Cross-sectoral Food Systems Policy Action for Nutrition: Lessons From National, Regional, and Global Experience

Document Type : Original Article

Authors

1 Leeder Centre for Health Policy, Economics and Data, Sydney School of Public Health, The University of Sydney, Sydney, NSW, Australia

2 Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia

3 Global Centre for Preventive Health and Nutrition (GLOBE), Institute for Health Transformation, Deakin University, Geelong, VIC, Australia

Abstract

Background 
Improving nutrition is a global priority for food systems transformation. The introduction of policy measures across multiple sectors relevant to food systems is critical to this transformation. However, integrating measures to improve nutrition into food system policies across multiple government sectors has proved challenging.
 
Methods 
A theory-informed qualitative policy analysis was conducted to identify enablers and barriers of “cross-sectoral” policy action for nutrition in government sectors related to the food system. The analysis drew on interview data (n = 43) with policy-makers at global, regional, and national level, in diverse policy sectors, who had experience of engaging successfully across food system policy sectors to improve nutrition.
 
Results 
Success in cross-sectoral policy related to the achievement of nutrition objectives in a way that also enabled achievement of other sectoral objectives, and involved strategic and constructive policy engagement across sectors. Challenges included the need to overcome diverse sectoral mandates and norms, siloed structures of governance, and fluctuations in political interest to engage effectively across sectors for policy change. Key enablers of cross-sectoral policy for nutrition included: supportive institutional structures, such as platforms for engagement, mandates and incentives; ideas that facilitated constructive engagement between policy sectors, including a shared vision, a long-term approach and effective framing; discursive approaches to engagement that balanced multiple interests across policy sectors; and ongoing learning.
 
Conclusion 
This analysis provides new insights to strengthen policy engagement and design more effective capacity building for nutrition policy-makers. This includes “soft skills” that enable effective engagement across sectors and strategic approaches to managing diverse interests influencing policy.

