“A [food] policy without product isn't much good”: Challenges initiating nutrition policy in the charitable food system

Abstract

The charitable food system (CFS) is the dominant response to alleviating immediate hunger among people experiencing food insecurity in many industrialised countries. Food relief occurs through diverse models, including via food banks and pantries, soup and community kitchens, food hampers and cash vouchers. Historically, the sector measured its success in terms of both reaching those in need and ensuring adequate calories, with little regard for the nutrition needs of the individual or the quality of the food provided. This is changing with the introduction of 'nutrition-focused food banking' (NFFB) over the past decade. NFFB acknowledges the collective interests that push the sector past the old paradigm emphasising 'food of any kind' toward a focus on healthier foods. (1) Little is known about policy approaches to NFFB. This research aimed to provide insights into the key challenges of initiating and implementing policy to improve the nutrition quality of food provided by the sector. A scoping review was undertaken to establish the theoretical context concerning policy approaches to NFFB in industrialised countries. It followed the Preferred Reporting Items for Systematic reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR). A key word search was performed across four databases (Medline, Global Health, ProQuest and Scopus) and the grey literature (Google Advanced Search). Papers describing the development or application of nutrition policy to improve the nutritional quality of foods in a food bank, pantry or shelf in industrialised countries were included. The search retrieved 1392 potentially relevant articles and 39 were retained after screening for eligibility. An adapted model, incorporating Sengul Orgut et al.'s (2015) Iron Triangle of Hunger Relief (2) and Campbell et al.'s (2013) conceptual framework (3) to guide data extraction was used. The adapted framework reflects the complex logistics and organisational challenges that influence the introduction of nutrition policy, respectively. The key themes that emerged related to supply and capacity, and demand to a lesser extent. In relation to supply, the unpredictability and variability in frequency, type and volume of donated food was evident across papers and a barrier to either stocking inventory or providing healthy foods to clients. 'Donor relationships' was also a key factor influencing supply, and that food banks' reliance on donors shapes the nutrition quality of the food inventory, which affects food banks willingness and ability to reduce unhealthy inventory for fear of losing donors. (1) In relation to capacity, the volunteer workforce, engagement of external stakeholders and gaining executive support were key capacity factors. The volunteer workforce was central to the management and distribution of nutritious food, while engagement with external stakeholders and gaining executive support represented opportunities to influence key decision makers within the sector. Acknowledging the significant supply constraints and capacity cha...