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Published in: BMC Public Health 1/2017

Open Access 01-12-2017 | Research article

Factors affecting evidence-use in food policy-making processes in health and agriculture in Fiji

Authors: Gade Waqa, Colin Bell, Wendy Snowdon, Marj Moodie

Published in: BMC Public Health | Issue 1/2017

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Abstract

Background

There is limited research on the use of evidence to inform policy-making in the Pacific. This study aims to identify and describe factors that facilitate or limit the use of evidence in food-related policy-making in the Health and Agriculture Ministries in Fiji.

Methods

Semi-structured face-to-face interviews were conducted with selected policy-makers in two government ministries that were instrumental in the development of food-related policies in Fiji designed to prevent Non-Communicable Diseases (NCDs). Snowball sampling was used to recruit, as key informants, senior policy-makers in management positions such as national advisors and directors who were based at either the national headquarters or equivalent. Interviewees were asked about their experiences in developing food-related or other policies, barriers or facilitators encountered in the policy development and implementation process and the use of evidence. Each interview lasted approximately 45–60 minutes, and was conducted in English. Audio-recorded interviews were transcribed, thematically coded and analyzed using N-Vivo 8.0 software.

Results

Thirty-one policy-makers from the Ministry of Health and Medical Services (MoHMS n = 18) and the Ministry of Agriculture (MoA n = 13) in Fiji participated in the study. Whilst evidence is sometimes used in food-related policy-making in both the Health and Agriculture Ministries (including formal evidence such as published research and informal evidence such as personal experiences and opinions), it is not yet embedded as an essential part of the process. Participants indicated that a lack of resources, poor technical support in terms of training, the absence of clear strategies for improving competent use of evidence, procedures regarding engagement with other stakeholders across sectors, varying support from senior managers and limited consultation across sectors were barriers to evidence use. The willingness of organizations to create a culture of using evidence was reported as a facilitator.

