Table 2. Proposed infrastructure support actions for the Government of New Zealand prioritized by experts.
| Proposed infrastructure support actions | Score (% of total points allocated)a | Rank |
|---|---|---|
| To demonstrate a national commitment, the government prioritizes improving nutrition and reducing childhood obesity by: | 390 (7.2) | 1 |
| including clear support for these priorities in the government statements of intent (especially for the MoH); | ||
| – setting a target to reduce the prevalence of childhood and adolescent obesity (for example, by 5% over the next six years). | ||
| To demonstrate commitment and to measure progress, the government specifies clear targets for the reduction of salt, sugar and saturated fat intake of the population based on WHO recommendations and the global NCD action plan (e.g. salt intake 5 g/day, saturated fat intake less than 10% of energy, and free sugar less than 10% of energy). | 317 (5.9) | 4 |
| To ensure the consistency of policies and messages on healthy diets, the government actively implements its food-based dietary guidelines including translating and promoting them to the public and to professional groups, industry groups and relevant settings. | 282 (5.2) | 10 |
| To convert its commitments to WHO’s Global Action Plan to reduce NCDs in the New Zealand context, the government develops, funds and implements a comprehensive national action plan to prevent NCDs. | 324 (6.0) | 3 |
| To articulate the high priority to reduce health inequalities, the government embeds explicit objectives to reduce health inequalities throughout the comprehensive plan. | 302 (5.6) | 5 |
| To minimize direct conflicts between commercial interests and the interests of public health nutrition, the government strengthens its conflict of interest procedures to ensure that food industry representatives with direct conflicts are not included in setting food-related policy objectives and principles (this does not apply to their participation in policy implementation). | 298 (5.5) | 6 |
| To track progress towards healthier food environments and to inform action, the government strengthens its monitoring of food environments by regular: | 292 (5.4) | 7 |
| – monitoring of marketing unhealthy foods to children through broadcast and non-broadcast media; and | ||
| – monitoring the nutritional quality of foods provided and sold in schools and early childhood education and care services. | ||
| To track progress towards healthier diets and to inform action, the government ensures that there are comprehensive regular (e.g. five yearly) food consumption surveys for adults and children, so that food and nutrient intakes and nutritional status can be assessed against nutritional and food-based guidelines and targets. | 278 (5.1) | 12 |
| To track progress and to inform action at a local level, the government institutes a system to deliver regular fine-grained estimates of overweight and obesity prevalence (especially for children and adolescents) at community levels for use by local communities. | 228 (4.2) | 18 |
| To track progress on NCDs and their risk factors, the government continues to invest in cardiovascular disease and diabetes risk assessments and investigates the inclusion of height and weight measurements and the use of the data for population monitoring. | 280 (5.2) | 11 |
| To ensure effectiveness and the efficient use of resources, the government includes robust programme evaluation in any major investment in improving population nutrition with approximately 10% of programme costs allocated for evaluation including outcome measures. | 288 (5.3) | 8 |
| To track progress and inform action on the underlying drivers of poor health and health inequalities, the government funds regular monitoring reports on the underlying societal and economic determinants of health and the related progress on the reduction of health inequalities. | 288 (5.3) | 9 |
| To ensure that sufficient resources are available to improve population nutrition, the government funding for population nutrition promotion is increased to at least NZ$ 70 million per year (equivalent to about 10% of the health-care costs of overweight/obesity and on a par with previous investments in prevention). | 339 (6.3) | 2 |
| To align research strategies with improving the healthiness of diets, the government ensures that the Science Challenges on Healthier Lives, Ageing Well, and A Better Startb have a strong focus on research to improve nutrition. | 232 (4.3) | 17 |
| To facilitate whole-of-government approaches to improving population nutrition and obesity, the government establishes cross-government mechanisms (national to local and between ministries) to coordinate food-related prevention policies (e.g. through the introduction of a new public sector challenge). | 264 (4.9) | 14 |
| To maximize the input and value from civil society, the government ensures there are formal platforms including a nutrition advisory committee and other mechanisms for civil society organizations to be involved proactively in food policy and programme development, implementation and evaluation. | 264 (4.9) | 15 |
| To maximize the impact of community-based programmes for obesity prevention, the government implements the Healthy Families New Zealand programme to at least the level of comprehensiveness, coverage and depth as the Healthy Together Victoria programme in Australia. | 273 (5.0) | 13 |
| To ensure that food policies are compatible with the objectives of improving population nutrition and reducing obesity and diet-related NCDs, the Ministry for Primary Industries and the Ministry of Business, Innovation, and Employment assess the wider health impact of food policies (not only from a safety point of view) on long-term population health. | 246 (4.6) | 16 |
| To ensure that government policies in general are compatible with the objectives of improving health, the government establishes a health impact assessment capacity, including funding for such capacity at the national and local level. | 227 (4.2) | 19 |
MoH: Ministry of Health; NCD: noncommunicable diseases; NZ$: New Zealand dollars; WHO: World Health Organization.
a The total points available per proposed policy action were 5412. One out of 58 experts did not prioritize the infrastructure support actions and one out of 58 experts allocated 92 instead of 95 points. Scores cannot be compared to the scores of the policy actions which were allocated a lower number of points by the experts.
b The National Science Challenges aim to align and focus New Zealand's research on large and complex issues by drawing scientists together from different institutions and across disciplines to achieve a common goal through collaboration.
Priority actions are listed in bold.