Benchmarking food environment policies for the prevention of diet-related non-communicable diseases in Kenya : national expert panel's assessment and priority recommendations

Introduction Unhealthy food environments drive the increase of diet-related non-communicable diseases (NCDs). Objective We aimed to examine healthy food environment policies in Kenya and identify priorities for future action. Methods Using the Healthy Food Environment Policy Index (Food-EPI) we collected evidence on the extent of government action to create healthy food environments across 13 policy and infrastructure support domains and 43 related good practice indicators between 2017 and 2018. A panel of 15 national experts rated the extent of government action on each indicator compared to the policy development cycle and international best practice respectively. Based on gaps found, actions to improve food environments in Kenya were identified and prioritized. Results In the policy development cycle, 16/43 (37%) of good practice policy indicators were judged to be in 'implementation' phase, including: food composition targets, packaged foods' ingredient lists/nutrient declarations; systems regulating health claims; restrictions on marketing breast milk substitutes; and school nutrition policies. Infrastructure support actions in 'implementation' phase included: food-based dietary guidelines; strong political support to reduce NCDs; comprehensive NCD action plan; transparency in developing food policies; and surveys monitoring nutritional status. Half (22/43) of the indicators were judged to be 'in development'. Compared to international best practice, the Kenyan Government was judged to be performing relatively well ('medium' implementation) in one policy (restrictions on marketing breast milk substitutes) and three infrastructure support areas (political leadership; comprehensive implementation plan; and ensuring all food policies are sensitive to nutrition). Implementation for 36 (83.7%) indicators were rated as 'low' or 'very little'. Taking into account importance and feasibility, seven actions within the areas of leadership, food composition, labelling, promotion, prices and health-in-all-policies were prioritized. Conclusion This baseline assessment is important in creating awareness to address gaps in food environment policy. Regular monitoring using Food-EPI may contribute to addressing the burden of diet-related NCDs in Kenya