Mandates for Action: Influencing Public Health Nutrition Practice

2. Intelligence Unit 6 - Mandates for Action • Policy exerts a powerful influence on public health nutrition (PHN) practice because it affects: • service delivery models • resource allocation • supports or resists actions required • Governments the world, are taking action on PHN issues by developing national nutrition policies and action plans • National nutrition policies set the priorities, strategic direction and provide the framework for PHN action in local communities Mandates for Action

3. Mandates for Action

4. The Policy Context • The term policy is used in different ways to describe the direction of an organisation or government, a decision to act on a particular problem or a set if guiding principles • Most mandates for action important to PHN are considered policies, examples include: • Local and national health policies and guidelines • Pan-European and global policies and guidelines • Legislation and regulation • Organisational mission statements and strategic plans • Professional standards and ethical guidelines Mandates for Action

5. The Policy Context • A vast array of policy areas are considered to impact on population nutrition-related health problems including, education, food, urban planning, transport, advertising and marketing • The policy context is largely considered a top-down process but practitioners can contribute to policy development through public consultation • → the outcomes of well evaluated PHN interventions contribute to the evidence-base utilised in policy development Mandates for Action

6. Policy Development • National governments generally set the fundamental policy direction, while locally policies tend to develop incrementally • Policy development follows a basic pathway (similar to program planning and intervention management) • → Problem identification, policy formulation, policy implementation, policy evaluation • However policy is rarely a purely rational process: • applies scientific and pragmatic intelligence • highly contextual - sensitive to political, economic, social and cultural factors • Influenced by political self-interest, lobby groups, media and public opinion Mandates for Action

7. Competing Policy Agendas • Traditional food policies ensured a safe food supply and have been popularly and politically supported • →development of national, and international policies (e.g. Codex Alimentaris) • Gaining consensus for policies that encourage the availability and promotion of a healthy food supply is more complex • → many competing and vested interests contributing to the debate: • power and dominance of food manufacturers and retailers • interests and needs of primary producers • demands of health and consumer groups • consumer confusion Mandates for Action

8. National Nutrition Policies • 1992 World Declaration on Nutrition, First Action Plan for Food & Nutrition 2000-2005 and Global Strategy on Diet, Physical Activity & Health • →development of national policies and action plans to address PHN issues across Europe • Nutrition action areas include: • Infant feeding, food security, food safety, nutrition, physical Activity, reducing obesity • Many Member States have developed policies related to food and nutrition however implementation appears to be a major challenge, specifically: • lack of funds, political commitment, coordination and expertise Mandates for Action

9. Mandates for Action in PHN Practice • Nutrition policies and action plans (mandates) provide a national government level mandate for action on PHN issues • Nutrition mandates codify priorities for action by: • Stating the PHN issues, target groups and settings for action • Focusing the PHN workforce effort for more effective outcomes • Implementation of the strategic priorities requires local practitioners to build the capacity of communities to effectively design, plan, implement and evaluate sustainable strategic interventions → national mandates and local intervention management are both needed to solve PHN problems Mandates for Action

10. Mandates for Action in PHN Practice • Nutrition policies and action plans are not the only mandates that need considering in PHN intervention management • Need to consider existing mandates of: • Your own organisation • Potential partners or competitors • Potential funding agencies • Relevant legislation and regulation • Professional association policies, guidelines and ethical standards • Assists secure managerial support for intervention, financial support and awareness of potential barriers/ objections Mandates for Action

11. Mandates for Action

12. Mandates for Action - examples • European Union - Commission of the European Communities • WHITE PAPER: A Strategy for Europe on Nutrition, Overweight and Obesity related health issueshttp://ec.europa.eu/health/ph_determinants/life_style/nutrition/documents/nutrition_wp_en.pdf • National Board of Health Denmark – Centre for Health Promotion and Prevention • National Action Plan Against Obesity. • http://www.sst.dk/publ/publ2003/National_action_plan.pdf • Richmond and Twickenham Primary Care Trust (PCT) is the National Health Service organisation responsible for health services in the London Borough of Richmond upon Thames. • http://www.richmondandtwickenham.nhs.uk/about-the-pct Mandates for Action