pb #1 role-reach of govt in nutrition - final

7/30/2019 PB #1 Role-Reach of Govt in Nutrition - FINAL

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JJuunnee 22001122

Note:

availability and accessto safe and nutritious

food are not

automatic to the poor,

socially excluded and

marginalised groups

health care costsgenerally, and

especially to treat

lifestyle diseases, are

high and rising;

government candirectly and indirectly

influence the kinds of

consumption choices

or food utilization

decisions towards

good health.

Understanding the Concepts

Nutrition:

- the process of providing or obtaining the food

necessary for health and growth;

- the provision to cells and organisms, of the

materials necessary (in the form of food) to

support life.

Government policy:

- a principle or rule to guide decisions and

achieve rational outcomes;

- a term used to describe any course of action

which intends to change a certain situation.

Also known as public policy

Nutritional guidelines:

- a set of recommendations on the proportional

intake of each food group necessary for

proper nutrition and health.

Nutrition is not

necessarily just food;

and food is not the only

source of nutrition.

An imbalanced diet in

relation to daily caloric

requirements can lead

to under nutrition or

over nutrition, both ofwhich have adverse

health and socio-

economic

consequences.

There is a growing

consensus on the need

to focus on nutrition as

opposed to just food

calorie-protein intake

for good health.

Contents:

1 Understanding the

Concepts.

2 Why should

Government

intervene in

nutrition security?

3 How CanGovernments

Influence Nutrition

Security?

4 Policy Intervention

Critical Control

Points.

5 Bottom line!

6 Recommended

reading

Healthy organic vegetables grown in

Suriname with support from NGO, The

Caribbean Institutes project working with

small farmers to revitalise horticulture

production.

(Photo: Maureen Silos)

Jamaican produce on sale in the

Barbados market through a US mass

marketing chain! As food prices rise, intra-

regional trade will become critical to food

security

(Photo: Brent Theophille).


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Nutrition security is enabled and assured within an environment that encourages and motivates society

to make food choices consistent with short- and long-term good health. Nutrition policies and

regulations must have an effect on the cost of producing healthy commodities; on how those costs

relate to final retail prices; on how responsive consumers are to price changes and on how the policy

directly influences the consumers preference for the healthy product (Ralston, 1999).

Why Should Governments Intervene in Nutrition Security?

The simple answer: prevention is better than the cure. It is also the more

cost-effective option in the long-run. There is enough evidence that health

care costs are astronomical, rising and out of reach of the majority of a

countrys citizens. Who bears the fall out? The government and ultimately, the

tax payers as more and more of a countrys tax revenues are diverted into

health care. It is therefore in Governments interest to nurture a healthy

population.

Although consumption choices are the ultimate responsibility of an

individual/household, there are a number of situations and circumstances

that may limit, disrupt or even prevent them from exercising their right to

make a healthy choice. Because economic activities and growth depend, in

part, on a productive labour force, government are required to intervene to

ensure that the citizens have access to food, and especially foods that are

essential to good health. A business as usual approach would significantly

compromise human capital formation in both the short and long run and for

resource-scare SIDs, including those of the Caribbean, and severely

undermine development.

The CARICOM Regional Food and Nutrition Security Policy (RFNSP, 2010) recognises the

regions vulnerabilities to policy shifts and economic and financial shocks in leading world

economies. The 2008 to 2010 financial crisis had immediate and deep impacts on food prices in

the Caribbean, threatening several vulnerable groups with food insecurity. Building resilience for

food and nutrition security (FNS) requires urgent and concerted attention to food system policy

and critically, nutrition policy. This challenges governments to unambiguously determine where,

how and to what extent they can make meaningful interventions. Recognising the need forinterventions primarily in consumer behavioural change, communication and in sharing best

practices across sectors linked to FNS, the CARICOM Council on Human and Social

Development (COHSOD) is an important partner in implementing the RFNSP. COHSOD is

supporting the design of food service operations in schools and has agreed to focal

points/teams from within the education sectors to support RFNSP implementation.

Shift to diets high in

fats, salt and refined

carbohydrates, and

low in fruits,

vegetables, legumes,

provisions and nuts

have been linked to

drastic increases in

incidences of chronic

non-communicable

diseases (CNCDs).


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How Can Governments Influence Nutrition Security?

Practitioners and policy makers have become more convinced of the

need to focus on nutrition as opposed to just food calorie/protein intake

in addressing the ongoing challenge of food andnutrition security (FNS).

