The document compares policies related to healthy lifestyles, food safety and quality in Indonesia, Ghana, Tanzania and Zimbabwe. All countries have ongoing policies but objectives, targets and implementation differ. Key actors involved in implementation vary between countries. Monitoring and evaluation processes exist but could be strengthened, especially by adding quantifiable indicators. Funding and infrastructure limitations were identified. Recommendations include ensuring policies are evidence-based, participatory and focused on self-efficacy with improved evaluation to create effective future policies.

1. HEALTHY LIFESTYLE, FOOD SAFETY AND
QUALITY – POLICIES OF INDONESIA, GHANA,
TANZANIA AND ZIMBABWE
1

2. GROUP MEMBERS
Pinta Lizti
Irene
(Indonesia)
Sophia D.
Amenyah
(Ghana)
Josephine T.
Kimario
(Tanzania)
Genesis
Chevure
(Zimbabwe)
2

3. OBJECTIVES OF POLICY REVIEW
• Understand current situation of healthy
lifestyle, food quality and safety issues
• Reveal and compare ongoing policies in
addressing healthy lifestyle, food quality
and safety issues.
• Assess quality of policies.
• Delivering recommendation for future
policy development.
3

4. CONTENT
Introduction
Countries Nutrition Situation
Policy Implementation
Policy Comparison
Policy Assessment
Recommendation

5. INTRODUCTION
Food Safety: all those hazards, whether chronic or acute,
that may make food injurious to the health of the
consumer. (FAO, 2001)
Food Quality: the totality of features and characteristics of
a product, process or service that bear on its ability to
satisfy stated or implied needs (Standard ISO 9000:2000),
excellence.
Healthy Behaviour: behavior patterns, actions and habits
that relate to health maintenance, to health restoration and
to health improvement (Gochmann, 1997)
5

6. RATIONALE BEHIND POLICIES
Protecting public health by reducing risk of underweight
and food borne illness, especially for vulnerable groups.
Protecting consumers from unsanitary and
unwholesome food.
Promoting healthy body and preventing illness of
population.
6

7. COUNTRIES NUTRITION SITUATION
Ghana
• High levels of communicable and
pregnancy-related diseases and
rising non communicable diseases.
• Malnutrition including under-
nutrition in children of poor
families, micro-nutrient deficiency
in children and pregnant women.
• Over nutrition in adults is known to
be underlying the high levels of
morbidity and mortality in the
country.
Indonesia
• Low knowledge and responsibility
from small-scale food producer and
low awareness of consumer
regarding food quality and safety.
• 9.08-10.23% of food product do not
pass food standard.
• 128 reported cases of foodborne
diseases in 2011.
• 48.2% of population do not exercise
physical activity regularly.
• 93% of population consume fruit
and vegetable less than
recommended daily amount
7

8. Tanzania
• High level of stunting, wasting, and
underweight children (35%, 4% and
16% respectively).
• High number of children suffered
from anaemia (69%).
• Double burden of malnutrition in
women (Underweight 11%, Obesity
and overweight 22%).
• Only 50% of productive woman
gives exclusive breastfeeding.
Zimbabwe
• High level of underweight, stunting,
and wasting children (between
30%, 5% respectively)
• Iron and vitamin A deficiency (30
&27% respectively)
• Exclusive breast feeding 45%
• HIV prevalence 5.5%,
• Infant mortality rate 37/1000
births,
• 8% food products are substandard,
• 30% do not do exercise regularly.
8
COUNTRIES NUTRITION SITUATION

9. POLICY IMPLEMENTATION
HEALTHY LIFESTYLE AND BEHAVIOUR
9

10. INDONESIA
Strategies
• Conducting socialization in the villages to head of villages and chief of local
organizations.
• Collecting the data in each household based on 10 indicators of healthy
behaviour in family program.
• Mapping the family based on existence of 10 indicators.
• Planning the problem priority, objectives, intervention, and schedule of
intervention.
• Conducting the intervention with full support by community leaders.
• Monitoring and evaluation the impact of intervention to the indicators.
• Providing awards to the three best villages based on the scoring indicators.
10
• Empower family to practice healthy behaviour and to
be actively involved in healthy action in society.
Policy
Objectives

