Stakeholder perspectives on Nigeria's national sodium reduction program: Lessons for implementation and scale-up.
<h4>Background</h4>To reduce excess dietary sodium consumption, Nigeria's 2019 National Multi-sectoral Action Plan (NMSAP) for the Prevention and Control of Non-communicable Diseases includes policies based on the World Health Organization SHAKE package. Priority actions and strateg...
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| Format: | Article |
| Language: | English |
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Public Library of Science (PLoS)
2023-01-01
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| Series: | PLoS ONE |
| Online Access: | https://doi.org/10.1371/journal.pone.0280226 |
| _version_ | 1797780586874535936 |
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| author | Olutobi A Sanuade Vanessa Alfa Xuejun Yin Hueiming Liu Adedayo E Ojo Gabriel L Shedul Dike B Ojji Mark D Huffman Ikechukwu A Orji Rosemary C B Okoli Blessing Akor Nanna R Ripiye Helen Eze Clementina Ebere Okoro Linda Van Horn Priya Tripathi Tunde M Ojo Kathy Trieu Bruce Neal Lisa R Hirschhorn |
| author_facet | Olutobi A Sanuade Vanessa Alfa Xuejun Yin Hueiming Liu Adedayo E Ojo Gabriel L Shedul Dike B Ojji Mark D Huffman Ikechukwu A Orji Rosemary C B Okoli Blessing Akor Nanna R Ripiye Helen Eze Clementina Ebere Okoro Linda Van Horn Priya Tripathi Tunde M Ojo Kathy Trieu Bruce Neal Lisa R Hirschhorn |
| author_sort | Olutobi A Sanuade |
| collection | DOAJ |
| description | <h4>Background</h4>To reduce excess dietary sodium consumption, Nigeria's 2019 National Multi-sectoral Action Plan (NMSAP) for the Prevention and Control of Non-communicable Diseases includes policies based on the World Health Organization SHAKE package. Priority actions and strategies include mandatory sodium limits in processed foods, advertising restrictions, mass-media campaigns, school-based interventions, and improved front-of-package labeling. We conducted a formative qualitative evaluation of stakeholders' knowledge, and potential barriers as well as effective strategies to implement these NMSAP priority actions.<h4>Methods</h4>From January 2021 to February 2021, key informant interviews (n = 23) and focus group discussions (n = 5) were conducted with regulators, food producers, consumers, food retailers and restaurant managers, academia, and healthcare workers in Nigeria. Building on RE-AIM and the Consolidated Framework for Implementation Research, we conducted directed content qualitative analysis to identify anticipated implementation outcomes, barriers, and facilitators to implementation of the NMSAP sodium reduction priority actions.<h4>Results</h4>Most stakeholders reported high appropriateness of the NMSAP because excess dietary sodium consumption is common in Nigeria and associated with high hypertension prevalence. Participants identified multiple barriers to adoption and acceptability of implementing the priority actions (e.g., poor population knowledge on the impact of excess salt intake on health, potential profit loss, resistance to change in taste) as well as facilitators to implementation (e.g., learning from favorable existing smoking reduction and advertising strategies). Key strategies to strengthen NMSAP implementation included consumer education, mandatory and improved front-of-package labeling, legislative initiatives to establish maximum sodium content limits in foods and ingredients, strengthening regulation and enforcement of food advertising restrictions, and integrating nutrition education into school curriculum.<h4>Conclusion</h4>We found that implementation and scale-up of the Nigeria NMSAP priority actions are feasible and will require several implementation strategies ranging from community-focused education to strengthening current and planned regulation and enforcement, and improvement of front-of-package labeling quality, consistency, and use. |
| first_indexed | 2024-03-12T23:46:10Z |
| format | Article |
| id | doaj.art-22c7e70502e34be3b9486df5ee2f1799 |
| institution | Directory Open Access Journal |
| issn | 1932-6203 |
| language | English |
| last_indexed | 2024-03-12T23:46:10Z |
| publishDate | 2023-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS ONE |
