Implementation of Government Policies and Actions to Orient Food Systems towards Healthier Diets in Thailand

Implementation of Government Policies and Actions to Orient Food Systems towards Healthier Diets in Thailand

Published: 2022.10.26
Accepted: 2022.10.19
71
Institute for Population and Social Research, Mahidol University, Thailand
Institute for Population and Social Research, Mahidol University, Thailand
Institute for Population and Social Research, Mahidol University, Thailand

ABSTRACT

Diets are shaped by food systems that determine population nutrition and are associated with population health outcomes. To improve food systems for healthier diets, effective policies and actions that address key determinants of the food systems are needed. This study aimed to determine and compare existing government policies and actions for food systems for healthy diets in Thailand with reference to internationally recommended policies and actions.

Documentary review was conducted to gather all information about policies and actions related to food systems that have been implemented by the Thai government. Data were assessed using Food Systems Dashboard Framework, which recommends ten policy domains with 42 policies and actions to get food systems working for healthier diets for all. Results showed that the Thai government implemented 31 policies and actions (out of 42 in total), especially in the following domains: agriculture, supply chain infrastructure, education and public awareness, national guidelines and public institution. The policies and actions that are not available in Thailand include trade policies to prioritize the supply of nutritious foods; mandatory large-scale food fortification programs; lower prices of nutritious foods; zoning laws to restrict fast food outlets and vendors; financial incentives and planning regulations to drive the establishment of new supermarkets, fresh food markets, shops and street vendors; and development of independent accountability mechanisms to monitor and publicly report on business progress. The findings of this study suggest that continued attention to promoting policies and actions related to sustainable agriculture as part of a healthy diet policy is needed. This should include gaining a balance in agriculture, the environment, and natural resources. Together, the government needs to build the strong governance capacity of the responsible organisations to carry out their responsibilities effectively in the long run. A robust monitoring and evaluation system for tracking progress on policy performance and targeted outcomes is essentially required.  

Keywords: food and agricultural policies, food systems, sustainability, healthy diets

INTRODUCTION

The double burden of malnutrition, characterised by the coexistence of overweight, obesity and diet-related non-communicable diseases (NCDs), along with undernutrition, is increasingly prevalent in Thailand. Overweight and obesity remained in the top five major risk factors for NCDs nationally (Burden of Disease Research Program Thailand, 2018). NCDs (particularly cardiovascular diseases, cancers, diabetes, and chronic respiratory diseases) were a major cause of mortality in Thailand, contributing to 14% of all premature deaths in 2014 (Burden of Disease Research Program Thailand, 2016). Undernutrition is also a prevalent issue, with stunting in children under five years of age accounting for 13.4% of the total population in this age group (Global Nutrition Report, 2021).

The Thailand Burden of Disease study showed that unhealthy diets, particularly the low intake of fruits and vegetables, are one of the leading causes of death and disability among the Thai population (Burden of Disease Research Program Thailand, 2018). The analysis of the burden of diseases attributable to risk factors from 2004 to 2014 demonstrates the increasing trend of the burden attributable to the low intake of fruits and vegetables. This dietary risk accounted for 341,000 disability-adjusted life years (DALYs) and 21,650 Thai deaths in 2014.

The double burden of disease and unhealthy diet are being driven by changes in food systems (the production, aggregation, processing, distribution, consumption and disposal of food products), embedded by sub-systems (farming system, waste management system, input supply system, energy system, trade system, health system, and more) (FAO, 2018). Food systems also interact with broader contexts (rapid population growth, urbanization, growing wealth, changing consumption patterns, and globalization, as well as climate change and the depletion of natural resources). The food systems thus encompass a range of actors (individuals or organizations) and are intrinsically related to health, environment, culture, politics and economy.

Thailand is facing dual challenges in food systems – both increasing food demand and resource competition (Food Systems Dashboard, 2020). While the Thai population increases each year, cereal yields slightly increased from 3.0% in 2016 to 3.2% in 2017, and vegetable yields increased from 7.8% in 2017 to 7.9% in 2018. Share of employment in agriculture remained unchanged, at 32% in 2017 and 2018. Agricultural infrastructure for supporting the food supply chain is still limited, with the agricultural infrastructure index score at 49 in 2019 (out of 100 for the best infrastructure support). Increased loss of fruits was observed, from 7.8% loss in 2000 to 10% loss in 2018. There was also a decline in supply, particularly of vegetables, fruit, pulses, fish and milk, per capita. Higher accessibility to and availability of processed food products such as ultra-processed foods was observed. The retail value of ultra-processed food sales per capita increased from US$155.8 in 2017 to USD168.3 in 2018. Modern grocery retailers and supermarkets grew from 1.8 stores per 100,000 inhabitants in 2017 to 1.9 stores per 100,000 inhabitants. Personal consumption expenditures rose from US$8,242 in 2017 to US$8,591 in 2018.