11. Main
Actors
Ministry of Health
Private company
(CSR Program)
Department of Health,
local hospital, local
organizations
• Monitoring using 10 healthy
behaviour indicators
• Conducted every year
Monitoring
and
Evaluation
11

12. GHANA
Strategies
• Empower individuals, households and communities to make
informed choices for their health through provision of
information, education and creation of an enabling environment.
• Develop standards for housing and introduce frequent inspections
accompanied by sanctions for constructing new houses without
adequate sanitary facilities.
• Ensure access to safe water and sanitation.
• To promote healthy lifestyles and reduce risk
factors of that arise from environmental,
economic, social and behavioural causes
Policy
Objectives
12

13. Strategies
• Facilitate the adoption of healthy lifestyles among students
through the curriculum, physical education, environmental
sanitation and the promotion of healthy eating
• Promote healthy eating programmes in schools and in
communities by introducing nutritional education into the school
curriculum
• Set up model regenerative health and nutrition facilities as
training centres to facilitate changes in lifestyle
• Promote physical exercise, rest and recreation by making physical
education mandatory in all schools and making recommendations
for adults.
• Ensure adequate levels of funding of health promotion and
nutrition in the health budget
13

14. • Ministry of Health, Ghana Education Service, Local
Government, Community Leaders, Town and
Country Planning, Rural Development Agencies,
Ministry of Employment, National Labour
Commission, the Media
Main
Actors
• Participatory planning and monitoring
process involving relevant stakeholders
• Peer review of cross-sectorial assessment
of the implementation
• Periodic evaluation based on annual
reviews
Monitoring
and
Evaluation
14

15. TANZANIA
Strategies
• Advise women of reproductive age and other caregivers on how to
improve dietary intake for themselves and their young children,
including the consumption of low-cost locally available foods and
fortified foods, where available and affordable
• Protect appropriate infant and young child feeding practices
• Increase access to quality nutrition services at
the community and facility level
• Enhance the nutrition behaviours of women,
caregivers, family and community members who
influence them
• Strengthen quality of nutrition services
• Integrate nutrition interventions and health
services
Policy
Objectives
15

16. • Educate school children and caregivers about the importance of
nutrition and options for improving dietary intake.
• Promote food preparation and processing technologies that
increase bioavailability and absorption of vitamins and minerals.
• Increase the dietary intake of vitamins and minerals, and include
supplementation, fortification, and dietary improvement
• Provision of nutritional care of persons living with HIV and AIDS
(PLHIV) and the prevention of mother to child transmission
(PMTCT) of HIV.
• Strengthen household food security by mobilizing action to
improve household food production, harvest and post-harvest
handling, storage and preservation, food processing and
preparation, animal husbandry and fishery .
16

17. • Public sector, Research institutes, Higher
learning and training institutions, Professional,
Private sector, Development partners, Civil
society, media and the community
Main
Actors
• Participatory through nutritional surveillance,
health management information system,
periodic surveys and other routine and non-
routine data systems
• Periodic evaluation/revision based on the
annual review/Joint Health Sector Review
• Mid-term and Post Evaluations
Monitoring
and
Evaluation
17

18. ZIMBABWE
Strategies:
• Country-wide campaigns to educate the people so that they will
make informed choices of healthy living.
• Introducing health education in schools and training institutions.
• Providing physical education and sporting facilities in villages and
communities and encouraging people to utilise them so as to
maintain a healthy lifestyle.
• Making it compulsory for every firm and industry to have the
environmental management departments to ensure a pollution
free environment.
• To ensure availability of funding to cover logistics costs.
18
• To promote healthy living and behaviour
Policy
Objectives

19. 19
• Ministries of Labour and Social Welfare,
Health and Child Welfare, Education, Sports
and Culture and Agriculture, Standards
Association of Zimbabwe
Main
Actors
•Periodic monitoring
•Active participation across board
•Periodic evaluation annually
Monitoring
and
Evaluation