Keywords


  1. United Nations. Secretary-General’s Chair Summary and Statement of Action on the UN Food Systems Summit. https://www.un.org/en/food-systems-summit/news/making-food-systems-work-people-planet-and-prosperity/. Updated September 23, 2021. Accessed February 28, 2025.
  2. United Nations. Take Action for the Sustainable Development Goals. https://www.un.org/sustainabledevelopment/sustainable-development-goals/. Updated 2025. Accessed February 28, 2025.
  3. World Health Organization (WHO). United Nations Decade of Action on Nutrition. https://www.who.int/initiatives/decade-of-action-on-nutrition/. Updated 2025. Accessed February 28, 2025.
  4. FAO, IFAD, UNICEF, WFP, WHO. The State of Food Security and Nutrition in the World 2024 – Financing to End Hunger, Food Insecurity and Malnutrition in All its Forms. Rome: Food and Agriculture Organization; 2024.
  5. HLPE. Nutrition and Food Systems. A Report by the High-Level Panel of Experts on Food Security and Nutrition of the Committee on World Food Security. Rome: CFS; 2017.
  6. Slater S, Baker P, Lawrence M. An analysis of the transformative potential of major food system report recommendations. Glob Food Sec. 2022;32:100610. doi:1016/j.gfs.2022.100610
  7. Ruben R, Cavatassi R, Lipper L, Smaling E, Winters P. Towards food systems transformation-five paradigm shifts for healthy, inclusive and sustainable food systems. Food Secur. 2021;13(6):1423-1430. doi:1007/s12571-021-01221-4
  8. FAO, IFAD, UNICEF, WFP, WHO. The State of Food Security and Nutrition in the World 2021: Transforming Food Systems for Food Security, Improved Nutrition and Affordable Healthy Diets for All. Rome: FAO; 2021.
  9. World Health Organization (WHO). Global Nutrition Policy Review 2016-2017: Country Progress in Creating Enabling Policy Environments for Promoting Healthy Diets and Nutrition. Geneva: WHO; 2018.
  10. Gillespie S, van den Bold M. Agriculture, food systems, and nutrition: meeting the challenge. Glob Chall. 2017;1(3):1600002. doi:1002/gch2.201600002
  11. Gillespie S, Haddad L, Mannar V, Menon P, Nisbett N. The politics of reducing malnutrition: building commitment and accelerating progress. Lancet. 2013;382(9891):552-569. doi:1016/s0140-6736(13)60842-9
  12. Baker P, Hawkes C, Wingrove K, et al. What drives political commitment for nutrition? A review and framework synthesis to inform the United Nations Decade of Action on Nutrition. BMJ Glob Health. 2018;3(1):e000485. doi:1136/bmjgh-2017-000485
  13. Popkin BM, Corvalan C, Grummer-Strawn LM. Dynamics of the double burden of malnutrition and the changing nutrition reality. Lancet. 2020;395(10217):65-74. doi:1016/s0140-6736(19)32497-3
  14. Béné C, Abdulai AR. Navigating the politics and processes of food systems transformation: guidance from a holistic framework. Front Sustain Food Syst. 2024;8:1399024. doi:3389/fsufs.2024.1399024
  15. Reeve E, Thow AM, Huse O, Bell C, Peeters A, Sacks G. Policy-makers' perspectives on implementation of cross-sectoral nutrition policies, Western Pacific region. Bull World Health Organ. 2021;99(12):865-873. doi:2471/blt.20.283366
  16. Barlow P, Thow AM. Neoliberal discourse, actor power, and the politics of nutrition policy: a qualitative analysis of informal challenges to nutrition labelling regulations at the World Trade Organization, 2007-2019. Soc Sci Med. 2021;273:113761. doi:1016/j.socscimed.2021.113761
  17. Ares G, Antúnez L, Cabrera M, Thow AM. Analysis of the policy process for the implementation of nutritional warning labels in Uruguay. Public Health Nutr. 2021;24(17):5927-5940. doi:1017/s1368980021002469
  18. Thow AM, Greenberg S, Hara M, Friel S, duToit A, Sanders D. Improving policy coherence for food security and nutrition in South Africa: a qualitative policy analysis. Food Secur. 2018;10(4):1105-1130. doi:1007/s12571-018-0813-4
  19. Gilmore AB, Fabbri A, Baum F, et al. Defining and conceptualising the commercial determinants of health. Lancet. 2023;401(10383):1194-1213. doi:1016/s0140-6736(23)00013-2
  20. Sackar SA, Apprey C, Aduku LN, Thow AM, Annan R. Operationalising multi-sectoral food- and nutrition-related policies to curb the rise in obesity in Ghana. Public Health Nutr. 2023;26(12):3230-3238. doi:1017/s136898002300037x