Making food systems sustainable requires the provision of support for population diets and nutrition. Policy interventions with the potential to create an enabling environment for sustainable food systems are needed (HLPE, 2017). The policy interventions should address each part of the food system to ensure its impact. As the food systems are complex, affected by many different factors and made up of many processes and actors, policy packaging with potential priority actions is an important strategy to ensure the impact of the food system on healthier diets for all populations. Potential policy packages developed by Food System Dashboards, for example, recommended 42 policies and actions with the potential to get food systems working for healthier diets (Hawkes C, Walton S, Haddad L, & Fanzo J, 2020). These policies and actions cover multiple domains of food systems across production, supply chain, food environments and consumers.

Although the Thai government has committed to improving the performance of the public sector to gear the food systems towards greater sustainability and balance in all dimensions, as well as strengthening food security and ensuring equitable access to safe and healthy food for all (Ministry of Foreign Affairs, 2021), there is limited evidence on the governmental progress in creating sustainable food systems for healthy diets for all. This information will be helpful for the governments and other stakeholders in identifying ways to make government actions both effective and politically feasible to change and improve food systems. Therefore, this study aimed to determine and compare existing government policies and actions on food systems for healthy diets in Thailand with reference to internationally recommended policies and actions.

MATERIALS AND METHODS

Data collection

Documentary review was conducted to gather all information about policies and actions related to food systems implemented by the Thai government. Data for national-level implementation were gathered and assessed using the Food Systems Dashboard framework (FSD). The FSD recommends ten areas, with 42 policies and actions in total, to get food systems working for healthier diets for all (Table 1) (Hawkes C et al., 2020). The ten areas include agriculture (7 actions), international trade (1 action), research, processing and technology (7 actions), supply chain infrastructure (6 actions), finance (4 actions), public institution (2 actions), business (5 actions), regulations and laws (5 actions), education and public awareness (4 actions), and national guidelines (1 action).

Table 1. 42 Policies and actions by Food System Dashboard

Policy area

Policy action

Area 1 Agriculture

  1. Agricultural extension programs, infrastructure and education 
  1. Agricultural development programs
  1. Providing women with agricultural assets, training and support 
  1. Animal-husbandry and training for animal rearing, safety management and processing along with nutrition education
  1. Indigenous crops
  1. (Peri-)urban agriculture programs 
  1. Home gardens

Area 2 International trade

  1. Trade policies to prioritize the supply of nutritious foods

Area 3 Research, processing and technology

  1. High-nutrient density when breeding crops 
  1. Bio-fortification programs 
  1. Postharvest storage technologies, packaging and processing techniques
  1. New processed products 
  1. Large-scale food fortification programs
  1. Processed food reformulation
  1. Alternative proteins sources

Area 4 Supply chain infrastructure

  1. Roads, transportation, storage, cold chain and logistical distribution infrastructure
  1. Development of e-commerce platforms 
  1. Markets selling nutritious foods to low-income communities 
  1. Empowerment of smallholder farmers and small farm businesses to access markets
  1. Reduction of loss and waste of nutritious foods 
  1. Training programs for food producers and retailers 

Area 5 Finance

  1. Redirecting agriculture subsidies 
  1. Nutritious foods and meals at lower prices at point-of-purchase 
  1. Cash transfer, voucher and food delivery programs 
  1. Taxes to decrease affordability and incentivize reformulation 

Area 6 Public institution

  1. School food programs
  1. Public food procurement policy 

Area 7 Business incentives

  1. Investment funds and technical support for start-ups and small-and medium-sized food processing business 
  1. New supermarkets, fresh food markets, shops and street vendors in underserved communities
  1. Fast food outlets, street food vendors and food service trucks to place nutritious options 
  1. Businesses to provide nutritious foods to their employees at lower prices
  1. Independent accountability mechanisms to monitor and publicly report on business progress