20. POLICY IMPLEMENTATION
FOOD SAFETY AND QUALITY
20

21. INDONESIA
Policy Objective
To educate school community about safe and nutritious
school food and to increase the quality, safety and
nutrition of school food.
Strategies
• Strengthening existing school food programmes
• Increasing awareness of school food community
• Increasing capacity of school caterers in creating
healthy and nutritious food.
• Modeling and replication of ideal school canteens
• Optimizing management of the program.
21

22. Schools Community Food Vendors
Department of Health
National Agency of Food and
Drug Control , Ministry of Health
Stakeholders
Monitoring and
Evaluation
• Conducting sampling and laboratory testing on
school food to check for its safety and quality.
• Using increment percentage of school food
which passed food safety standard.
22

23. GHANA
• To enact and enforce legislation regarding food
and food standards to ensure enabling
environments for healthy lifestyles.
Policy
Objective
• Developing and enforcing standards for the
production, storage, sale and handling of food
and drinks in markets, restaurants and other
vendors
• Promoting the adoption of standards and
regulation of the health and food industry
Strategies
23

24. Main
ActorsFood and drugs
authority
Food vendors and
restaurants
Ministry of trade
and industry
Ghana
Standards
Authority
Ghana Police
Service
Association of
Ghana industries
Monitoring and Evaluation
Participatory planning process involving relevant sectors and
stakeholders
Peer review of cross-sectorial assessment of the
implementation
Periodic evaluation based on annual reviews
24

25. TANZANIAObjectives
Create measures to
prevent unethical
marketing of breast milk
substitutes
Ensure adequate labelling
and quality of products for
infant and child feeding
Provide Tax-exemption of
commodities for nutrition
and food fortification
Strategies
Strengthen implementation,
monitoring and legislation
enforcement
Developing regulations,
standards and guidelines to
support the implementation
of legislation
25

26. Main
Actors
Government institutions
Research institutes and
institutions of training and
higher learning
Private sector and
development partners
Civil society, the media
and the communities
Monitoring and Evaluation
Nutrition surveillance, HMIS, periodic surveys, routine
and non-routine data collection
Periodic evaluation/revision based on the annual review
26

27. ZIMBABWE
27
• To ensure all food meets national public
health legislation and international
standards for quality and safety
Policy Objectives
Strategies
• Putting legal standards in place to control
production, processing, storage, handling and
trade in food
• Awareness campaign to educate people so they
make informed choices with their food
consumption.
• Making nutrition education compulsory in
schools and tertiary institutions
• Ensuring availability of adequate funding

28. 28
Main Actors
Ministry of Health and Child Welfare, Local government,
Community leaders, business community, Office of the
President and Cabinet, Ministry of Food Agriculture, Food
and Nutrition Council of Zimbabwe
Monitoring and evaluation
- Periodic monitoring
- Active participation across board
- Periodic evaluations annually

29. Summary - Healthy Lifestyle and Behaviour
Objective
Different objectives for all countries.
Main Actors/Stakeholders
- Ghana and Tanzania’s implementation
involve comprehensive actors.
-Indonesia puts CSR activities from
private companies as important player.
Strategy
- All countries has wide range of
activities in promoting healthy
behaviours.
- Tanzania gives special focus to
nutritional care for people living with
HIV and AIDS.
Monitoring and Evaluation
-All countries has periodic evaluation.
-When Ghana, Tanzania, and Zimbabwe
conduct participatory monitoring,
Indonesia only conduct top-down
monitoring.
29

30. Summary - Food Safety and Quality
Objective
-All countries in Africa focus on
legislation, while Indonesia focus on
implementation.
-Different target focus. Ghana targets
whole population, Zimbabwe targets
vulnerable family, Indonesia targets
school community.
Strategy
Ghana and Tanzania focused in
developing and enforcing
implementation of legislation. While
Indonesia focuses in awareness and
capacity increment.
Main Stakeholder
All countries involve government
agencies that responsible in health,
food, and drugs and private sector.
Monitoring and Evaluation
-All countries conduct yearly periodic
evaluation to review target fulfillment.
-Indonesia specifically conducts
sampling and laboratory checking for
food safety and quality.
30