Policies and regulations can directly or indirectly affect both the supplyand demand side of the food system. The primary objective of

government policy should be to encourage positive changes in diets

and lifestyles. This can be done through regulating and modifying the

food system, making healthy foods more acceptable (i.e. whether

through affordability or any other set of critical societal factors), and

educating individuals and communities to make healthy lifestyle

choices.

Effective interventions must have focus as to exactly who will be

impacted and how. The recommendation is to focus on strategies that

address the specific aspects of the susceptibilities (e.g. access to food-

production resources, purchasing power, nutrition deficiency in

commonly utilized foods, etc.) of the most vulnerable nutrition groups

(i.e. pregnant and nursing mothers, young children and the

elderly/infirmed).

Bodi, ochro and pumpkin on sale at a vendors stall on Charlotte Street, Port-of-Spain, TrinidadSource: Central Bank: Floods may have affected rising food prices, Published: January 8, 2012

Shaliza Hassanali, http://guardian.co.tt

According to Ralston

(1999), whether or

not they are directed

specifically at the food

sector, regulations can

affect the: (1) varieties

and qualities of foods

available for purchase,

(2) prices consumers

face, (3) information

consumers receive

about a product, and

(4) consumer

confidence in the food

supply.


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Policy Intervention Critical Control Points (PICCP):

building blocks.

Using the 4 main areas suggested by Ralston (see pg.3) one can construct a

framework for policy interventions to influence dietary choices in favour of

nutrition.

The Supply side:

Influencing the cost of producing healthy commoditiesThe assumption that this relates to local/regional food production, is implicit.

One could ask: what and who determines which commodities are healthy?

Based on the nutrients required for healthy life, nutritionists are able to identify

and recommend a range of food options (plant and animal based) to suit

particular health profiles, i.e., nutritional guidelines!

If good agricultural practices (GAP) are in place, then food crops and livestock

are farmed this way. i.e., in a manner than maintains their inherent nutrient

values. Healthy foods start with good practices. However, in contemporaryagriculture, use of genetically modified organisms (GMOs) is standard for the

major food crops (e.g., corn, wheat, white potato, soy bean) and livestock

(e.g., dairy, poultry). This has raised concerns over possible adverse

consequences on human health from consumption of GM foods. In fact there

has been an ongoing debate in the US on biotechnology food policy, and the

state of California is getting ready to vote on the issue of labelling of GM foods,

which if approved by voters would become the first of its kind in the nation. Of

course, the giant food companies are fighting vigorously against its success.

Relying on the market is neither sufficient nor a desirable option. Government

must intervene to ensure that food produced in the farm maintains its inherentnutritional value and is safe and that the associated production costs are not

prohibitive or exclusive to a small portion of the population.

There is a direct link between continuous consumption of highly refined and

processed foods and beverages and chronic lifestyle diseases, such as obesity.

The nutritional labels generally indicate that the majority of these consumables

are empty calories, laden with artificial ingredients and additives that have

zero or questionably nutritional value. Extra-regional imports dominate the

content of processed foods, whether as ingredients or final product. This is

explained as a lack of competitiveness of local raw materials, in terms of

consistent supplies of low priced and standardised quality farm produce for

processing.

Since Caribbean consumers have exhibited a preference for processed

foods, Government must also intervene to ensure that the health factor in

the transformation chain from fresh to chilled-packs to processed is

maintained. Such interventions should aim at facilitating and enabling

production of healthy options of processed foods at comparable prices.

Food Production:

Government will need to:-

-provide incentives forproduction of preferredhealthier commodities to

help moderate production

costs, promote GAP and

mitigate risks;

-articulate a clear policy onGMOs, food additives and

other elements that influence

the nutritional and safety

status of foods and hence

human health;

-encourage and support foodand beverage

manufacturers who produce

healthy; processed food

options;Associated Policy Issues:-Farming Systems Research

such as raising productivitylevels for nutrient dense

commodities and production

input research;

-Food processing andproduct development

technologies to optimise use

of local nutrient-dense food

varieties.

-Bio-safety and Food safetyregulations that enhance thehealth factor and reduce

production costs;

Governments should make

more effective use of Green

Box measures for efficient and

sustainable production of

healthier foods.


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Influencing the costs of final retail prices of healthy commoditiesIt is understood that this must consider both local/regionally produced and

imported food commodities.

