses to noncommunicable diseases in seven Caribbean countries: challenges to addressing unhealthy diets and physical inactivity |
title_full_unstemmed |
Evaluating policy responses to noncommunicable diseases in seven Caribbean countries: challenges to addressing unhealthy diets and physical inactivity |
title_sort |
evaluating policy responses to noncommunicable diseases in seven caribbean countries: challenges to addressing unhealthy diets and physical inactivity |
publisher |
Pan American Health Organization |
series |
Revista Panamericana de Salud Pública |
issn |
1020-4989 1680-5348 |
publishDate |
2018-12-01 |
description |
Objective. To identify, assess, and compare existing policies on noncommunicable diseases (NCDs) in the Caribbean, gaps in policy responses, and the factors influencing successful policy development and implementation following the Port of Spain Declaration of 2007. Specifically, to examine policies that target the upstream determinants of two NCD risk factors—unhealthy diets and physical inactivity. Methods. A total of 76 semi-structured interviews with 80 relevant stakeholders in government, the private sector, and civil society were complemented by policy document analysis. Interviews were analyzed pragmatically, framed by the CARICOM government commitments, the WHO NCD Action Plan, a Multiple Streams framework approach, and realist evaluation ideas. Results. The most widely-reported policy successes involved health promotion activities (e.g., school meal programs) that leveraged multisectoral collaboration among government ministries, such as Health, Education, and Agriculture. Large policy gaps still exist around creating legislative, physical, and social environments to support healthy eating and physical activity at the population level. Multisectoral NCD commissions successfully reached across sectors, but had limited influence on policy development. Different policy levels emerged with national-level policies considered a lengthy process, while “On-the-ground” programming was considered faster to implement than national policies. External barriers included a reliance on food imports enabled by international trade agreements limited availability, quality, and affordability of healthy foods. International pushback limited legislation to reduce food imports and the absence of an international/regional framework, similar to the Framework Convention on Tobacco Control, further impedes efforts. Conclusions. Regional collaboration and political support across sectors are essential to accelerating the pace of action to support healthy eating and active living environments. Policy “blueprints” could accelerate the process of development. Regional “NCD champions” could spearhead such responses and approaches. |
topic |
Noncommunicable diseases policy making health policy exercise nutrition public health Caribbean region |
url |
http://iris.paho.org/xmlui/handle/123456789/49573 |
work_keys_str_mv |
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