Area 8 Regulations and laws

  1. Mandatory limits on trans fats, sugar, salt/sodium and/or saturated fat in packaged foods
  1. Nutrition labelling on packages/menus
  1. Restriction of all forms of marketing, advertizing and in-store promotions of HFSS foods
  1. Zoning laws 
  1. Safety regulations, surveillance mechanisms and protocols 

Area 9 Education and public awareness

  1. Nutrition education, food literacy and skills training 
  1. Dietary counselling to women during antenatal care and pregnancy
  1. Mass media and behavior change communication campaigns 
  1. Traditional food cultures 

Area 10 National guidelines

  1. Alignment of all food systems policies and programs with food-based dietary guidelines

Relevant policy documents were collected by searching websites and publications of governmental and non-governmental organisations and major Thai newspapers. Policy data that were used for analysis were the government policies being currently implemented from October to December 2021 (from the start date to the finish date of data collection).  

Data analysis

This study employed content analysis to describe the details of each policy action compared with the FSD recommendations of 42 policies and actions across ten domains and identify implementation gaps of each policy action. The analysis was performed by SP and ST, whereby the coded categories were derived directly from the framework. This is an iterative process of abstraction where sentences and paragraphs from the documents related to the 42 policies and actions across ten domains were identified and compared with the FSD.  

RESULTS

Figure 1 illustrates a proportion of policy actions in each policy area that were implemented in Thailand. The Thai government implemented 31 policies and actions (out of 42), especially in the following policy areas: supply chain infrastructure, public institution, education and public awareness, and national guidelines. Most recommended policy actions that were not in place were observed in the areas of international trade, finance and business incentives.

Table 2 summarizes the presence or absence of the 42 policy actions organized under ten policy areas of FSD recommendations in Thailand. The policies and actions that were implemented by the Thai Government were described, including responsible actors. Among the ten areas, Area 4 ‘Supply chain infrastructure,’ Area 6 ‘Public institution,’ Area 9 ‘Education and public awareness,’ and Area 10 ‘National guidelines’ were the areas where all recommended policy actions took place in Thailand.

Area 1 ‘Agriculture,’ Area 3 ‘Research, processing and technology,’ Area 5 ‘Finance,’ and Area 8 ‘Regulations and laws’ had at least 50% of recommended actions being implemented. The actions that are not yet in place were Action 4 on animal-husbandry and training for animal rearing, safety management and processing along with nutrition education, Action 6 on (peri-)urban agriculture programs, Action 13 on large-scale food fortification programs, Action 35 on restriction of all forms of marketing, advertising and in-store promotions of HFSS foods, and Action 36 on zoning laws.

Area 2 ‘International trade’ and Area 7 ‘Business incentives’ were the least implemented areas. Area 2 lacked Action 8 on trade policies to prioritize the supply of nutritious foods. Area 7 lacked Action 29 on new supermarkets, fresh food markets, shops and street vendors in underserved communities, Action 31 on businesses to provide nutritious foods to their employees at lower prices, and action 32 on independent accountability mechanisms to monitor and publicly report on business progress.

Table 2 Policy area and actions of FSD recommendations and their implementation in Thailand  

Policy area

Policy action

Thailand’s implementation based on FSD recommendations

Description

Responsible actor

Area 1 Agriculture

Action 1 Agricultural extension programs, infrastructure and education 

1. Strategic Plan of the Department of Agricultural Extension B.E.2560 – 2564 (2017-2021)
2. Three-Year Digital Economy and Society Action Plan of the Department of Agricultural Extension B.E. 2563-2565 (2020-2022)
3. Village Agricultural Volunteers
4. Strategy for Climate Change in Agriculture (B.E. 2560 – 2564) (2017-2021)
5. Work manual of New Theory agriculture, Fiscal Year B.E. 2563-2565 (2020-2022)
6. Developing skills for sustainable agricultural development based on sustainable agriculture project B.E.2561 (2018)

1-6 Ministry of Agriculture and Cooperatives

Action 2 Agricultural development programs

20-Year Strategic Plan (B.E. 2560 – 2579) (2017-2036), National Bureau of Agricultural Commodity and Food Standards
Five-Year Strategic Plan (B.E. 2560 – 2564) (2017-2021), National Bureau of Agricultural Commodity and Food Standards
Master Plan under National Strategy (3) Agriculture (B.E. 2561 - 2580) (2018-2037)

