Table 4

Changing societal conditions and focusing events as commitment-building opportunities or challenges

TypeIdentified examples presenting opportunities (↑) or challenges (↓)
Societal conditions: Long-duration phenomena that influenced many aspects of government policy agendas that were directly or indirectly related to nutrition.31 32↑ Long-term trends in population health, food systems change and nutrition status (eg, epidemiological transition, nutrition transition)28 37 57; ↑ transition to democracy enabling more socially orientated policies45 66; ↑ economic growth enabling greater resources for nutrition budgetary commitments.27 55 ↓ Sustained conflict/insecurity39 44 70 91 100; ↓ weak government revenue-raising capacity constraining nutrition budgetary commitments27 52 58 68 70; ↓ widespread corruption and embezzlement27 52 68; ↓ economic downturn/austerity reducing support for food regulations targeting obesity prevention due to perceived costs/impacts on food industry.28 32 34 58
Focusing events: short-duration processes that focused attention directly onto nutrition or indirectly by association with closely related issues.27 31↑ Famines, natural disasters, political upheavals and economic crises15 31 39 55 63 64 91; ↑ high-profile and/or consistent media coverage12 27 36 41 55 63 68 69 73 75 84; ↑↓ political developments including changes within the executive, legislative and/or administrative branches of government, government planning cycles, high-level speeches/debates and ratifying international agreements12 14 20 27 28 30 56 57 61; ↑ emergence of broader policy discourses that nutrition actors could sensitise (eg, HIV/AIDS, Millennium Development Goal implementation, primary healthcare, poverty reduction)31 55 59; ↑ direct actions of nutrition actors (eg, high-profile events, publishing reports).15 27 43 ↓ Famines, natural disasters, political upheavals, economic downturn and other crises when institutionalising food distribution responses that excluded nutrition.31