Strengthening Food Systems Governance to Achieve Multiple Objectives: A Comparative Instrumentation Analysis of Food Systems Policies in Vanuatu and the Solomon Islands

Offline to online: a systematic mapping review of evidence to inform nutrition-related policies applicable to online food delivery platforms

BACKGROUND

Online food delivery (OFD) platforms offer easy access to an abundance of energy-dense and nutrient-poor takeaway foods and may exacerbate existing unhealthy food environments. Efforts to improve population diets include a range of policy recommendations focused on improving the healthiness of food environments; however, the way in which such policies may apply to OFD platforms is not clear. This paper aimed to synthesise the existing evidence to inform nutrition-related policies applicable to OFD platforms for population health and well-being. A secondary aim was to scan existing nutrition-related policies in Australia and internationally, which have the potential to be applicable to OFD platforms.

METHODS

Seven electronic databases including Medline, Embase, CINAHL, Business Source Ultimate, Scopus, Web of Science, and Proquest were searched from January 2010 to October 2023. Evidence from studies was mapped to five existing policy domains outlined by the Healthy Food Environment Policy Index (Food-EPI) including (i) food labelling; (ii) food promotion; (iii) food composition and nutritional quality; (iv) food retail; and (v) food pricing. Relevant data sources were searched for currently implemented nutrition-related government policies that may have relevance to OFD platforms.

RESULTS

A total of 2012 records were screened, and 43 studies were included. There were 70 relevant study outcomes across the included studies, which addressed one or more of the 5 domains. Of these, 21 were relevant to 'Food Promotion' (30%), 18 to 'Food Retail' (26%), 15 to 'Food Composition (21%), 11 to 'Food Prices' (16%), and six to 'Food Labelling' (9%). Three existing policies from international jurisdictions (England, Singapore, EU) included OFD platforms, of which one was a voluntary measure. Several existing policies under food labelling have the potential to be amended to include OFD platforms under regulatory definitions.

CONCLUSION

OFD platforms have emerged as a disruptor to how people acquire their food and have yet to be widely included in existing nutrition-related policies. Advancing the evidence base to support the design of effective policy actions and mitigate the potential negative health impacts of OFD platforms will support efforts to improve population diets.

Why health systems cannot fix problems caused by food systems: a call to integrate accountability for obesity into food systems policy

Overweight and obesity now impact one-third of the entire adult population globally, and play a role in the development of 3 of the 4 more common causes of death. Accountability systems for obesity prevention centring on food environment policies and health system strengthening have been vital for raising awareness to the lack of progress in prevention. However, health systems have struggled to prevent and treat obesity - in part because critical food systems reforms largely lay outside the mandate of health sectors and with government agencies for agriculture, industry, infrastructure, trade and investment, and finance. In this commentary we highlight aspects of food systems that are driving poor diets and obesity, and demonstrate a powerful but largely overlooked opportunity for accountability mechanisms for obesity that better address food systems as a main driver. We draw on lessons generated in the Pacific Islands Region where they have demonstrated remarkable commitment to obesity prevention through food system reforms, and the adoption of accountability systems that bring leaders to account on these. We make recommendations for accountability mechanisms that facilitate greater cooperation of food systems sectors on obesity and NCD prevention.

Food price and availability in Solomon Islands during COVID-19: A food environment survey

Background: In Solomon Islands, the retail food environment is an important food source, for instance, the dominant source of fresh fruit and vegetables for urban consumers is open markets. The effects of COVID-19 mitigation measures (such as restriction of human movement and border closures) in early 2020 placed food security at risk in many parts of the community. Of particular concern was the risk of price gouging in an already price-sensitive market. Aims: The study aimed to provide rapid and policy-relevant information on the pricing of foods in the urban food environment in Solomon Islands in the context of the unfolding COVID-19 pandemic. Methods: A vendor survey was conducted in July to August 2020 and repeated in July 2021 using a survey tool that collected information on type, quantity, and price of food on offer. Findings: We found price reductions among the majority of fresh fruit and non-starchy vegetables available. A trend of rising prices was reported for some other commodities, such as fresh locally caught fish. Conclusion: Our findings highlight the impact of 'schocks to the system' on food prices as a potential barrier or enabler to consumption of fresh foods purchased from urban areas - an important finding in a price sensitive market. The survey design was successful in collecting pricing data from the retail food environment during a time of external 'shock to the system'. Our approach is applicable to other settings needing a rapid survey of the external food environment.

Food trade among Pacific Island countries and territories: implications for food security and nutrition

BACKGROUND

There is growing attention to intra-regional trade in food. However, the relationship between such trade and food and nutrition is understudied. In this paper, we present an analysis of intra-regional food trade in the Pacific region, where there are major concerns regarding the nutritional implications of international food trade. Using a new regional database, we examine trends in food trade among Pacific Island Counties and Territories (PICTs) relative to extra-regional trade.

RESULTS

Intra-regional trade represents a small, but increasing proportion of total imports. The major food group traded within the Pacific is cereal grains and flour, which represented 51% of total intra-regional food trade in 2018. Processed and prepared foods, sweetened or flavoured beverages, processed fish, and sugar and confectionary are also traded in large quantities among PICTs. Trade in root crops is negligible, and overall intra-regional trade of healthy foods is limited, both in terms of tonnage and relative to imports from outside the region. Fiji remains the main source of intra-regional imports into PICTs, particularly for non-traditional staple foods.

CONCLUSIONS

This study highlights the growth in trade of staple foods intra-regionally, indicating a role for Fiji (in particular) in regional food security. Within this overall pattern, there is considerable opportunity to enhance intra-regional trade in traditional staple foods, namely root crops. Looking forward, the current food system disruption arising from the COVID-19 pandemic and associated policy measures has highlighted the long-term lack of investment in agriculture, and suggests an increased role for regional approaches in fostering trade in healthy foods.

Research protocol for impact assessment of a project to scale up food policies in the Pacific

BACKGROUND

One of the challenges for countries implementing food policy measures has been the difficulty in demonstrating impact and retaining stakeholder support. Consequently, research funded to help countries overcome these challenges should assess impact and translation into practice, particularly in low-resource settings. However, there are still few attempts to prospectively, and comprehensively, assess research impact. This protocol describes a study co-created with project implementers, collaborative investigators and key stakeholders to optimize and monitor the impact of a research project on scaling up food policies in Fiji.

METHODS

To develop this protocol, our team of researchers prospectively applied the Framework to Assess the Impact from Translational health research (FAIT). Activities included (i) developing a logic model to map the pathway to impact and establish domains of benefit; (ii) identifying process and impact indicators for each of these domains; (iii) identifying relevant data for impact indicators and a cost-consequence analysis; and (iv) establishing a process for collecting quantitative and qualitative data to measure progress. Impact assessment data will be collected between September 2022 and December 2024, through reports, routine monitoring activities, group discussions and semi-structured interviews with key implementers and stakeholders. The prospective application of the protocol, and interim and final research impact assessments of each project stream and the project as a whole, will optimize and enable robust measurement of research impact.

DISCUSSION

By applying this protocol, we aim to increase understanding of pathways to impact and processes that need to be put in place to achieve this. This impact evaluation will inform future projects with a similar scope and will identify transferable and/or translatable lessons for other Pacific Island states and low- and middle-income countries.