Ministry of Agriculture and Cooperatives

Action 3 Providing women with agricultural assets, training and support 

Establishment and Implementation Manual of Farm Women Group

Ministry of Agriculture and Cooperatives

Action 4 Animal-husbandry and training for animal rearing, safety management and processing along with nutrition education

NA

NA

Action 5 Indigenous crops

1. The First National Master Plan on Thai Herbal Development B.E.2560–2564 (2017-2021)
2. The Five-Year Master Plan of the Royal Development Projects (B.E.2560-2564) (20172021)
3. The Eight-Year Highland Research and Development Plan (B.E.2563-2570) (2020-2027)
4. Plant Variety Protection Act
5. The Five-Year Action Plan of the Department of Agriculture (B.E. 2560 - 2564) (2017-2021)
6. Establishment of Marketing Organization for Farmers Decree B.E.2517 (1974)
Master Plan under National Strategy (3) Agriculture (B.E. 2561 - 2580) (2018-2037)

1. Ministry of Public Health
2. Royal Project Foundation
3. Highland Research and Development Institute (Public Organization)
4.-6. Ministry of Agriculture and Cooperatives

Action 6 (Peri-)urban agriculture programmes 

NA

NA

Action 7 Home gardens

Handbook of Vegetable Gardening

Ministry of Interior

Area 2 International trade

Action 8 Trade policies to prioritise the supply of nutritious foods

NA

NA

Area 3 Research, processing and technology

Action 9 High-nutrient density when breeding crops 

Master Plan under National Strategy

(3) Agriculture (B.E. 2561 - 2580) (2018-2037)

Ministry of Agriculture and Cooperatives

Action 10 Biofortification programmes 

Master Plan under National Strategy

(3) Agriculture (B.E. 2561 - 2580) (2018-2037)

Ministry of Agriculture and Cooperatives

Action 11 Postharvest storage technologies, packaging and processing techniques

Master Plan under National Strategy

(3)  Agriculture (B.E. 2561 - 2580) (2018-2037)

Ministry of Agriculture and Cooperatives

Action 12 New processed products 

Master Plan under National Strategy

(3) Agriculture (B.E. 2561 - 2580) (2018-2037)

Ministry of Agriculture and Cooperatives

Action 13 Large-scale food fortification programmes

   

Action 14 Processed food reformulation

Intellectual Property Innovation Driven Enterprise Development Project

Chulalongkorn University Intellectual Property Institute

Action 15 Alternative proteins sources

Mycoprotein alternative protein products

National Center for Genetic Engineering and Biotechnology (BIOTEC)

Area 4 Supply chain infrastructure

Action 16 Roads, transportation, storage, cold chain and logistical distribution infrastructure

1. 20-Year strategy for the development of the Thai transportation system (B.E. 2561-2580) (2018-2037)
2. Strategic plan of the Ministry of Transport to Support the Development of the National Logistics System No.3 (B.E.2560-2564) (2017-2021)
3. Good Practices for Animal Welfare: Transport of Animals by Land
4. Master Plan under National Strategy (4) Future Industries and Services (B.E. 2561 - 2580) (2018-2037)

1.-2. Ministry of Transport
3. Ministry of Agriculture and Cooperatives
4. Ministry of Industry

Action 17 Development of e-commerce platforms 

1. Online “Smart Farmer” for the World Market Seminar
2. “Produced by Agriculture, Marketed by Commerce” policy
3. Master Plan under National Strategy (3) Agriculture (B.E. 2561 - 2580) (2018-2037)

1.-2. Ministry of Commerce
3. Ministry of Agriculture and Cooperatives

Action 18 Markets selling nutritious foods to low-income communities 

Master Plan of the Ministry of Commerce B.E. 2555-2564 (2012-2021)

Ministry of Commerce

Action 19 Empowerment of smallholder farmers and small farm businesses to access markets

1. Cooperatives Act B.E. 2542 (1999)
2. The 20-Year Strategic Plan of Cooperative Promotion Department (B.E. 2560-2579) (2017-2036)
3. Co-operative Development Plan No.4 (B.E.2563-2565) (2020-2022)

1.-3. Ministry of Agriculture and Cooperatives

Action 20 Reduction of loss and waste of nutritious foods 

1. Sustainable Consumption and Production Roadmap B.E. 2560 – 2580 (2017-2037) (Revised Version 1)
2. National Food Loss Index as an indicator
3. Food loss index as an indicator

1. Ministry of Natural Resources and Environment
2. The Sub-Committee on Food Loss, Ministry of Agriculture and Cooperatives
3. Technology and Informatics Institute for Sustainability, National Science and Technology Development Agency

