City Research Online

Abstract

Introduction: Generating country-level political commitment will be critical to driving forward action throughoutthe United Nations Decade of Action on Nutrition (2016-2025). In this review of the empirical nutrition policy literature we ask: what factors generate, sustain and constrain political commitment for nutrition, how, and under what circumstances? Our aim is to inform strategic ‘commitment-building’ actions.

Method: We adopted a framework synthesis method and realist review protocol. An initial framework was derived from relevant theory and then populated with empirical evidence to test and modify it. Five steps were undertaken: initial theoretical framework development; search for relevant empirical literature; study selection and quality appraisal; data extraction, analysis and synthesis; and framework modification.

Results: 75 studies were included. We identified 18 factors that drive commitment, organized into five categories: actors; institutions; political and societal contexts; knowledge, evidence and framing; and capacities and resources. Irrespective of country-context, effective nutrition actor networks, strong leadership, civil society mobilization, supportive political administrations, societal change and focusing events, cohesive and resonant framing, and robust data systems and available evidence, were commitment drivers. Low and middle-income country studies also frequently reported international actors, empowered institutions, vertical coordination, and capacities and resources. In upper-middle and high-income country studies private sector interference frequently undermined commitment.

Conclusion:
Political commitment is not something that simply exists or emerges accidentally; it can be created and strengthened over time through strategic action. Successfully generating commitment will likely require a ‘core set’ of actions with some context-dependent adaptations. Ultimately, it will necessitate strategic actions by cohesive, resourced and strongly-led nutrition actor networks that are responsive to the multi-factorial, multi-level and dynamic political systems in which they operate and attempt to influence. Accelerating the formation and effectiveness of such networks over the Nutrition Decade should be a core task for all actors involved.

Publication Type:	Article
Additional Information:	© Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted. This is an Open Access article distributed in accordance with the terms of the Creative Commons Attribution Non-Commercial(CC BY NC 4.0) license, which permits others to distribute, remix, adapt and build upon this work, for commercial use, provided the original work is properly cited. See: http://creativecommons.org/licenses/by-nc/4.0/
Publisher Keywords:	nutrition, under nutrition, micronutrient deficiencies, obesity, noncommunicable diseases, politics, policy, priority, commitment
Departments:	School of Health & Psychological Sciences > Healthcare Services Research & Management School of Health & Psychological Sciences > Healthcare Services Research & Management > Food Policy
SWORD Depositor:	Symplectic Administrator

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