Evaluating policy responses to noncommunicable diseases in seven Caribbean countries: challenges to addressing unhealthy diets and physical inactivity

Murphy, Madhuvanti M.; Unwin, Nigel; Samuels, T. Alafia; Hassell, Trevor; Bishop, Lisa; Guell, Cornelia

doi:10.26633/rpsp.2018.174

Cited by 15 publications

(21 citation statements)

References 15 publications

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“…Investigators believed that there is not a clear national research agenda and that there is not enough local research to address national health problems. This assessment of the national research landscape speaks to the challenges within the current environment to meet the needs of stakeholders, which are consistent across the Caribbean (14). A government lead research agenda can facilitate prioritizing of research needs, advocates for partnerships and buy in from stakeholders to promote meaningful change (11,15,16).…”

Section: Local Researchmentioning

confidence: 81%

A cross-sectional analysis of investigator needs for non-communicable disease research at the University of the West Indies, Mona

Williamson

Rodrigo

Guthrie-Dixon

et al. 2021

Revista Panamericana De Salud Pública

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Objective. To describe the needs of academic staff conducting non-communicable disease (NCD) research at the University of the West Indies, Mona Campus in Jamaica. Methods. Utilizing a cross-sectional design an online survey was created using the research electronic data capture application (REDCap); it was disseminated via email to 708 academic staff members in the Faculties of Medical Sciences and Science & Technology between September and November 2018. Participants were asked to indicate their level of access to expertise, training and equipment for conducting research. Descriptive analysis was conducted using STATA version 14. Results. Most respondents were women (74.2%), predominantly scientists (33.1%) or specialist physicians (22.6%). Less than 2/3 of respondents reported publishing research findings in peer reviewed journals, with a quarter not disseminating their research findings in any medium. Resources for field research/data collection, epidemiological methods and principles, and data management/data analysis were generally available. However, there was limited access to training, expertise and equipment in emerging techniques for NCD research such as metabolomics, bioinformatics/analysis of large-scale data sets and health economics. Additional challenges included limited access to financing for research, inadequate workspace and poor administrative support for conducting research. Conclusions. There is a need for more local research seed funding, stronger administrative support for researchers, and opportunities for training in cutting edge NCD research techniques. Jamaican researchers could benefit from being part of a regional research centre of excellence with critical research skills and equipment that builds research networks and strengthens the NCD research response.

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Section: Local Researchmentioning

confidence: 81%

A cross-sectional analysis of investigator needs for non-communicable disease research at the University of the West Indies, Mona

Williamson

Rodrigo

Guthrie-Dixon

et al. 2021

Revista Panamericana De Salud Pública

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“…This type of support is likely to be particularly important for those smaller countries with the least capacity for developing and implementing policy. This relationship is explored further in two papers in this supplement, by Murphy et al (19) and by Kirton et al (22).…”

Section: Discussionmentioning

confidence: 93%

“…Health in All Policies remains a concept that has yet to be institutionalized. These issues are addressed in the paper in this supplement by Murphy et al (19).…”

Section: Discussionmentioning

confidence: 97%

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The 2007 Caribbean Community Port-of-Spain Declaration on noncommunicable diseases: an overview of a multidisciplinary evaluation

Samuels

Unwin

2018

Rev Panam Salud Publica

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Objectives Noncommunicable diseases (NCDs) are a threat to social and economic development, including in the Caribbean. In 2007 the Caribbean Community (CARICOM) held the world's first-ever summit of heads of government on NCD prevention and control and issued the landmark Declaration of Port-of-Spain: Uniting to Stop the Epidemic of Chronic NCDs. The objectives of this paper are to provide an overview of a formal evaluation of the Declaration and to highlight key findings that could inform further implementation of the Declaration's 15 mandates. Methods The evaluation's six research objectives were decided through stakeholder engagement and assessed by concurrent quantitative and qualitative research methods, using the following four themes: 1) trends in risk factors, morbidity, and mortality; 2) national and Caribbean-wide policy responses, and factors associated with policy successes and difficulties; 3) the international impact of the Declaration; and 4) the potential for raising revenue from tobacco and alcohol taxation in order to support NCD prevention and control. Results There are marked disparities in NCD mortality and trends among the 20 CARICOM member countries and territories. No CARICOM member had fully implemented all of the Declaration's 15 mandates (which were monitored by 26 indicators), with 10 CARICOM members implementing fewer than half of the indicators, and with most members lacking a well-functioning multisectoral NCD Commission. Larger CARICOM members tended to have higher levels of implementation than did smaller members. Mandates that received active support from regional institutions tended to be better implemented by the CARICOM members than did mandates that lacked that kind of support. Feasible national tobacco and alcohol tax increases could more than cover the cost of implementing the World Health Organization NCD “best buy” interventions in the CARICOM member countries and territories. Conclusions Priorities for further implementation of the mandates from the Port-of-Spain Declaration include establishing throughout the CARICOM member countries and territories fully functioning national bodies to support multisectoral action for NCD prevention; greater regional support in policy development and implementation for smaller countries; and greater targeted use of taxes on tobacco and alcohol to support NCD control and prevention.

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“…An evaluation of the Port of Spain Declaration in 2018 found that taking effective measures to address the distal (or upstream) determinants of an unhealthy diet and physical inactivity (e.g. cultural and environmental conditions) remained challenging, 8 although new initiatives, such as taxing sugar-sweetened beverages, were being implemented.…”

Section: Introductionmentioning

confidence: 99%

Evidence for factors associated with diet and physical activity in African and Caribbean countries

Turner-Moss

Razavi

Unwin

et al. 2021

Bull. World Health Organ.

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Objective To identify and describe summarized evidence on factors associated with diet and physical activity in low- and middle-income countries in Africa and the Caribbean by performing a scoping review of reviews. Methods We searched the Medline®, LILACS, Scopus, Global Health and Web of Science databases for reviews of factors associated with diet or physical activity published between 1998 and 2019. At least 25% of studies in reviews had to come from African or Caribbean countries. Factors were categorized using Dahlgren and Whitehead’s social model of health. There was no quality appraisal. Findings We identified 25 reviews: 13 on diet, four on physical activity and eight on both. Eighteen articles were quantitative systematic reviews. In 12 reviews, 25–50% of studies were from Africa or the Caribbean. Only three included evidence from the Caribbean. Together, the 25 reviews included primary evidence published between 1926 and 2018. Little of the summarized evidence concerned associations between international health or political factors and diet or associations between any factor and physical activity across all categories of the social model of health. Conclusion The scoping review found a wide range of factors reported to be associated with diet and physical activity in Africa and the Caribbean, but summarized evidence that could help inform policies encouraging behaviours linked to healthy diets and physical activity in these regions were lacking. Further reviews are needed to inform policy where the evidence exists, and to establish whether additional primary research is needed.

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Evaluating policy responses to noncommunicable diseases in seven Caribbean countries: challenges to addressing unhealthy diets and physical inactivity

Cited by 15 publications

References 15 publications

A cross-sectional analysis of investigator needs for non-communicable disease research at the University of the West Indies, Mona

A cross-sectional analysis of investigator needs for non-communicable disease research at the University of the West Indies, Mona

The 2007 Caribbean Community Port-of-Spain Declaration on noncommunicable diseases: an overview of a multidisciplinary evaluation

Evidence for factors associated with diet and physical activity in African and Caribbean countries

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