Conclusion

The use of evidence in policy-making will only become a reality in Fiji if it is a formalized part of the government’s policy-making systems. A systems approach to food-related policy-making and implementation may achieve this by helping Ministries manage the complex and dynamic nature of food-related policy-making in Fiji.
Literature
1.
go back to reference Lozano R, et al. Global and regional mortality from 235 causes of death for 20 age groups in 1990 and 2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet. 2012;380(9859):2095–128.CrossRefPubMed Lozano R, et al. Global and regional mortality from 235 causes of death for 20 age groups in 1990 and 2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet. 2012;380(9859):2095–128.CrossRefPubMed
3.
go back to reference Waters E, et al. Interventions for preventing obesity in children. Sao Paulo Med J. 2014;132(2):128–9.CrossRef Waters E, et al. Interventions for preventing obesity in children. Sao Paulo Med J. 2014;132(2):128–9.CrossRef
4.
go back to reference Fernstrom MH, et al. Communication strategies to help reduce the prevalence of non-communicable diseases: proceedings from the inaugural IFIC Foundation Global Diet and Physical Activity Communications Summit. Nutr Rev. 2012;70(5):301–10.CrossRefPubMedPubMedCentral Fernstrom MH, et al. Communication strategies to help reduce the prevalence of non-communicable diseases: proceedings from the inaugural IFIC Foundation Global Diet and Physical Activity Communications Summit. Nutr Rev. 2012;70(5):301–10.CrossRefPubMedPubMedCentral
5.
go back to reference Gortmaker SL, et al. Changing the future of obesity: science, policy, and action. The Lancet. 2011;378(9793):838–47.CrossRef Gortmaker SL, et al. Changing the future of obesity: science, policy, and action. The Lancet. 2011;378(9793):838–47.CrossRef
6.
go back to reference Strehlenert H, et al. Evidence-informed policy formulation and implementation: a comparative case study of two national policies for improving health and social care in Sweden. Implement Sci. 2015;10(1):169.CrossRefPubMedPubMedCentral Strehlenert H, et al. Evidence-informed policy formulation and implementation: a comparative case study of two national policies for improving health and social care in Sweden. Implement Sci. 2015;10(1):169.CrossRefPubMedPubMedCentral
7.
go back to reference Waqanivalu TK. Pacific islanders pay heavy price for abandoning traditional diet. Bull World Health Organ. 2010;88(7):484–5.CrossRef Waqanivalu TK. Pacific islanders pay heavy price for abandoning traditional diet. Bull World Health Organ. 2010;88(7):484–5.CrossRef
8.
go back to reference Oliver K, et al. A systemic review of the barriers to and facilitators of the use of evidence by policymakers. BMC Health Services Research. 2014;14(2). Oliver K, et al. A systemic review of the barriers to and facilitators of the use of evidence by policymakers. BMC Health Services Research. 2014;14(2).
9.
go back to reference Humphreys K, Piot P. Scientific evidence alone is not sufficient basis for health policy. Bmj. 2012;344:e1316. doi:10.1136/bmj.e1316. PMID:22371864 Humphreys K, Piot P. Scientific evidence alone is not sufficient basis for health policy. Bmj. 2012;344:e1316. doi:10.​1136/​bmj.​e1316. PMID:22371864
10.
go back to reference World Health Organisation. Obesity: preventing and managing the global epidemic. Report of a WHO consultation. Geneva: World Health Organisation; 2000. p. 253. World Health Organisation. Obesity: preventing and managing the global epidemic. Report of a WHO consultation. Geneva: World Health Organisation; 2000. p. 253.
12.
go back to reference Nutley S, Davies H, Walter I. University of St. Andrews: Research Unit for Research Utilisation. 2004. Nutley S, Davies H, Walter I. University of St. Andrews: Research Unit for Research Utilisation. 2004.
13.
go back to reference Lobstein T, Frelut M. Prevalence of overweight among children in Europe. Obes Rev. 2003;4(4):195–200.CrossRefPubMed Lobstein T, Frelut M. Prevalence of overweight among children in Europe. Obes Rev. 2003;4(4):195–200.CrossRefPubMed
15.
go back to reference Parkhurst JO. Appeals to evidence for the resolution of wicked problems: the origins and mechanisms of evidentiary bias. Policy Sciences. 2016;49(4):373–93. Parkhurst JO. Appeals to evidence for the resolution of wicked problems: the origins and mechanisms of evidentiary bias. Policy Sciences. 2016;49(4):373–93.
