Accelerating Nutrition Polices in the Caribbean

Create bottom up movement for incentives for healthy food.

Our support to policy makers must be in the realm of encouraging strong advocacy and action among our communities and community partners. Launching our "attack" from the ground up is a well documented strategy to achieve our desired objective for action above. We must therefore re-double our efforts in this regard if we are to achieve any meaningful and serious action. Time is of the essence.

To design policies that can be measured and implemented with sufficient capacity and resources.

Policymakers are traditionally not very good implementors. Civil Society should "insist" on being utilized and tasked with the implementation, while policymakers ensure that standards and policies are adhered to and audited, and provide some (if not most) of the financial backing to implement. The "buy-in" that is needed needs to begin with dialogue prior to policy making, between us and the policymakers. So we need to be accessible and ready to assist policymakers.

Strong national education and Advocacy work at the level of both the policymakers and the other critical stakeholders in the process.

To answer this question, I think we should first identify which factors hinder the implementation of nutrition policies in general. From my perspective the main thing why implementation of nutrition policies goes wrong in Suriname, is the lack of collaboration between all parties at all levels (political, policy-making, managerial and operational levels). To overcome this barrier, we can support policymakers by providing them with the competencies, capacities, practical guidance on how to set up an arrangement that connects all parties in a process of committed, continuous collaboration.

Strengthen and harness public support.

Develop an evidence based unified nutrition policy for the region to be implemented in a form similar to the food pyramid.

Develop effective mechanisms for intersectoral work.

To set in place engagement channels for young people to voice and be heard across government — when it comes to challenges that affect our youth’s health, such as childhood obesity, young people are in the best position to hold the government accountable to adequately respond and implement policies that will ultimately impact their future.

Creating "blueprints" that can be tailored accordingly, which should reduce the need for additional resources (such as consultancies) and the time needed to develop and implement policies.

The most important thing is sensitization of the policymakers to the need for healthy food environments and to showcase local research pertaining to obesity levels and lifestyle habits. Policies are needed if we want to create a positive food environment so our children can eat healthy foods.

Nutrition policies play a key role in creating healthy children and communities in general because they assist these individuals to inter alia achieve and maintain healthier diets based on various guidelines.

Create a strong lobby among civil society activists, business leaders, farmers, communities and ordinary citizens to create the level of buy-in by the public at large to give politicians and policy-makers the courage to act decisively.

They key ingredients in achieving the desired objectives are partnerships and collaborations – all stakeholders need to come together across the board – government, food industry, hospitality industry, media, civil society groups, educational institutions, corporate, parents, teachers and the children – the should be continuous efforts to bring everyone together – create a middle ground – recommend, adopt and implement healthy eating habits.

Continue to advocate for implementation by providing initiatives and activities for implementation, building their capacity in understanding of the issue, conducting research which shows impact of policies not being implemented. Remain committed and passionate to the cause.

1. Create models for supportive environments.
2. Educate and empower parents teachers and children.
3. Uncourage owernship of lifestyle efforts and projects in schools , churches , communities etc.
4. Create blue prints for the practical implementation of policy.
5. Build body of advocates demanding change.
6. Develop a multisectorial and mulrigenerational approach to this fight.

To promote intersectorial approach for food healthy environment regulation
To ensure that all key actors can contribute to this agenda
To promote, to support, to establish monitoring and evaluation process on Public policies (nutrition policies, food healthy environment regulation, …)
To establish and support international cooperation between countries (regional network,…) allowing best practices exchanges, technical discussion, technical/political support.

Ensure an enabling nutrition policy environment by utilizing a multipronged approach inclusive of engagement, education, and empowerment.

In an effort to support policy makers in the implementation of nutrition policy for the benefit of children and communities, it is important to partner with policymakers supporting all aspects of the implementation process. Also collaborate with advocacy groups and stakeholders to provide programs and activities to increase awareness of the process in school, churches and by extension the community.

For any sustainable behaviour change we need to have an intersectoral approach targeting the broader socio-cultural determinants of dietary choices. As NGOs, we can support policy makers through using our platforms to educate and mobilize our diverse target groups on the benefits of nutrition policies and the impacts of healthy choices on quality of life and long-term health outcomes. Gaining community buy-in is critical.

Clarify what we mean by NCDs to ordinary people (communication).
Mobilise patient organisations and civil society to 'make noise' (Advocacy) using a digital health approach.
Use more political economy analysis to inform strategies.

Host forums for families.

It is important to keep abreast of the best practices and the evidence so that we may give the best guidance possible. It is also important to think critically about how various measures may be adopted at the country level to suit the local context.

To support policy makers to implement nutrition policies which create healthy children and communities, the following must be done:
– They need to appreciate the importance of the initiative
– Data must be presented highlight evidence
– They must be convinced of economic value
– They must understand how it directly affects quality of lives

We can support them sharing and promotion at every level of our interaction. When we wait on macro level implementation we forfeit true sensitization and appreciation of the what is at stake. The children form the next generation so they must be aware of the significance of their actions at a formative stage. The conversation must be from a bottom up approach. Community outreach programs, schools, supermarkets, restaurants, churches and social media need to be utilized as a tool to truly promote policies regarding nutrition.

There are several critical things that can be done to support policymakers to implement nutrition policies which create healthy children and communities. These include: • Having current evidence to support the policy initiatives.
• Suggesting reasonable strategies to achieve the goals.
• Incorporating existing expertise in the implementation of the plan of action.
• Include all stakeholders from the planning stage for buy-in and sustainability of efforts.
• Continuous dialogue.

Advocate to members of the society the need to choose healthier lifestyles through advertising, and promotional campaigns, thereby making it easier for policy to be accepted and supported by the populace. Once the populace supports the policies there should be no push back and implementation of nutrition policies would be widely supported.

