Strengthening national salt reduction strategies using multiple methods process evaluations: case studies from Malaysia and Mongolia.

IF 3 3区 医学 Q2 NUTRITION & DIETETICS
Briar L McKenzie, Feisul Idzwan Mustapha, Bat-Erdene Battumur, Enkhtungalag Batsaikhan, Arunah Chandran, Viola Michael, Jacqui Webster, Kathy Trieu
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Abstract

Objective: To understand the extent to which national salt reduction strategies in Malaysia and Mongolia were implemented and achieving their intended outcomes.

Design: Multiple methods process evaluations conducted at the mid-point of strategy implementation, guided by theoretical frameworks.

Setting: Malaysia (2018-2019) and Mongolia (2020-2021).

Participants: Desk-based reviews of related documents, interviews with key stakeholders (n 12 Malaysia, n 10 Mongolia), focus group discussions with health professionals in Malaysia (n 43) and health provider surveys in Mongolia (n 12).

Results: Both countries generated high-quality local evidence about salt intake and levels in foods and culturally specific education resources. In Malaysia, education and reformulation activities were delivered with moderate dose (quantity) but reach among the population was low. Within 5 years, Mongolia implemented education among schools, health professionals and food producers on salt reduction with high reach, but with moderate dose (quantity) and reach among the general population. Both countries faced challenges in implementing legislative interventions (mandatory salt labelling and salt limits in packaged foods) and both could improve the scaling up of their reformulation and education activities.

Conclusions: In the first half of Malaysia's and Mongolia's strategies, both countries generated necessary evidence and education materials, mobilised health professionals to deliver salt reduction education and achieved small-scale reformulation in foods. Both subsequently should focus on implementing regulatory policies and achieving population-wide reach and impact. Process evaluations of existing salt reduction strategies can help strengthen intervention delivery, aiding achievement of WHO's 30 % reduction in salt intake by 2025 target.

利用多种方法进程评估加强国家减盐战略--马来西亚和蒙古的案例研究。
目标:了解马来西亚和蒙古在多大程度上实施了国家减盐战略并取得了预期成果:了解马来西亚和蒙古在多大程度上实施了国家减盐战略并取得了预期成果:设计:在理论框架的指导下,在战略实施的中期进行多种方法的过程评估:马来西亚(2018-19 年)和蒙古(2020-21 年):对相关文件进行案头审查,对主要利益相关者进行访谈(马来西亚 12 人,蒙古 10 人),在马来西亚与卫生专业人员进行焦点小组讨论(43 人),在蒙古对卫生服务提供者进行调查(12 人):结果:两个国家都获得了有关盐摄入量和食品中盐含量的高质量本地证据,以及针对特定文化的教育资源。在马来西亚,教育和重新配制活动的剂量(数量)适中,但在人群中的覆盖率较低。在 5 年内,蒙古在学校、卫生专业人员和食品生产商中开展了减盐教育,覆盖率较高,但在普通人群中的剂量(数量)和覆盖率适中。这两个国家在实施立法干预措施(强制性食盐标签和包装食品中的食盐限量)方面都面临挑战,而且都可以改进其重新制定配方和教育活动的规模:在马来西亚和蒙古战略的前半部分,两国都制定了必要的证据和教育材料,动员卫生专业人员开展减盐教育,并实现了小规模的食品配方改革。随后,两国都应将重点放在实施监管政策和实现全民覆盖和影响上。对现有减盐战略的过程评估有助于加强干预措施的实施,帮助实现世卫组织到 2025 年将盐摄入量减少 30% 的目标。
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来源期刊
Public Health Nutrition
Public Health Nutrition 医学-公共卫生、环境卫生与职业卫生
CiteScore
6.10
自引率
6.20%
发文量
521
审稿时长
3 months
期刊介绍: Public Health Nutrition provides an international peer-reviewed forum for the publication and dissemination of research and scholarship aimed at understanding the causes of, and approaches and solutions to nutrition-related public health achievements, situations and problems around the world. The journal publishes original and commissioned articles, commentaries and discussion papers for debate. The journal is of interest to epidemiologists and health promotion specialists interested in the role of nutrition in disease prevention; academics and those involved in fieldwork and the application of research to identify practical solutions to important public health problems.
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