Preventing Childhood Obesity - Evidence Policy and Practice.pdf

Chapter 3
should liaise with schools and community services to
ensure that their messages are given prominence.
Health care staff also have a role in monitoring
children ’ s growth to recognize early signs of “ mis -
nourishment ” , including stunting and overweight,
and to provide appropriate responses. The contacts
between parents and the maternal/child health nurses
are especially important “ learning moments ” and
should be utilised to encourage breastfeeding and
teach parents about appropriate growth trajectories
and feeding practices for their children. The evidence
on effective primary care management is very limited
(as outlined in Chapter 12 ) and many of the existing
structures in primary care, especially the funding
structures that dictate the short consultation periods,
conspire against this setting being used to its full
potential (see Chapter 31 ).
Community-wide approaches
Enabling environments must encompass all communities
and must also operate within a given community,
affecting transport policies, urban design policies
and access to healthy diets. Community - wide
approaches play an important role in providing the
broader approach, and these are covered in more
detail in Chapters 7 , 26 , 27 . However, it is worth
emphasizing the need to ensure adequate access to
healthy foods for low - income families. This may
require programs and policies to ensure that healthy
food is more readily available, affordable and better
promoted than the unhealthy alternatives.
National p olicies
While there are several key players in obesity prevention
(governments, international organizations, the
private sector and civil society/non - governmental
organizations), governments need to take the lead and
to drive the policy changes. Each country should select
a mix of promising policies and actions that are in
accord with national capabilities, laws and economic
realities. 13 Ministries of health have a crucial convening
role in bringing together other ministries that are
needed for effective policy design and implementation.
However, it is important to realize that while
health usually takes a large slice of national budget,
ministers of health are not usually the most powerful
members of cabinet. Governments need to work
together with the private sector, health professional
bodies, consumer groups, academics, the research
community and other non - governmental bodies if
sustained progress is to occur.
National policies and programs should explicitly
address equality and diminish disparities by focusing
on the needs of the more disadvantaged communities
and population groups. Furthermore, since women
generally make decisions about household nutrition,
strategies need to be gender sensitive. Continued
support for the full implementation of the WHO -
UNICEF Code of Marketing of Breast Milk Substitutes
is vital in all countries. Recommendations for local
and central governments are delineated in the WHO
Global Strategy on Diet, Physical Activity and Health
(DPAS) 14 and, in addition to the specific measures to
address childhood obesity, they also have a fundamental
role in providing the support strategies for
effective obesity prevention, as shown in the box
below.
Support f unctions for
g overnments in a ddition to
s pecific o besity p revention
i nterventions
• Monitoring programs on outcomes (obesity), and
determinants (e.g., behaviors and environments)
should report to a parliamentary scrutiny committee
or an “ obesity observatory ” .
• Coordination to ensure cross - departmental, cross -
sectoral polices can be implemented and these
should managed centrally by government but monitored
by a separate agency.
• Capacity should be built at national and at local
levels, through training programs and other support
structures and funding.
• State support for commerce (e.g. food enterprises,
agricultural enterprises) should include health
criteria.
• Political donations from food companies should be
restricted.
• Access to and affordability of fruits and vegetables
should be improved, especially for low - income and
disadvantaged population groups.
• National governments should support WHO moves
to ensure that all UN agencies have policies that are
consistent with the Global Strategy.
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