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Evaluation of the Norwegian Nutrition Policy with Focus on the Action Plan

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Evaluation of the Norwegian Nutrition Policy with Focus on the Action Plan The WHO Regional Office for Europe The World Health Organization (WHO) is a specialized agency of the United Nations created in 1948 with the primary responsibility for international health matters and public health. The WHO Regional Office for Europe is one of six regional offices throughout the world, each with its own programme geared to the particular health conditions of the countries it serves. Member States Albania Andorra Armenia Austria Evaluation of the Norwegian nutritionNutrition policyPolicy with with Azerbaijan Belarus Belgium focusa focus on on the the Action Action Plan Plan on on Nutrition Nutrition (2007-2011) 2007–2011 Bosnia and Herzegovina Bulgaria Croatia Cyprus Action Plan on Nutrition 2007–2011 Evaluation of the Norwegian nutrition policy with a focus on Czech Republic Denmark Estonia Finland France Georgia Germany Greece Hungary Iceland Ireland Israel Italy Kazakhstan Kyrgyzstan Latvia Lithuania Luxembourg Malta Monaco Montenegro Netherlands Norway Poland Portugal Republic of Moldova Romania Russian Federation San Marino Serbia Slovakia Slovenia Spain Sweden Switzerland Tajikistan The former Yugoslav Republic of Macedonia Turkey Turkmenistan Ukraine United Kingdom Uzbekistan World Health Organization Regional OfficeWorld for Health Europe Organization Regional Office for Europe UN City, Marmorvej 51, DK-2100 CopenhagenScherfigsvej Ø, Denmark 8, DK-2100 Copenhagen Ø, Denmark 1 Tel.: +45 45 33 70 00. Fax: +45 33 70 01.Tel.: Email: +45 [email protected] 17 17 17. Fax: +45 39 17 18 18. E-mail: [email protected] Web site: www.euro.who.int Web site: www.euro.who.int focus on the Action Plan on Nutrition (2007-2011) Evaluation of the Norwegian Nutrition Policy with Evaluation of the Norwegian nutrition policy with a focus on the Action Plan on Nutrition 2007–2011 ABSTRACT The WHO Regional Office for Europe conducted an evaluation of the Norwegian Action Plan on Nutrition (2007–2011) in 2012. The evaluation was commissioned by the Directorate of Health of the Norwegian Ministry of Health and Care Services under the terms of the framework agreement between the Regional Office and the Directorate of Health. The overall aim of the assignment was to provide an independent evaluation of the Action Plan on Nutrition and an assessment of the possible options for the future in terms of policy recommendations. Keywords DIET FOOD HEALTH POLICY NUTRITION AND FOOD SAFETY NUTRITION POLICY SOCIOECONOMIC FACTORS Address requests about publications of the WHO Regional Office for Europe to: Publications WHO Regional Office for Europe UN City, Marmorvej 51 DK-2100 Copenhagen Ø, Denmark Alternatively, complete an online request form for documentation, health information, or for permission to quote or translate, on the Regional Office web site (http://www.euro.who.int/pubrequest). © World Health Organization 2013 All rights reserved. The Regional Office for Europe of the World Health Organization welcomes requests for permission to reproduce or translate its publications, in part or in full. The designations employed and the presentation of the material in this publication do not imply the expression of any opinion whatsoever on the part of the World Health Organization concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries. Dotted lines on maps represent approximate border lines for which there may not yet be full agreement. The mention of specific companies or of certain manufacturers’ products does not imply that they are endorsed or recommended by the World Health Organization in preference to others of a similar nature that are not mentioned. Errors and omissions excepted, the names of proprietary products are distinguished by initial capital letters. All reasonable precautions have been taken by the World Health Organization to verify the information contained in this publication. However, the published material is being distributed without warranty of any kind, either express or implied. The responsibility for the interpretation and use of the material lies with the reader. In no event shall the World Health Organization be liable for damages arising from its use. The views expressed by authors, editors, or expert groups do not necessarily represent the decisions or the stated policy of the World Health Organization. 