31. COMPARISON OF POLICIES
31

32. Healthy Lifestyle and Behavior
Indonesia Ghana Tanzania Zimbabwe
Policy
Status
On-going On-going On-going On-going
Target Productive
couple, pregnant
and breast-
feeding mother,
children,
teenager, adult,
elderly people,
baby sitter
General population,
with specific strategies
targeting various
sections of the
population such as
children, pregnant
women etc.
General
population but
more attention to
children and
women
General
population
Source
of
funding
Indonesian
Government and
Private Company
Ghana Government Tanzania
Government,
Development
Partners, national
and international
NGOs, CBOs, FBOs
Zimbabwe
Government
32

33. Food Safety and Quality
Indonesia Ghana Tanzania Zimbabwe
Policy
Status
On-going On-going On-going On-going
Target Student, student’s
parent, teachers,
street food vendor,
canteen staffs
General
population
General population General
population
Source
of
Funding
Indonesia
Government
Ghana
Government
Tanzania
Government,
Development
Partners
national and
international NGOs,
CBOs, FBOs
Zimbabwe
Government
33

34. ASSESSMENT OF POLICIES
34

35. Healthy Lifestyle and Behaviour
Indonesia Ghana Tanzania Zimbabwe
Clear objectives Clearly stated Clearly stated Clearly stated Clearly stated
Quantifiable indicators Present Absent Present Absent
Orderly, well-defined
processes
Yes Yes Yes Yes
Sufficient funding to
implement
Insufficient Sufficient Insufficient Insufficient
Stakeholder
Recognition and
cooperation
Defined expectations
Yes
Not well defined
Yes
Well defined
Yes
Well defined
Yes
Not well defined
Monitoring and
Evaluation Process
Yes for periodical
monitoring
Yes, evaluation
planned but not yet
carried out
Yes, on-going Yes, on-going
35

36. Food Safety and Food Quality
Indonesia Ghana Tanzania Zimbabwe
Clear objectives Clearly stated Clearly stated Clearly stated Clearly stated
Quantifiable
indicators
Present Absent Present Absent
Orderly, well defined
processes
Yes Yes Yes Yes
Sufficient funding to
implement
Insufficient Sufficient Insufficient Insufficient
Stakeholder
Recognition and
cooperation
Defined expectations
Yes
Not well defined
Yes
Well defined
Yes
Well defined
Yes
Not well defined
Monitoring and
Evaluation process
Yes for periodical
monitoring
Yes, evaluation
planned but not
yet carried out
Yes-ongoing Yes –ongoing
36

37. Indonesia
Weaknesses
• Low number of medical
assistant in remote areas.
• Limitation of clean water and
proper sanitation in remote
areas.
• Limited area coverage for
policy implementation
• Limited number of school
canteens available
• Low enforcement of food
safety laws with regard to
vendors
37
Strengths
• Well-planned policy.
• Practicing participatory
process that involves target
group directly.

38. Ghana
Strengths
• Demonstration of political will
by allocating specific budget
for implementation of policy.
• Involvement of main actors
and stakeholders from
planning until
implementation and
evaluation stages.
• Environmental modifications
included to support
behaviour change
• Use of multifaceted strategies
which shows the complexity
of nutrition problems
Weaknesses
• No quantifiable indicators
stated.
• No review and update of
policy during implementation
• Capacity to evaluate may be
limited
• Impact may be difficult to
determine since lifestyle
changes may take long
periods to manifest
38

39. Tanzania
Strengths
• Clearly stated objectives.
• Quantifiable indicators stated
• Involvement of multiple
stakeholders in the
implementation of nutrition
activities in the country,
including the public sector
Weaknesses
• Limited financial resources
for nutrition from
government and
development partners
• Few health facilities provide
the full set of nutrition
interventions
• Inadequate linkages between
health facilities, communities
and referral systems
• Policies, standards and
guidelines in nutrition not
fully used at implementation
level 39

