Extent of implementation of food environment policies by the Malaysian Government: gaps and priority recommendations.

Seehoe Ng,Stefanie Vandevijvere,Heather Yeatman,Bridget Kelly,Mohd Noor Ismail,Tilakavati Karupaiah,Boyd Swinburn

doi:10.1017/s1368980018002379

Abstract

To determine the degree of food environment policies that have been implemented and supported by the Malaysian Government, in comparison to international best practice, and to establish prioritised recommendations for the government based on the identified implementation gaps. The Healthy Food-Environment Policy Index (Food-EPI) comprises forty-seven indicators of government policy practice. Local evidence of each indicator was compiled from government institutions and verified by related government stakeholders. The extent of implementation of the policies was rated by experts against international best practices. Rating results were used to identify and propose policy actions which were subsequently prioritised by the experts based on 'importance' and 'achievability' criteria. The policy actions with relatively higher 'achievability' and 'importance' were set as priority recommendations for government action. Malaysia. Twenty-six local experts. Majority (62 %) of indicators was rated 'low' implementation with no indicator rated as either 'high' or 'very little, if any' in terms of implementation. The top five recommendations were (i) restrict unhealthy food marketing in children's settings and (ii) on broadcast media; (iii) mandatory nutrition labelling for added sugars; (iv) designation of priority research areas related to obesity prevention and diet-related non-communicable diseases; and (v) introduce energy labelling on menu boards for fast-food outlets. This first policy study conducted in Malaysia identified a number of gaps in implementation of key policies to promote healthy food environments, compared with international best practices. Study findings could strengthen civil society advocacies for government accountability to create a healthier food environment.

Highlights

MethodsAn in-depth discussion on the suitability of the tool was conducted on 15–16 August 2016 in Kuala Lumpur, Malaysia
Our aims were to: (i) determine the degree of implementation of food environment policies and supports provided by the Malaysian Government, against international best practices; and (ii) establish prioritised recommendations for the government based on the identified implementation gaps
The findings indicated that Malaysia was not meeting any of the recognised international benchmarks

Summary

Methods

Official meeting, face-to-face interviews, telephone calls and emails to approach for information. Actions were decided based on one of three criteria, when there was: (i) poor implementation compared with international best practice; (ii) a need to broaden the scope of the current plans of government; or (iii) more evidence required to support action. Proposed actions with relatively higher ‘achievability’ and ‘importance’ based on the points allocated by the experts were packaged into the ‘Recommendations to Malaysian Government’. Ratings of indicators by the experts were calculated based on the scoring from the rating forms after the workshop and expressed as mean percentages of implementation compared with best practice. The higher the points allocated for the ‘achievability’ and ‘importance’ criteria, the more likely the proposed policy actions to be assigned at the upper-right quadrant of the scatter graph, indicating the top recommendations. Statistical significance was set as P value threshold of 0·05 for all data analysis

Results

Discussion