4 Contents Acknowledgements. iv 1. Introduction .......................................................1 1.1 Why this evaluation and why now? ...........................1 1.2 Nutrition and public health policy in Norway ...................1 1.3 Terms of reference ........................................2 1.4 Process and conduct of the review ...........................2 2. Nutrition in Norway: analysis of the situation ............................2 2.1 Nutrition policy ...........................................2 2.2 Broader policy context .....................................7 3. Evaluation of the implementation of the Action Plan. .9 3.1 General comments ........................................9 3.2 Evaluation of focus areas and measures in the Action Plan .......13 3.3 Findings in relation to social inequalities in dietary intake ........21 4. Overall recommendations of the evaluation. .25 4.1 General recommendations .................................25 4.2 Specific recommendations regarding the Action Plan ............25 4.3 Key priorities in nutrition policy .............................27 5. Future policy priorities .............................................30 References ........................................................31 Annex 1 List of experts on the evaluation panel ..........................34 Annex 2 List of key informants ........................................35 Annex 3 Internal government monitoring matrix ..........................37 Acknowledgements This report was commissioned by the Directorate of Health of the Norwegian Ministry of Health and Care Services. The WHO Regional Office for Europe would like to express its appreciation to the key national informants for the documentation and data they supplied relative to the objectives specified in the Norwegian Action Plan on Nutrition 2007–2011. Thanks are also due to the national and international experts on the evaluation panel for their valuable contribution to a consultative workshop with policy-makers and stakeholders, held in Oslo in April 2012, and to the preparation of this report. The Regional Office is most grateful to the Norwegian Directorate of Health for its support for the printing of this report. iv 1. Introduction 1.1 Why this evaluation and why now? This report presents the findings of an evaluation of the Norwegian Action Plan on Nutrition 2007–2011. Recipe for a healthier diet (1) and recommendations for the future. The evaluation was commissioned by the Directorate of Health of the Norwegian Ministry of Health and Care Services under the terms of the framework agreement between the WHO Regional Office for Europe and the Directorate of Health, and was carried out by the Nutrition, Physical Activity and Obesity Programme of the Regional Office. The overall aim of the assignment was to provide an independent evaluation of the Action Plan on Nutrition and an assessment of the possible options for the future in terms of policy recommendations. More specifically, the objectives of the evaluation were detailed in the terms of reference and mainly focused on: • an analysis of the results of the policy and a comparison with its objectives; • an assessment of the efficiency of the policy in meeting these objectives; • consideration of whether changes are needed to the policy and suggestions for possible improvements to the scope, structure and working practices, with due consideration of different policy options; and • recommendations for the design of future policy. This report details the work undertaken and the answers to the points set out in the terms of reference. The analysis is based on the stakeholder consultation process that took place in an intensive evaluation workshop in Norway in April 2012, including interviews with stakeholders and policy-makers and a review of the existing documents and data. The evaluation was planned as a two-stage process: quantitative and qualitative. The first stage was to gather relevant and available documentation and data related to the objectives specified in the Action Plan (a quantitative internal evaluation was carried out by the Directorate of Health). The second stage was a qualitative evaluation, whereby the Regional Office supported the Directorate of Health in setting up a group of national and international experts to conduct an intensive workshop in Oslo from 16 to 20 April 2012, with the aims of interviewing key informants (policy-makers and stakeholders), analysing the available data and discussing suggestions and inputs for the future. The members of the evaluation panel are listed in Annex 1 and the key informants in Annex 2. This report, which has been written by the Regional Office together with the external expert group, is an output of the consultation process and provides a summary evaluation for the Directorate of Health. 1.2 Nutrition and public health policy in Norway The Action Plan on Nutrition 2007–2011. Recipe for a healthier diet (1) set out the government’s measures to promote health and prevent disease through a healthier diet. The emphasis of the Plan was on helping to make it easier for individuals to make healthy choices, to facilitate
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