16.
go back to reference Wertz MS, et al. The toxic effects of cigarette additives. Philip Morris’ project mix reconsidered: an analysis of documents released through litigation. PLoS Med. 2011;8(12):e1001145.CrossRefPubMedPubMedCentral Wertz MS, et al. The toxic effects of cigarette additives. Philip Morris’ project mix reconsidered: an analysis of documents released through litigation. PLoS Med. 2011;8(12):e1001145.CrossRefPubMedPubMedCentral
19.
go back to reference Oliver K, Lorenc T, Innvær S. New directions in evidence-based policy research: a critical analysis of the literature. Health Res Policy Syst. 2014;12:34.CrossRefPubMedPubMedCentral Oliver K, Lorenc T, Innvær S. New directions in evidence-based policy research: a critical analysis of the literature. Health Res Policy Syst. 2014;12:34.CrossRefPubMedPubMedCentral
20.
go back to reference Lavis, J, et al. SUPPORT tools for evidence-informed health policymaking (STP) 5: Using research evidence to frame options to address a problem. Health Research Policy & Systems. 2009;7(suppl 1):I1. Lavis, J, et al. SUPPORT tools for evidence-informed health policymaking (STP) 5: Using research evidence to frame options to address a problem. Health Research Policy & Systems. 2009;7(suppl 1):I1.
21.
go back to reference Waqa G, et al. Participants’ perceptions of a knowledge-brokering strategy to facilitate evidence-informed policy-making in Fiji. BMC Public Health. 2013;13(1):725.CrossRefPubMedPubMedCentral Waqa G, et al. Participants’ perceptions of a knowledge-brokering strategy to facilitate evidence-informed policy-making in Fiji. BMC Public Health. 2013;13(1):725.CrossRefPubMedPubMedCentral
22.
23.
go back to reference Innvaer S, et al. Health policy-makers’ perceptions of their use of evidence: a systematic review. J Health Serv Res Policy. 2002;7:239–44.CrossRefPubMed Innvaer S, et al. Health policy-makers’ perceptions of their use of evidence: a systematic review. J Health Serv Res Policy. 2002;7:239–44.CrossRefPubMed
25.
go back to reference Chunharak S. An interactive integrative approach to translating knowledge and building a “learning organization” in health services management. Bulletin of the World Health Organization. 2006;84(8):652–57. Chunharak S. An interactive integrative approach to translating knowledge and building a “learning organization” in health services management. Bulletin of the World Health Organization. 2006;84(8):652–57.
26.
go back to reference FAO. Enhancing evidence-based decision making for sustainable agriculture sector development in Pacific Island Countries, Report of an FAO Expert Consultation Meeting held in Nadi. Fiji: FAO: Sub-regional Office for the Pacific Islands, Apia; 2010. FAO. Enhancing evidence-based decision making for sustainable agriculture sector development in Pacific Island Countries, Report of an FAO Expert Consultation Meeting held in Nadi. Fiji: FAO: Sub-regional Office for the Pacific Islands, Apia; 2010.
28.
go back to reference Waqa G, et al. Knowledge brokering between researchers and policymakers in Fiji to develop policies to reduce obesity: a process evaluation. Implement Sci. 2013;8:74.CrossRefPubMedPubMedCentral Waqa G, et al. Knowledge brokering between researchers and policymakers in Fiji to develop policies to reduce obesity: a process evaluation. Implement Sci. 2013;8:74.CrossRefPubMedPubMedCentral
29.
go back to reference Waqa G, Snowdon W, Mavoa H. An integrative approach of Knowledge to Action with Policy Makers in a small Pacific nation. Fiji Journal of Public Health. 2012;1(2):44–6. Waqa G, Snowdon W, Mavoa H. An integrative approach of Knowledge to Action with Policy Makers in a small Pacific nation. Fiji Journal of Public Health. 2012;1(2):44–6.
30.
go back to reference Hawkes C, et al. Smart food policies for obesity prevention. The Lancet. 2015;385(9985):2410–21.CrossRef Hawkes C, et al. Smart food policies for obesity prevention. The Lancet. 2015;385(9985):2410–21.CrossRef
32.
go back to reference Taylor FE, et al. Health status and behavior among middle-school children in a midwest community: What are the underpinnings of childhood obesity? American Heart Journal. 2010;160(6):1185–1189. Taylor FE, et al. Health status and behavior among middle-school children in a midwest community: What are the underpinnings of childhood obesity? American Heart Journal. 2010;160(6):1185–1189.