Who and what determines the final retail prices of food? That depends on

the number, operational efficiencies and influence of the players along the

chain from its production to retailing. Government, though policy, is a major

player.

From observation, generally, price should not always be the standard

yardstick for measuring the health attributes of a food commodity.

However, with the growth of the organic movement, organic foods,

marketed as healthier, usually come with a higher retail price tag, and out

of the pocket of the average consumer.

To make meaningful interventions through food pricing, government will

need to be guided by nutritional guidelines which provide indications of the

relative weighting among foods. Once a basket of preferred healthy

commodity options is identified, then the extent of influence and hence

mechanisms that governments can use will differ, depending on whether

such commodities:

- are produced locally or imported;- are offered in their fresh form or processed;- appeal to and attract the aspirational buyers, i.e., branded foods.

Generally, the most effective means of interventions are through taxes,

which have an instant and direct price impact. Another indirect means is

through incentives along the farm to market chain, which impact on

production and transactions costs, and could lead to lower retail prices.

However, there are some elements of pricing that may not be as easily

influenced by government policy, such as, branding and advertising, which

strongly influence consumer perceptions and purchasing decisions beyond

just affordability issues.

For fresh commodities, taxation may not be the most effective option since

in most CARICOM states, fresh farm produce, especially locally grown and

regional imports are generally exempt from consumption and other taxes.

However, if the preferred basket of healthy commodities contains fresh

fruit, vegetables and other produce from extra-regional sources, then there

is scope to use tax policy and other concessions to influence retail prices.

For the healthier processed foods, a similar consideration will need to be

made in terms of government actions that impact both production and

transactions cost and/or institute some measure of price controls that are

not in violation of international trade rules. Another direct option that does

not depend on influencing price, but enhances purchasing power, is

through an appropriate mix of food procurement and safety net measures

that enhance access for vulnerable groups and influence demand.

Food Pricing:

Government will need to:

-build capacity in the foodsystem for efficient handling,

storage and distribution of foo

that retains quality and safetyand moderates transactions

costs;

-institute a special FNS incentiveregime for a basket of preferre

healthy commodities that

facilitates their efficient post-

harvest preparations, distributi

and retailing (especially with

regards to the imported

elements) at affordable prices

-enhance efficiency of foodsafety regulations (inspections

approval of food additives, et

so as not to unduly increase th

prices of healthier foods;

-arrive at a consensus-basedindustry marketing-advertising

codes that do not unduly

promote unhealthy foods ove

the healthier commodities;

-integrate access to healthy focommodities as a special aspe

of safety net programmes for t

vulnerable.Since there is a limit to how

Government can intervene

pricing, the need for Governm

to work with private retailers is k

to influencing retail prices. primary strategy should be

partner with private sector with

goal of enhancing availability a

affordability of a specified F

basket of healthier commodities


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The Demand side:

Influencing how responsive consumers are to price changes;

Influencing consumers preference for the healthy product;Can Government influence the food choices of an individual or household?

The answer is not a straightforward yes or no. There are actions that can be

taken by Government to promote greater utilisation of a number of

commodities that are deemed important to a healthy diet. But in the finalanalysis, the purchasing decisions and methods of utilising and consuming

food, rest with the customer.

A number of factors influence consumer preferences, including:

- level of health consciousness and health status- religious beliefs- incomes and purchasing capacity- relative prices- capacity to substitute- perceptions of safety and quality- convenience- marketing and advertising- proximity and placement on supermarket shelvesand a host of other factors that are not as obvious or not easily be measured.

This makes Governments ability to influence purchasing decisions and

consumption habits very complex, especially when working in an environment

where retailers are not generally interested in, or supportive of a national

policy for healthy eating.

Government will need to act on the basis of an understanding that a 'one-

type-plate does not fit-all-palates(1). This requires that interventions aimed at

influencing demand, need to be target-specific, such as, pregnant or

breastfeeding mothers, to the diabetic and others inflicted with CNCDs, to the

sporting community, etc. Such interventions need to be informed by analysis

of the different population segments based on well defined criteria (to

include age/stage of growth, religious beliefs, health profile, extent of physical

activity, etc.,) and the food options that are best suited for nutrition and good

health.

Government will also need to exercise its power of influence through its food

procurement programmes, mandating that the food it purchases, provides or

makes available is in keeping with the nutritional guidelines standards

established by its authorities. Through programmes already in existence (e.g.

meal programmes in schools and hospitals), Governments have an avenue to

directly influence the purchase and use of healthy and nutritious foods. Similar

programmes aimed at other state institutions and then transferred to the

private sector could further amplify the benefit to society.

