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Implementing effective salt reduction programs and policies in low- and middle-income countries: learning from retrospective policy analysis in Argentina, Mongolia, South Africa and Vietnam

Title: Implementing effective salt reduction programs and policies in low- and middle-income countries: learning from retrospective policy analysis in Argentina, Mongolia, South Africa and Vietnam
Authors: Webster, J; Santos, JA; Hogendorf, M; Trieu, K; Rosewarne, E; Mckenzie, B; Allemandi, L; Enkhtungalag, B; Do, HTP; Naidoo, P; Farrand, C; Waqanivalu, T; Cobb, L; Buse, K; Dodd, R; Santos, Joseph Alvin
Source: urn:ISSN:1368-9800 ; urn:ISSN:1475-2727 ; Public Health Nutrition, 25, 3, 805-816
Publisher Information: Cambridge University Press (CUP)
Publication Year: 2022
Collection: UNSW Sydney (The University of New South Wales): UNSWorks
Subject Terms: 4206 Public Health; 42 Health Sciences; Social Determinants of Health; Clinical Research; 3.1 Primary prevention interventions to modify behaviours or promote wellbeing; 8.3 Policy; ethics; and research governance; 8.1 Organisation and delivery of services; Generic health relevance; Argentina; Developing Countries; Health Policy; Humans; Mongolia; Policy Making; Retrospective Studies; Sodium Chloride; Dietary; South Africa; Vietnam; Health policy analysis; Low- and middle-income countries; Non-communicable diseases; Salt reduction; anzsrc-for: 4206 Public Health; anzsrc-for: 42 Health Sciences; anzsrc-for: 11 Medical and Health Sciences; anzsrc-for: 32 Biomedical and clinical sciences
Description: Objective: To understand the factors influencing the implementation of salt reduction interventions in low- and middle-income countries (LMIC). Design: Retrospective policy analysis based on desk reviews of existing reports and semi-structured stakeholder interviews in four countries, using Walt and Gilson's 'Health Policy Triangle' to assess the role of context, content, process and actors on the implementation of salt policy. Setting: Argentina, Mongolia, South Africa and Vietnam. Participants: Representatives from government, non-government, health, research and food industry organisations with the potential to influence salt reduction programmes. Results: Global targets and regional consultations were viewed as important drivers of salt reduction interventions in Mongolia and Vietnam in contrast to local research and advocacy, and support from international experts, in Argentina and South Africa. All countries had population-level targets and written strategies with multiple interventions to reduce salt consumption. Engaging industry to reduce salt in foods was a priority in all countries: Mongolia and Vietnam were establishing voluntary programs, while Argentina and South Africa opted for legislation on salt levels in foods. Ministries of Health, the WHO and researchers were identified as critical players in all countries. Lack of funding and technical capacity/support, absence of reliable local data and changes in leadership were identified as barriers to effective implementation. No country had a comprehensive approach to surveillance or regulation for labelling, and mixed views were expressed about the potential benefits of low sodium salts. Conclusions: Effective scale-up of salt reduction programs in LMIC requires: (1) reliable local data about the main sources of salt; (2) collaborative multi-sectoral implementation; (3) stronger government leadership and regulatory processes and (4) adequate resources for implementation and monitoring.
Document Type: article in journal/newspaper
File Description: application/pdf
Language: unknown
Relation: https://hdl.handle.net/1959.4/103997; https://doi.org/10.1017/S136898002100344X
DOI: 10.1017/S136898002100344X
Availability: https://hdl.handle.net/1959.4/103997; https://unsworks.unsw.edu.au/bitstreams/3c82cc0c-b42c-4632-a06d-8a59dde0c4f4/download; https://doi.org/10.1017/S136898002100344X
Rights: open access ; https://purl.org/coar/access_right/c_abf2 ; CC BY ; https://creativecommons.org/licenses/by/4.0/ ; free_to_read
Accession Number: edsbas.D0F1FA28
Database: BASE