Build an effective and sustainable partnership amongst the advocates (Public Health – national, regional and international bodies, and like minded civil society organisatons), the private sector (particularly those engaged in food production and processing), and the relevant policy makers (agriculture, health education and finance) to confront the concerns and to develop an agreed plan of action with sequential outputs towards realising the desirable outcome of healthy children and communities.

Provide technical and step by step implementation support.

Work collaboratively to support and share best practices.

Parent/ caregiver education and capacity building seems to be an area in which we have been lacking. It requires varied and consistent contact and the parents and caregivers population is large. the MOHW is unable to do all that is necessary. Schools have been indicating that they struggle with getting parents to support healthy nutrition related policies. This sometimes derails the efforts of the schools.

?: There needs to be more education and sensitization on the topics of NCDs and Childhood obesity, especially since our cultures are such that NCDs such as Mental Health are not given as much attention in comparison to the more popular types of cancer, heart disease etc. Public education on such would then garner support for the policies being implemented as they would understand the implications of these diseases and why it is important for the government to take certain measures to combat them.

The most important thing we can do to support policy makers is to ensure that all the programmes are fully implemented in the strategic plans of the various sectors both public and private sector. That is, to ensure that there is a component of nutrition and healthy behaviours and or physical activity, and healthy work environments. Specifically targeting employers, employees, patrons, children, and other community partners.

Utilise a health in all policies approach to nutrition policy making. Involve key sectors (health, education, agri, trade, foreign affairs) in policy review, program development and operationalise of policies across sectors. Create tools, and build capacity for joint gap analysis, planning, monitoring of nutritional policies and strategies, with Civil society, professional and regional bodies. Build capacity for documentation, research and policy evaluation. Obtain policy approval at a high level (Cabinet/Parliament) to ensure multiple sector implementation and funding.

Share experiences from across the region so that we can reduce potential barriers to implementation of sustainable nutrition policies.

From the perspective of the education sector, of which I am currently employed, I would say conducting research that provides timely, accurate information to address the current and evolving landscape. From a consultancy perspective, it is also important to provide proven options for various implementation strategies that work best for the communities/societies for which the policies were designed.

Disseminate more information about the negative externalities associated with certain lifestyle and nutritional choices.

From a youth perspective, it is imperative that we engage in peer to peer education on the importance of a healthy lifestyle because we are more capable of getting across the information to the youth, as we are the youth. One of the biggest challenges in implementing policies is the backlash that will arise from the populous. Thus, if the youth find the policy useless due to a lack of knowledge, there will be issues. So we have to sensitize our peers, who will then sensitize their parents, allowing for a smooth and understood policy revolving around NCD's to be put into effect.

Policy makers usually are hesitant to develop and implement certain policy because of the fear that they will be met with resistance and may have repercussions on economic viabilities of the country. The use of regional interventions such as the development of policies aimed at reducing transfat, sodium and refined sugars in manufactured products as a regional stance may provide the additional support that countries may need. Taxation of imports from outside of CARICOM which are high in those ingredients may be another way to go. Incorporating the above and more into a regional strategy.

To continue community engagement, parental education and school administrators regarding the behavioural changes and accessibility issues regarding low nutrient calorie dense options as opposed to better food choices.

Use our platforms to promote the healthy eating agenda, provide our unique technical resources to tackle the issue from all angles and keep the pressure on! Knowing how critical these policies are and how constituents support them is a vital step in ensuring policymakers' determination to continuously move forward.

Perhaps the most important thing we can all do to support policy makers is to continue our advocacy on the subject with a consistent message regarding the critical importance of childhood obesity prevention policies for our country’s future. As the message is amplified and echoed throughout our societies there will be a greater level of traction and buy-in regarding its value proposition which would then provide the basis for our governments to raise the level of priority and hence resources directed at addressing this problem and to provide more credible leadership and sustained action.

1) Make a meaningful contribution at the development stage of the policies through sharing ideas, research and information based on experience.
2) Communicating via our social media platforms how the policy has impacted our personal lives and those of our loved ones.
3) Hold policy makers responsible not just for the implementation but also for the enforcement, monitoring and evaluation and communication back to the masses about its effectiveness and was in which the policy can be improved.

We need to listen and learn how to communicate our evidence more effectively among political leaders; specifically we need to work with health policymakers to ensure nutrition policies resonate with leaders that may not share our ideologies (about framing as much as evidence). We also need to be braver in calling out political economies that are undermining implementation, and more adept at explaining how the commercial determinants can be tackled.

Agitate for policies that aligned with health policies and best practices.

As policymakers we must ensure that we lend support to the policymakers that implement policies which create healthy children and communities by efficiently and effectively fulfilling the tasks/actions that we have responsibility for. A chain is as strong as its weakest link, therefore, a further breakdown in nutrition would occur if there are any inefficiencies along the 'implementation chain'. Also, as individuals implement the principles of a healthy lifestyle in our homes, actively participate in the initiatives and by being advocates in our communities.

Lobby using existing legal framework that supports the implementation of policies supporting healthy nutrition.

Initiatives focused on improving aspects of students' well-being in schools such as childhood obesity is gaining momentum. However, efforts are often implemented in silos without the recognition of their interconnection. To continuously advance this, coordinated efforts that integrate multiple components of the healthy school environments must be addressed.

When we often speak about policymakers, we think of the technocrats in the Ministries that seek to develop policies. Oftentimes we fail to forget that we too as the general population are also part of the policymakers. We can therefore support the policymakers by getting involved in the development, assist in creating supporting and enabling environments both at home and in the communities and commencing any applicable behavior change as a family unit.