  21. Ngqangashe Y, Friel S, Schram A. The regulatory governance conditions that lead to food policies achieving improvements in population nutrition outcomes: a qualitative comparative analysis. Public Health Nutr. 2021;25(5):1-11. doi:1017/s1368980021004730
  22. Committee on World Food Security (CFS). Voluntary Guidelines on Food Systems and Nutrition. Rome: CFS; 2021.
  23. Marsh D, McConnell A. Towards a framework for establishing policy success. Public Adm. 2010;88(2):564-583. doi:1111/j.1467-9299.2009.01803.x
  24. Rose R. Lesson-Drawing in Public Policy: A Guide to Learning Across Time and Space. Chatham, NJ: Chatham House Publishers; 1993.
  25. Yin RK. Case Study Research: Design and Methods. USA: SAGE Publications; 2003.
  26. Easton G. Critical realism in case study research. Ind Mark Manag. 2010;39(1):118-128. doi:1016/j.indmarman.2008.06.004
  27. Campbell JL. Institutional analysis and the role of ideas in political economy. Theory Soc. 1998;27(3):377-409. doi:1023/a:1006871114987
  28. Hall PA. Policy paradigms, social learning, and the state: the case of economic policymaking in Britain. Comp Polit. 1993;25(3):275-296. doi:2307/422246
  29. Walt G, Shiffman J, Schneider H, Murray SF, Brugha R, Gilson L. 'Doing' health policy analysis: methodological and conceptual reflections and challenges. Health Policy Plan. 2008;23(5):308-317. doi:1093/heapol/czn024
  30. Webb P, Sonnino R. Everyone at the Table: Co-Creating Knowledge for Food Systems Transformation. Brussels: Publications Office of the European Union; 2021. doi:2760/21968
  31. Candel JJ, Pereira L. Towards integrated food policy: main challenges and steps ahead. Environ Sci Policy. 2017;73:89-92. doi:1016/j.envsci.2017.04.010
  32. Gillespie S, Menon P, Kennedy AL. Scaling up impact on nutrition: what will it take? Adv Nutr. 2015;6(4):440-451. doi:3945/an.115.008276
  33. Mauli S, Maelaua J, Reeve E, et al. Systemic capacity in food system governance in the Solomon Islands: “it’s more than just training”. Sustainability. 2023;15(13):10710. doi:3390/su151310710
  34. Ssennyonjo A, Ssengooba F, Criel B, Titeca K, Van Belle S. 'Writing budgets for meetings and teas?': A multitheoretical analysis of intragovernmental coordination for multisectoral action for health in Uganda. BMJ Glob Health. 2022;7(2):e007990. doi:1136/bmjgh-2021-007990
  35. Namugumya BS, Candel JJ, Talsma EF, Termeer CJ. A mechanisms-based explanation of nutrition policy (dis)integration processes in Uganda. Food Policy. 2020;92:101878. doi:1016/j.foodpol.2020.101878
  36. Phulkerd S, Sacks G, Vandevijvere S, Worsley A, Lawrence M. Barriers and potential facilitators to the implementation of government policies on front-of-pack food labeling and restriction of unhealthy food advertising in Thailand. Food Policy. 2017;71:101-110. doi:1016/j.foodpol.2017.07.014
  37. Latu C, Moodie M, Coriakula J, Waqa G, Snowdon W, Bell C. Barriers and facilitators to food policy development in Fiji. Food Nutr Bull. 2018;39(4):621-631. doi:1177/0379572118797083
  38. Kugelberg S, Bartolini F, Kanter DR, et al. Implications of a food system approach for policy agenda-setting design. Glob Food Sec. 2021;28:100451. doi:1016/j.gfs.2020.100451
  39. Rogers EM. Diffusion of Innovations. New York: Free Press; 2003.
  40. Pelletier D, Gervais S, Hafeez-Ur-Rehman H, Sanou D, Tumwine J. Boundary-spanning actors in complex adaptive governance systems: the case of multisectoral nutrition. Int J Health Plann Manage. 2018;33(1):e293-e319. doi:1002/hpm.2468
  41. Friel S, Collin J, Daube M, et al. Commercial determinants of health: future directions. Lancet. 2023;401(10383):1229-1240. doi:1016/s0140-6736(23)00011-9
  42. Chan M. WHO Director-General addresses health promotion conference. In: 8th Global Conference on Health Promotion. Helsinki, Finland: WHO; 2013. https://www.who.int/director-general/speeches/detail/who-director-general-addresses-health-promotion-conference.
  43. Mialon M, Swinburn B, Sacks G. A proposed approach to systematically identify and monitor the corporate political activity of the food industry with respect to public health using publicly available information. Obes Rev. 2015;16(7):519-530. doi:1111/obr.12289
Volume 14, Issue 1
2025
Pages 1-9
  • Received Date: 25 February 2025
  • Revised Date: 15 July 2025
  • Accepted Date: 16 September 2025
  • First Published Date: 28 September 2025
  • Published Date: 01 December 2025