Nutrition-related non-communicable disease and sugar-sweetened beverage policies: a landscape analysis in Kenya

Milkah N Wanjohi; Ann Marie Thow; Safura Abdool Karim; Gershim Asiki; Agnes Erzse; Shukri F Mohamed; Hermann Pythagore Pierre Donfouet; Pamela A Juma; Karen J Hofman

doi:10.1080/16549716.2021.1902659

Nutrition-related non-communicable disease and sugar-sweetened beverage policies: a landscape analysis in Kenya

Glob Health Action. 2021 Jan 1;14(1):1902659. doi: 10.1080/16549716.2021.1902659.

Authors

Milkah N Wanjohi¹, Ann Marie Thow², Safura Abdool Karim³, Gershim Asiki¹, Agnes Erzse³, Shukri F Mohamed^{4

5}, Hermann Pythagore Pierre Donfouet⁶, Pamela A Juma⁷, Karen J Hofman⁸

Affiliations

¹ Maternal and Child Well Being Unit, African Population and Health Research Center, Nairobi, Kenya.
² Menzies Centre for Health Policy and Director of Academic Titles, School of Public Health, The University of Sydney, Sydney, Australia.
³ SAMRC Centre for Health Economics and Decision Science Research-PRICELESS SA, School of Public Health, University of the Witwatersrand, Johannesburg, South Africa.
⁴ Health and Systems for Health Unit, African Population and Health Research Center, Nairobi, Kenya; Academic Unit of Primary Care (AUPC) and the NIHR Global Health Research Unit on Improving Health in Slums, University of Warwick, Coventry, UK.
⁵ Lown Scholars Program, Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
⁶ Social Policy Panning Monitoring and Evaluation (SPPME), UNICEF, N'Djamena, Tchad.
⁷ Independent Research Consultant.
⁸ University of the Witwatersrand, Johannesburg, South Africa.

Abstract

Background: The burden of undernutrition is significant in Kenya. Obesity and related non-communicable diseases are also on the increase. Government action to prevent non-communicable diseases is critical. Taxation of sugar-sweetened beverages has been identified as an effective mechanism to address nutrition-related non-communicable diseases, although Kenya is not yet committed to this.Objective: To assess the policy and stakeholder landscape relevant to nutrition related non -communicable diseases and sugar-sweetened beverage taxation in Kenya.Methods: A desk review of evidence and policies related to nutrition related non-communicable diseases and sugar-sweetened beverages was conducted. Data extraction matrices were used for analysis. Key informant interviews were conducted with 10 policy actors. Interviews were thematically analysed to identify enablers of, and barriers to, policy change towards nutrition-sweetened beverage taxation.Results: Although nutrition related non-communicable diseases are recognised as a growing problem in Kenya most food-related policies focus on undernutrition and food security, while underplaying the role of nutrition related non-communicable diseases. Policy development on communicable diseases is multi-sectoral, but implementation is biased towards curative rather than preventive services. An excise tax is charged on soft drinks, but is not specific to sugar-sweetened beverages. Government has competing roles: advocating for industrial growth, such as sugar and food processing industries to foster economic development, yet wanting to control nutrition related non-communicable diseases. There is no national consensus about the dangers posed by sugar-sweetened beverages.Conclusion: Nutrition related non-communicable diseases policies should reflect a continuum of issues, from undernutrition to food security, nutrition transition, and the escalation of nutrition related non-communicable diseases. A local advocacy case for sugar-sweetened beverage taxation has not been made. Public and policy maker education is critical to challenge the prevailing attitudes towards sugar-sweetened beverages and the western diet.

Keywords: Diet; actors; data review; industry tactics; policy review; politics.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Beverages
Humans
Kenya
Noncommunicable Diseases* / prevention & control
Sugar-Sweetened Beverages*
Taxes

Grants and funding

This work was carried out with support from the International Development Research Centre (IDRC), Ottawa Canada (grant number 108648-001). The views expressed herein do not necessarily represent those of the IDRC or its Board of Governors. The research reported in this manuscript was also partly supported by the South African Medical Research Council.