This case study describes the delivery and achievements of the public health nutrition programme in Queensland, Australia, over more than three decades. Analysis of publicly available documents related to statewide nutrition policy and programmes from 1983 to 2014 identified key inputs and programme impacts and outcomes, including an increase in fruit and vegetable intake by 1.1 serves per person per day and rates of exclusive breastfeeding for the first 6 months quadrupled. Mapping factors and milestones against a framework on determinants of political priority highlighted correlation with effective nutrition promotion policy and practice. Identified enablers included the influence of policy champions and advocates, quality of governance, focus on whole-of-population approaches, and periods of political will and economic prosperity. Key barriers included changes of ideology with government leadership; lack of commitment to long-term implementation and evaluation; and limited recognition of and support for preventive health and nutrition promotion. The case study shows that a coordinated, well-funded, intersectoral approach to improve nutrition and prevent chronic disease and malnutrition in all its forms can be achieved and produce promising impacts at state level, but that sustained effort is required to secure and protect investment. Political support for long-term investment in nutrition is essential to reduce the high cost of all diet-related diseases. Public health leadership to better prepare for risks around political cycles, secure adequate resources for evaluation, and better communicate impacts and outcomes may help protect future investments and achievements.
Keywords: evaluation; health promotion programme; nutrition; policy; political economy.
Poor diet causes a large proportion of the disease burden in Australia and globally. Better nutrition reduces societal impacts of diet-related disease and healthcare costs, yet government investment in programmes aimed at improving nutrition is low globally. This paper presents a case study of the statewide nutrition promotion programme in Queensland, Australia, over three decades. It explores how and why nutrition issues become a priority, or not, for governments, and any impacts of relevant investment. We searched for publications on nutrition policy actions, promotion programmes and evaluations from 1983 to 2014. Mapping these against a framework of factors influencing political priorities highlighted potential reasons for the ‘rise’ and ‘demise’ of strategic nutrition policy action, and helped identify key enablers of, and barriers to, ongoing nutrition strategies at a programme level. The case study shows that a coordinated, well-funded, inter-sectoral approach delivered promising impacts, but also that ongoing efforts—including consistent evaluation, coordinated communication and constant advocacy by a range of policy champions—is needed to improve sustainability of nutrition policy and programmes to address all diet-related diseases.
© The Author(s) 2021. Published by Oxford University Press.