Abstract

Unhealthy food marketing shapes children’s preference towards obesogenic foods. In Malaysia, policies regulating this food marketing were rated as poor compared to global standards, justifying the need to explore barriers and facilitators during policy development and implementation processes. The case study incorporated qualitative methods, including historical mapping, semi-structured interviews with key informants and a search of cited documents. Nine participants were interviewed, representing the Federal government (n = 5), food industry (n = 2) and civil society (n = 2). Even though the mandatory approach to government-led regulation of food marketing to children was the benchmark, more barriers than facilitators in the policy process led to industry self-regulations in Malaysia. Cited barriers were the lack of political will, industry resistance, complexity of legislation, technical challenges, and lack of resources, particularly professional skills. The adoption of industry self-regulation created further barriers to subsequent policy advancement. These included implementer indifference (industry), lack of monitoring, poor stakeholder relations, and policy characteristics linked to weak criteria and voluntary uptake. These underlying barriers, together with a lack of sustained public health advocacy, exacerbated policy inertia. Key recommendations include strengthening pro-public health stakeholder partnerships, applying sustained efforts in policy advocacy to overcome policy inertia, and conducting monitoring for policy compliance and accountability. These form the key lessons for advocating policy reforms.

Highlights

  • Introduction published maps and institutional affilLow- and middle-income countries (LMICs) are not immune to obesity and noncommunicable diseases (NCDs) [1,2]

  • This case study provided an in-depth assessment of the aetiology of food marketing policies in Malaysia up to 2017 that ideally benchmarked to WHO recommendations, which enabled us to identify key barriers to the policy processes

  • ‘Stakeholder relations’ posed a critical barrier to both policy development and implementation, which we identified in this case study but not prevalent in the previous studies relating to food marketing policies [36,37,85]

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Summary

Introduction

Low- and middle-income countries (LMICs) are not immune to obesity and noncommunicable diseases (NCDs) [1,2]. Rising sales volume of ultra-processed products pose dietary risks for obesity and diet-related NCDs in LMICs [6,7,8,9]. Their high consumption is attributed to being cheap, convenient, palatable and heavily marketed [10]. Advertising of ultra-processed foods such as sugar-sweetened beverages, sweet snacks, fast foods and savoury snacks is dominant on Malaysian children’s popular television channels [11]. Exposure of children to such advertisements increases awareness of promoted foods and brands, establish food/brand iations

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