Development of Salt and Sodium Reduction Strategy by Using the Process of Stakeholder Participation

Abstract

 “Non-communicable diseases or NCDs” represent the number one health threat for both the world and Thailand. One of the main reasons is the improper consumption behavior. Evidences confirm that getting more sodium than the need is associated with the occurrence of hypertension, kidney disease and stroke. While implementations to reduce salt and sodium consumption in the past have limitations and challenges in almost all aspects, such as lack of clear mechanisms and operational strategies for problem management, coordination between network sectors and monitoring and evaluation.

This study is an operational research to determine the framework and goal of the strategy to reduce salt and sodium intake which is suitable for the context of Thailand and to identify measures and key issues under the strategy to reduce salt and sodium intake in order to achieve the desired vision and goal. In by qualitative methodology, this study is divided to stages. At the review and preparation, the researcher conducted documentary analysis to study the feasibility of developing a strategy to reduce salt and sodium intake.

At the frameworks and strategies development stage, 54 participants were from agencies in both the public and private sectors involved in the production, distribution, communication, knowledge development for the public, consumer capacity development, legislation and others related to reducing salt and sodium intake in Thailand. The researcher used the Outcome Mapping, developed by the International Development Research Centre (IDRC), as a tool in creating a strategy to reduce the salt and sodium intake of Thailand. The policy recommendations development stage was conducted through the mechanism of the National Health Assembly.

The results of phase 1 study found that the strategies to support the reduction of salt and sodium intake has achieved as national agenda in many countries. The strategy is an important tool in determining the direction of joint operations with network partners from many sectors. It is especially suitable for the sodium intake patterns of Thai people that are derived from many sources both from home cooking, eating out and manufactural food eating. In addition, the dimensions of values and consumption culture are also involved. Parties who are involved in the health sector are not sufficient in the strategy development. Phase 2: the development of frameworks and forms of strategies for reducing salt and sodium intake used the results from the first step for the joint operation of the Department of Disease Control and network partners. The researcher used the Outcome Mapping tool with the participation of all sectors involved in reducing salt and sodium intake. The draft of Thailand’s salt and sodium intake reduction strategies 2016-2025 consists of 5 sub-strategic issues as follows: 1) Strategy S Stakeholder network), creating, developing and expanding partnerships, 2) A Awareness) strategy, increasing knowledge, awareness and enhancing skills for people at the manufacturer / operator, related professional personnel and policy makers, 3) L strategy (Legislation and environmental reform) Environmental change in order to produce, improve, change and produce low sodium products. Including increasing alternatives and channels to access low-sodium foods, 4) Technology and innovation, research development and knowledge and implementation, and 5) S (Surveillance, monitoring and evaluation) development of surveillance system, follow up and evaluation throughout the process output and outcomes with the goal of making people healthy by reducing salt and sodium intake by 30% by 2025.

Suggestions

The development of policy recommendations in each strategy in Phase 3 should give priority to participation through the National Health Assembly to determine the national policy agenda which will ensure the smooth implementation and monitoring by the cooperation of all sectors.