34.
go back to reference Thow AM, et al. Trade and the nutrition transition: strengthening policy for health in the pacific. Ecol Food Nutr. 2011;50(1):18–42.CrossRefPubMed Thow AM, et al. Trade and the nutrition transition: strengthening policy for health in the pacific. Ecol Food Nutr. 2011;50(1):18–42.CrossRefPubMed
35.
go back to reference Thow AM, et al. Taxing soft drinks in the Pacific: implementation lessons for improving health”. Health Promot Int. 2011;26(1):55–64.CrossRefPubMed Thow AM, et al. Taxing soft drinks in the Pacific: implementation lessons for improving health”. Health Promot Int. 2011;26(1):55–64.CrossRefPubMed
36.
go back to reference Snowdon W. Challenges of noncommunicable diseases in the Pacific Islands: the need for evidence and data. Asia Pac J Public Health. 2011;23:110–1.CrossRefPubMed Snowdon W. Challenges of noncommunicable diseases in the Pacific Islands: the need for evidence and data. Asia Pac J Public Health. 2011;23:110–1.CrossRefPubMed
37.
go back to reference Lim SS, et al. A comparative risk assessment of burden of disease and injury attributable to 67 risk factors and risk factor clusters in 21 regions, 1990–2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet. 2012;380(9859):2224–60.CrossRefPubMedPubMedCentral Lim SS, et al. A comparative risk assessment of burden of disease and injury attributable to 67 risk factors and risk factor clusters in 21 regions, 1990–2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet. 2012;380(9859):2224–60.CrossRefPubMedPubMedCentral
39.
go back to reference Thow AM, et al. Trade and food policy: Case studies from three Pacific Island countries. Food Policy. 2010;35:556–64.CrossRef Thow AM, et al. Trade and food policy: Case studies from three Pacific Island countries. Food Policy. 2010;35:556–64.CrossRef
40.
go back to reference Thow AM, et al. The role of policy in improving diets: experiences from the Pacific Obesity Prevention in Communities food policy project. Obes Rev. 2011;12:68–74.CrossRefPubMed Thow AM, et al. The role of policy in improving diets: experiences from the Pacific Obesity Prevention in Communities food policy project. Obes Rev. 2011;12:68–74.CrossRefPubMed
43.
go back to reference Swinburn B, et al. The Pacific OPIC (Obesity Prevention In Communities) - Objectives and designs. Pac Health Dialog. 2007;14(2):139–46.PubMed Swinburn B, et al. The Pacific OPIC (Obesity Prevention In Communities) - Objectives and designs. Pac Health Dialog. 2007;14(2):139–46.PubMed
44.
go back to reference Mavoa H, et al. Knowledge Exchange in the Pacific: The TROPIC (Translational Research into Obesity prevention Policies for Communities) project. BMC Public Health. 2012;12:552.CrossRefPubMedPubMedCentral Mavoa H, et al. Knowledge Exchange in the Pacific: The TROPIC (Translational Research into Obesity prevention Policies for Communities) project. BMC Public Health. 2012;12:552.CrossRefPubMedPubMedCentral
45.
go back to reference Snowdon W, et al. Prioritizing policy interventions to improve diets? Will it work, can it happen, will it do harm? Health Promot Int. 2010;25(1):123–33.CrossRefPubMedPubMedCentral Snowdon W, et al. Prioritizing policy interventions to improve diets? Will it work, can it happen, will it do harm? Health Promot Int. 2010;25(1):123–33.CrossRefPubMedPubMedCentral
46.
go back to reference Mannheimer L, Lehto J, Ostlin P. Window of opportunity for intersectoral health policy in Sweden-open, half-open or half-shut? Health Promot Int. 2007;22(4):307–15.CrossRefPubMed Mannheimer L, Lehto J, Ostlin P. Window of opportunity for intersectoral health policy in Sweden-open, half-open or half-shut? Health Promot Int. 2007;22(4):307–15.CrossRefPubMed
47.
go back to reference Hawkes C, et al. Linking agricultural policies with obesity and noncommunicable diseases: a new perspective for a globalising world. Food Policy. 2012;37(3):343–53.CrossRef Hawkes C, et al. Linking agricultural policies with obesity and noncommunicable diseases: a new perspective for a globalising world. Food Policy. 2012;37(3):343–53.CrossRef
48.