40. Zimbabwe
Strengths
• High literacy level which
makes it easy to educate the
population about the policies.
• Good infrastructure.
Weaknesses
• Political instability
• Inadequate budgetary support
especially without donor
funding.
40

41. RECOMMENDATIONS
• Policies should be based on local context and evidence.
• Policy planning should be participatory and involve stakeholders to ensure
effectiveness.
• Policy makers and governments should be committed to policy
implementation.
• In order ensure sustainability, policies should be more focused on improving
individual self-efficacy for healthy lifestyles.
• Local funding should be sourced in order to ensure implementation of locally
relevant policies.
• Improvement in general infrastructure to support policy implementation.
• Evaluation should play a critical role in policy development and
implementation to ensure the creation of more effective policies in the future
• Importance to bridge the gap between the research community and
policymakers.
41

42. REFERENCES
JOURNAL/ BOOK
• FAO. (2001). Assuring Food Safety And Quality.
http://www.who.int/foodsafety/publications/capacity/en/Englsih_Guidelines_F
ood_control.pdf
• D S Gochman (Ed), (1997). Handbook of Health Behavior Research New York,
Vols. 1–4: Plenum.
GHANA
• Ghana National Health Policy- Creating Wealth through Health
• Ghana Ministry of Health: http://www.moh-ghana.org/
• Ghana Health Service : http://www.ghanahealthservice.org/
42

43. INDONESIA
• Food and Nutrition National Action Plan Year 2011-2015
• Strategic Plan of Ministry of Health Year 2009-2014
• Strategic Plan of National Agency of Food and Drug Control Year 2009-2014
• Government Institution Performance Accountability Report of National
Agency of Food and Drug Control Year 2013
• Guideline of Assessment and Development of Healthy and Clean Behaviour in
Household
• Yearly Report of National Agency of Food and Drug Control Year 2013
• Indonesia Health Profile Year 2012
43
REFERENCES

44. TANZANIA
• Nutrition Country Paper – The United Republic of Tanzania (Draft) The
National Road Map Strategic Plan to Accelerate Reduction of Maternal,
Newborn and Child Deaths in Tanzania 2008 - 2015
• The United Republic of Tanzania: National Nutrition Social and Behaviour
Change Communication Strategy July 2013 – June 2018
• The United Republic of Tanzania: National Nutrition Strategy JULY 2011/12 –
JUNE 2015/16
ZIMBABWE
• Zimbabwe Vulnerability assessment Committee (ZIMVAC) 2013,
http://reliefweb.int/sites/reliefweb.int/files/resources/2013%20ZimVAC%20
DRAFT%20REPORT.pdf accessed on 05 October 2014
• Zimbabwe Food Security Issues Paper for Forum for Food Security in Southern
Africa, http://www.odi.org/sites/odi.org.uk/files/odi-assets/publications-
opinion-files/5613.pdf accessed on 11 October 2014
44
REFERENCES

45. • Ms K. Mukudoka (2013) Intersectoral Coordination for Scaling Up Nutrition in
Zimbabwe- The Food and Nutrition Security Policy in the context of Economic
Growth and Development
http://www.fao.org/fileadmin/user_upload/wa_workshop/PPT_SA/DAY3_SU
NZimbabwe.pdf accessed on 23 October 2014
• Zimbabwe: Achieving Household and National Food Security,
http://siteresources.worldbank.org/EXTMULTIDONOR/Resources/Findings2-
Food-security.pdf accessed on 23 October 2014
• Ministry of Health and Child Welfare (2014), The National health Strategy for
Zimbabwe (2009-2013): Equity and Quality in Health, A people’s right
http://www.zadhr.org/national-documents/53-zim-health-policy.html
accessed on 25 October 2014.
• Zimbabwe National Nutrition Survey 2010, http://www.zadhr.org/national-
documents/103-zimbabwe-national-nutrition-survey-2010.html accessed on
25 October 2014
45
REFERENCES

46. 46