Implementation of healthy food environment policies to prevent nutritionrelated non-communicable diseases in Ghana: National experts’ assessment of government action
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Date
2020-05-19
Journal Title
Journal ISSN
Volume Title
Publisher
Food Policy
Abstract
Nutrition-related non-communicable diseases (NR-NCDs) are a global health problem, increasingly recognised as
driven by unhealthy food environments. Yet little is known about government action to implement food environment-
relevant policies, particularly in low-and lower-middle income countries. This study assessed government
action, implementation gaps, and priorities to improve the food environment in Ghana. Using the
Healthy Food-Environment Policy Index (Food-EPI), a panel comprising government and independent experts
(n = 19) rated government action to improve the healthiness of food environment in Ghana against international
best practices and according to steps within a policy cycle. Forty-three good practice indicators of food
environment policy and infrastructure support were used, with ratings informed by systematically collected
evidence of action validated by government officials. Following the rating exercise, the expert panel proposed
and prioritized actions for government implementation. Three-quarters of all good practice indicators were rated
at ‘low’/‘very little’ implementation. Restricting the marketing of breast milk substitutes was the only indicator
rated “very high”. Of ten policy actions prioritized for implementation, restricting unhealthy food marketing in
children’s settings and in the media were ranked the highest priority. Providing sufficient funds for nationallyrelevant
research on nutrition and NCDs was the highest priority infrastructure-support action. Other priority
infrastructure-support actions related to leadership, monitoring and evaluation. This study identified gaps in
Ghana’s implementation of internationally-recommended policies to promote healthy food environments.
National stakeholders recommended actions, which will require legislation and leadership. The findings provide
a baseline for measuring government progress towards implementing effective policies to prevent NR-NCDs.
Description
Research Article
Keywords
Healthy food environment, Policy implementation, Obesity, Nutrition-related non-communicable diseases, Policy, Lower-middle Income country