Abstract
BackgroundObesity and non-communicable diseases are significant public health issues globally and particularly in the Pacific. Poor diet is a major contributor to this issue and policy change is a powerful lever to improve food security and diet quality. This study aims to apply systems thinking to identify the causes and consequences of poor evidence use in food-related policymaking in selected government ministries in Fiji and to illicit strategies to strengthen the use of evidence in policymaking.MethodsThe Ministry of Health and Medical Services and the Ministry of Agriculture in Fiji were invited through their respective Permanent Secretaries to participate in the study. Three 180-minute group model building (GMB) workshops were conducted separately in each ministry over three consecutive days with selected policymakers who were instrumental in developing food-related policies designed to prevent non-communicable diseases. The GMB workshops mapped the process of food-related policymaking and the contribution of scientific and local evidence to the process, and identified actions to enhance the use of evidence in policymaking.ResultsAn average of 10 policymakers participated from each ministry. The causal loop diagrams produced by each ministry illustrated the causes and consequences of insufficient evidence use in developing food policies or precursors of the specific actions. These included (1) consultation, (2) engagement with stakeholders, (3) access and use of evidence, and (4) delays in policy processes. Participants agreed to potential leverage points on the themes above, addressing pertinent policymaker challenges in precursor control, including political influence, understanding of trade policies, competing government priorities and level of awareness on the problem. Specific actions for strengthening evidence use included training in policy development and research skills, and strengthening of coordination between ministries.ConclusionsThe GMB workshops improved participants’ understanding of how different parts of the policy system interact. The causal loop diagrams and subsequent action plans enabled the identification of systems-level interventions in both ministries to improve evidence-informed policy development. A guide for integrating multi-sectoral consultation and stakeholder engagement in developing cross-cutting policies is currently being developed.
Highlights
Obesity and non-communicable diseases are significant public health issues globally and in the Pacific
This study aims to identify the causes and consequences of poor evidence use in food-related policymaking in the health and agriculture ministries in Fiji and to illicit strategies to strengthen the use of evidence informed by the following research question: Where could evidence levers be applied within the food-related policymaking processes in Fiji?
Research design This study used group model building (GMB) and a system dynamics approach [28, 35] to gain insights into the connections between variables influencing the use of evidence in food-related policymaking in the two selected government ministries in Fiji
Summary
Obesity and non-communicable diseases are significant public health issues globally and in the Pacific. The country is starting to look upstream at disease determinants [5, 6], with a view to creating public health policy with the power to influence both individual- and population-level behavioural change [7, 8]. Structural changes in the food system (shift from locally grown, traditional foods to highly processed imported food) have created an environment where NCDpromoting foods are cheap, abundant and highly palatable. Efforts to reverse these structural changes and improve the healthiness of food environments will need multilevel, multi-actor engagement [7, 14]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