1 phrase coined by CaRAPN to emphasise the need to offer a range of options for nutritional guidelines and daily diets that meet

the health, religious and other requirements of different segments of a population.

Influencing Demand:

Government will need to:

-provide and make accessiblecredible nutrition information an

food needs guidelines that matc

various health and preference

profiles in order to help to informconsumers choices by using:

Food Information Regulationthat provides guidelines for

labelling requirements,

advertising restrictions, and

standards of identity and

product grades, etc.

upgrading the scope ofGovernment market

development agencies to

support the marketing oftargeted healthier

commodities ;

- enforce adherence to nutritionguidelines in government-led

meal-nutrition programmes in

schools, hospitals and other

public institutions as a strategic

advantage to reach and

influence citizens on nutrition

and health issues related to foo

choices;

Government needs to partner wit

retailers, housewives associations

and consumer groups to create a

environment for nutrition.

The endgame should be to

encourageand enable positive

changes in diets and lifestyles

through regulating the food suppl

system, enhancing acceptability o

healthy foods, and providing

information to allow individuals,

families and communities to make

healthy choices.


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Notes:


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Recommended Readings:

Ralston, K. How Government Policies and Regulations Can Affect Dietary Choices.

www.ers.usda.gov/publications/aib750/aib750q.pdf>

Sinha, D.P. 1995. Changing patterns of food, nutrition and health in the Caribbean.

Nut. Research, 15(6): 899 - 938.

WHO. 2011. From Burden to Best Buys: Reducing the Economic Impact of Non -

Communicable Diseases in Low- and Middle-Income Countries.

www.who.int/nmh/publications/best_buys_summary.pdf>

World Health Organization, Food and Nutrition Policy and Plans of Action, Report

for the WHO-FAO Inter-Country Workshop Hyderabad, India, 17-21 December

2007. Accessed February 12th, 2012 ,

www.searo.who.int/LinkFiles/Publications_SEA-NUT-175.pdf

Martorell R, Kettel Khan L, Hughes ML. 2000. Grummer-Strawn LM. Overweight and

Obesity in preschool children from developing countries Int J Obesity 24:959-967.

FAO. 2002. Safe Food and Nutritious Diet for the Consumer.

www.fao.org/worldfoodsummit/sideevents/papers/y6656e.htm>

CDC. 2011. Improving the Food Environment Through Nutrition Standards: A Guide

for Government Procurement. U.S. Department of Health and Human Services,

Centers for Disease Control and Prevention, National Center for Chronic Disease

Prevention and Health Promotion, Division for Heart Disease and Stroke

Prevention. www.cdc.gov/salt/pdfs/DHDSP_Procurement_Guide.pdf>

Janice Meerman, Making Nutrition a National Priority: Review of policy processes in

developing countries and a case-study of Malawi, (2008). Accessed February

12th, 2012

http://www.foodsec.org/fileadmin/user_upload/eufao-

fsi4dm/docs/malawi_case_study.pdf

TThhee RRoollee aanndd RReeaacchh ooff GGoovveerrnnmmeenntt PPoolliiccyy iinn NNuuttrriittiioonn SSeeccuurriittyy

Bottom line

The responsibility for safe and nutritious food is shared by all players in the food system. This requires

cooperation and coordination of producer activities guided by government directives and adoption

encouraged by appropriate incentives. An efficient food system should ensure that foods meetscience-based safety characteristics, while ensuring the appropriate balance of other qualities

taking into consideration other relevant factors such as technical feasibility, costs considerations, as

well as social, ethical and environmental concerns through the integrated activities of al

stakeholders - both private and public. In all interventions, whether public or private sector led, there

should be no compromise on at least three core elements:

1. providing assurance of food safety and quality,

2. enhancing consumers ability to access and afford the recommended healthier food choices,

3. adopting a multi-sectoral approach to create the synergies necessary for efficient actions.

Research/

Content:

Brent TheophilleJeanelle Clarke

Editor: Diana Francis

The views and opinions

expressed herein, errors and

omissions are those of the autho

and not necessarily those of

Inter-American Institute forCooperation on Agriculture

(IICA), the Technical Centre for

Agriculture and Rural

Cooperation (CTA) or the

Caribbean Regional Agricultura

Policy Network (CaRAPN) an

IICA-CTA initiative in the

Caribbean.

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