go back to reference El-Jardali F, et al. Constraints to applying systems thinking concepts in health systems: A regional perspective from surveying stakeholders in Eastern Mediterranean countries. Int J Health Policy Manag. 2014;3:399–407.CrossRefPubMedPubMedCentral El-Jardali F, et al. Constraints to applying systems thinking concepts in health systems: A regional perspective from surveying stakeholders in Eastern Mediterranean countries. Int J Health Policy Manag. 2014;3:399–407.CrossRefPubMedPubMedCentral
49.
go back to reference Beaglehole R, et al. UN high-level meeting on non-communicable diseases: addressing four questions. The Lancet. 2011;378(9789):449–55.CrossRef Beaglehole R, et al. UN high-level meeting on non-communicable diseases: addressing four questions. The Lancet. 2011;378(9789):449–55.CrossRef
50.
go back to reference Snowdon W, et al. Non-communicable diseases and health system responses in Fiji. Melbourne: The Nossal Institute, University of Melbourne; 2013. Snowdon W, et al. Non-communicable diseases and health system responses in Fiji. Melbourne: The Nossal Institute, University of Melbourne; 2013.
51.
go back to reference Cheng MH. Asia-Pacific faces diabetes challenge. The Lancet. 2010;375(9733):2207–10.CrossRef Cheng MH. Asia-Pacific faces diabetes challenge. The Lancet. 2010;375(9733):2207–10.CrossRef
53.
go back to reference Herforth A, Ahmed S. The food environment, its effects on dietary consumption, and potential for measurement within agriculture-nutrition interventions. Food Security. 2015;7(3):505–20.CrossRef Herforth A, Ahmed S. The food environment, its effects on dietary consumption, and potential for measurement within agriculture-nutrition interventions. Food Security. 2015;7(3):505–20.CrossRef
55.
go back to reference Corluka A, et al. Exploring health researchers’ perceptions of policymaking in Argentina: a qualitative study. Health Policy Plan. 2014;29 suppl 2:ii40-ii49.CrossRefPubMedCentral Corluka A, et al. Exploring health researchers’ perceptions of policymaking in Argentina: a qualitative study. Health Policy Plan. 2014;29 suppl 2:ii40-ii49.CrossRefPubMedCentral
57.
go back to reference de Savigny D, et al. Introducing vouchers for malaria prevention in Ghana and Tanzania: context and adoption of innovation in health systems. Health Policy Plan. 2012;27 suppl 4:iv32-iv43.CrossRef de Savigny D, et al. Introducing vouchers for malaria prevention in Ghana and Tanzania: context and adoption of innovation in health systems. Health Policy Plan. 2012;27 suppl 4:iv32-iv43.CrossRef
58.
go back to reference Hendriks Anna-Marie, et al., Perspectives of Fijian Policymakers on the Obesity Prevention Policy Landscape. BioMed Research International, 2015. 2015, Article ID 926159, 10 pages, 2015. doi:10.1155/2015/926159. Hendriks Anna-Marie, et al., Perspectives of Fijian Policymakers on the Obesity Prevention Policy Landscape. BioMed Research International, 2015. 2015, Article ID 926159, 10 pages, 2015. doi:10.​1155/​2015/​926159.
59.
go back to reference Paina L, Peters DH. Understanding pathways for scaling up health services through the lens of complex adaptive systems. Health Policy Plan. 2012;27(5):365–73.CrossRefPubMed Paina L, Peters DH. Understanding pathways for scaling up health services through the lens of complex adaptive systems. Health Policy Plan. 2012;27(5):365–73.CrossRefPubMed
60.
go back to reference Agyepong IA, et al. When ‘solutions of yesterday become problems of today’: crisis-ridden decision making in a complex adaptive system (CAS)—the Additional Duty Hours Allowance in Ghana. Health Policy Plan. 2012;27 suppl 4:iv20-iv31.CrossRef Agyepong IA, et al. When ‘solutions of yesterday become problems of today’: crisis-ridden decision making in a complex adaptive system (CAS)—the Additional Duty Hours Allowance in Ghana. Health Policy Plan. 2012;27 suppl 4:iv20-iv31.CrossRef
61.
go back to reference WHO. Monitoring the building blocks of health systems: a handbook of indicators and their measurement strategies. Geneva: World Health Organization; 2010. WHO. Monitoring the building blocks of health systems: a handbook of indicators and their measurement strategies. Geneva: World Health Organization; 2010.
Metadata
Title
Factors affecting evidence-use in food policy-making processes in health and agriculture in Fiji
Authors
Gade Waqa
Colin Bell
Wendy Snowdon
Marj Moodie
Publication date
01-12-2017
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2017
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/s12889-016-3944-6

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