| spelling | doaj.art-22c7e70502e34be3b9486df5ee2f17992023-07-14T05:30:52ZengPublic Library of Science (PLoS)PLoS ONE1932-62032023-01-01181e028022610.1371/journal.pone.0280226Stakeholder perspectives on Nigeria's national sodium reduction program: Lessons for implementation and scale-up.Olutobi A SanuadeVanessa AlfaXuejun YinHueiming LiuAdedayo E OjoGabriel L ShedulDike B OjjiMark D HuffmanIkechukwu A OrjiRosemary C B OkoliBlessing AkorNanna R RipiyeHelen EzeClementina Ebere OkoroLinda Van HornPriya TripathiTunde M OjoKathy TrieuBruce NealLisa R Hirschhorn<h4>Background</h4>To reduce excess dietary sodium consumption, Nigeria's 2019 National Multi-sectoral Action Plan (NMSAP) for the Prevention and Control of Non-communicable Diseases includes policies based on the World Health Organization SHAKE package. Priority actions and strategies include mandatory sodium limits in processed foods, advertising restrictions, mass-media campaigns, school-based interventions, and improved front-of-package labeling. We conducted a formative qualitative evaluation of stakeholders' knowledge, and potential barriers as well as effective strategies to implement these NMSAP priority actions.<h4>Methods</h4>From January 2021 to February 2021, key informant interviews (n = 23) and focus group discussions (n = 5) were conducted with regulators, food producers, consumers, food retailers and restaurant managers, academia, and healthcare workers in Nigeria. Building on RE-AIM and the Consolidated Framework for Implementation Research, we conducted directed content qualitative analysis to identify anticipated implementation outcomes, barriers, and facilitators to implementation of the NMSAP sodium reduction priority actions.<h4>Results</h4>Most stakeholders reported high appropriateness of the NMSAP because excess dietary sodium consumption is common in Nigeria and associated with high hypertension prevalence. Participants identified multiple barriers to adoption and acceptability of implementing the priority actions (e.g., poor population knowledge on the impact of excess salt intake on health, potential profit loss, resistance to change in taste) as well as facilitators to implementation (e.g., learning from favorable existing smoking reduction and advertising strategies). Key strategies to strengthen NMSAP implementation included consumer education, mandatory and improved front-of-package labeling, legislative initiatives to establish maximum sodium content limits in foods and ingredients, strengthening regulation and enforcement of food advertising restrictions, and integrating nutrition education into school curriculum.<h4>Conclusion</h4>We found that implementation and scale-up of the Nigeria NMSAP priority actions are feasible and will require several implementation strategies ranging from community-focused education to strengthening current and planned regulation and enforcement, and improvement of front-of-package labeling quality, consistency, and use.https://doi.org/10.1371/journal.pone.0280226 |
| spellingShingle | Olutobi A Sanuade Vanessa Alfa Xuejun Yin Hueiming Liu Adedayo E Ojo Gabriel L Shedul Dike B Ojji Mark D Huffman Ikechukwu A Orji Rosemary C B Okoli Blessing Akor Nanna R Ripiye Helen Eze Clementina Ebere Okoro Linda Van Horn Priya Tripathi Tunde M Ojo Kathy Trieu Bruce Neal Lisa R Hirschhorn Stakeholder perspectives on Nigeria's national sodium reduction program: Lessons for implementation and scale-up. PLoS ONE |
| title | Stakeholder perspectives on Nigeria's national sodium reduction program: Lessons for implementation and scale-up. |
| title_full | Stakeholder perspectives on Nigeria's national sodium reduction program: Lessons for implementation and scale-up. |
| title_fullStr | Stakeholder perspectives on Nigeria's national sodium reduction program: Lessons for implementation and scale-up. |
| title_full_unstemmed | Stakeholder perspectives on Nigeria's national sodium reduction program: Lessons for implementation and scale-up. |
| title_short | Stakeholder perspectives on Nigeria's national sodium reduction program: Lessons for implementation and scale-up. |
| title_sort | stakeholder perspectives on nigeria s national sodium reduction program lessons for implementation and scale up |
| url | https://doi.org/10.1371/journal.pone.0280226 |
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