Intelligence Unit 6 - Mandates for Action Policy exerts a powerful influence on public health nutrition (PHN) practice because it affects:  service delivery models  resource allocation  supports or resists actions required Governments the world, are taking action on PHN issues by developing national nutrition policies and action plans National nutrition policies set the priorities, strategic direction and provide the framework for PHN action in local communities Mandates for Action

The Policy Context The term policy is used in different ways to describe the direction of an organisation or government, a decision to act on a particular problem or a set if guiding principles Most mandates for action important to PHN are considered policies, examples include:  Local and national health policies and guidelines  Pan-European and global policies and guidelines  Legislation and regulation  Organisational mission statements and strategic plans  Professional standards and ethical guidelines

The Policy Context A vast array of policy areas are considered to impact on population nutrition-related health problems including, education, food, urban planning, transport, advertising and marketing The policy context is largely considered a top-down process but practitioners can contribute to policy development through public consultation → the outcomes of well evaluated PHN interventions contribute to the evidence- base utilised in policy development Mandates for Action

Policy Development National governments generally set the fundamental policy direction, while locally policies tend to develop incrementally Policy development follows a basic pathway (similar to program planning and intervention management) → Problem identification, policy formulation, policy implementation, policy evaluation However policy is rarely a purely rational process:  applies scientific and pragmatic intelligence  highly contextual - sensitive to political, economic, social and cultural factors  Influenced by political self-interest, lobby groups, media and public opinion Mandates for Action

Competing Policy Agendas Traditional food policies ensured a safe food supply and have been popularly and politically supported → development of national, and international policies (e.g. Codex Alimentaris) Gaining consensus for policies that encourage the availability and promotion of a healthy food supply is more complex → many competing and vested interests contributing to the debate:  power and dominance of food manufacturers and retailers  interests and needs of primary producers  demands of health and consumer groups  consumer confusion Mandates for Action

National Nutrition Policies 1992 World Declaration on Nutrition, First Action Plan for Food & Nutrition and Global Strategy on Diet, Physical Activity & Health → development of national policies and action plans to address PHN issues across Europe Nutrition action areas include:  Infant feeding, food security, food safety, nutrition, physical Activity, reducing obesity Many Member States have developed policies related to food and nutrition however implementation appears to be a major challenge, specifically:  lack of funds, political commitment, coordination and expertise

Mandates for Action in PHN Practice Nutrition policies and action plans (mandates) provide a national government level mandate for action on PHN issues Nutrition mandates codify priorities for action by:  Stating the PHN issues, target groups and settings for action  Focusing the PHN workforce effort for more effective outcomes Implementation of the strategic priorities requires local practitioners to build the capacity of communities to effectively design, plan, implement and evaluate sustainable strategic interventions → national mandates and local intervention management are both needed to solve PHN problems Mandates for Action

Mandates for Action in PHN Practice Nutrition policies and action plans are not the only mandates that need considering in PHN intervention management Need to consider existing mandates of:  Your own organisation  Potential partners or competitors  Potential funding agencies  Relevant legislation and regulation  Professional association policies, guidelines and ethical standards Assists secure managerial support for intervention, financial support and awareness of potential barriers/ objections Mandates for Action

Funding agencies and government bodies want to see that the interventions they are financing are contributing to the prioritised health objectives. Knowing the national and organisational mandates for action is a vital component of PHN intervention management and must be addressed in intervention plans and funding submissions. Highlight how your intervention will contribute to priorities action areas and work plans to demonstrate your understanding of the policy context and your interventions role in supporting the broader public health objectives. In short, this makes it easier for bureaucrats to support your plans.

Mandates for Action Mandates for Action - examples European Union - Commission of the European Communities WHITE PAPER: A Strategy for Europe on Nutrition, Overweight and Obesity related health issues National Board of Health Denmark – Centre for Health Promotion and Prevention National Action Plan Against Obesity. Richmond and Twickenham Primary Care Trust (PCT) is the National Health Service organisation responsible for health services in the London Borough of Richmond upon Thames.