Action 21 Training programmes for food producers and retailers 

1. Trainings and activities related to food, including a training on “product processing and quality control of freeze-dried and vacuum-frying dehydration processes”
2. Skill training related to agricultural and food products, including processing of seafood, meat, agricultural product, and fruits and vegetables preservation

1. Ministry of Industry
2. Ministry of Labour

Area 5 Finance

Action 22 Redirecting agriculture subsidies 

Programme to Promote Organic Rice Production

Ministry of Agriculture and Cooperatives

Action 23 Nutritious foods and meals at lower prices at point-of-purchase 

NA

NA

Action 24 Cash transfer, voucher and food delivery programmes 

NA

NA

Action 25 Taxes to decrease affordability and incentivise reformulation 

the excise tax on sugary beverages (based on the sugar content)

Ministry of Finance

Area 6 Public institution

Action26 School food programmes

Thai School Lunch

School Lunch Project Fund Bureau; Office of the Permanent Secretary, Ministry of Education; Office of the Basic Education Commission, Ministry of Education

Action 27 Public food procurement policy 

Sustainable Consumption and Production Roadmap B.E. 2560 – 2580 (2017-2037)

Ministry of Natural Resources and Environment

Area 7 Business incentives

Action 28 Investment funds and technical support for start-ups and small-and medium-sized food processing business 

Star-up investment policy

Thailand Board of Investment

Action 29 New supermarkets, fresh food markets, shops and street vendors in underserved communities

NA

NA

Action 30 Fast food outlets, street food vendors and food service trucks to place nutritious options 

Street Food Good Health

Ministry of Public Health

Action 31 Businesses to provide nutritious foods to their employees at lower prices

NA

NA

Action 32 Independent accountability mechanisms to monitor and publicly report on business progress

NA

NA

Area 8 Regulations and laws

Action 33 Mandatory limits on trans fats, sugar, salt/sodium and/or saturated fat in packaged foods

1. Implementation Guidelines for Notification of the Ministry of Public Health (No.388) B.E.2561 (2018) Re. Prescribed Prohibited Food to be Produced, Imported, or Sold.
2. Notification of the Ministry of Public Health Re. Edible Salt
3. Strategic Plan to Reduce Salt Consumption (Sodium) in Thailand B.E. 2559-2568 (2016-2026)

1.-3. Ministry of Public Health

Action 34 Nutrition labelling on packages/menus

1. Notification of Ministry of Public Health (No.182) B.E.2541 (1998) Re. Nutrition Labeling, as announced in the Government Gazette
2. Notification of Ministry of Public Health (No.219) B.E.2544 (2001) Re. Nutrition Labeling (No.2), as announced in the Government Gazette
3. Notification of Ministry of Public Health (No.392) B.E.2561 (2018) Re. Nutrition Labeling (No.3), as announced in the Government Gazette
4. Notification of the Food and Drug Administration Re. Declaration of Nutrient Function Claim, as announced in the Government Gazette
5. Notification of the Food and Drug Administration Re. Explanation of the Ministry of Public Health No.392 (B.E.2561) (2018) Issued by virtue of the Food Act B.E.2522 (1979) Re. Nutrition Labeling (No.3)
6. Notification of the Ministry of Public Health (No.373) B.E.2559 (2016) Re. The Display of Nutrition Symbol on Food Label., as announced in the Government Gazette
7. Notification of the Food and Drug Administration Re. Explanation of Notification of the Ministry of Public Health No.373 (B.E.2559) (2016) Re. The Display of Nutrition Symbol on Food Label
8. Notification of the Sub-Committee of Developing and Promoting the Use of Simplified Nutrition Symbol Re. Criteria, Condition, and Methods of the Display of “Healthier Choice” Nutrition Symbol on Food Label
9. Notification of the Sub-Committee of Developing and Promoting the Use of Simplified Nutrition Symbol Re. Criteria, Condition, and Methods of the Display of “Healthier Choice” Nutrition Symbol on Food Label (No.2)
10. Notification of the Sub-Committee of Developing and Promoting the Use of Simplified Nutrition Symbol Re. Criteria, Condition, and Methods of the Display of “Healthier Choice” Nutrition Symbol on Food Label for Each Food Category
11. Notification of the Sub-Committee of Developing and Promoting the Use of Simplified Nutrition Symbol Re. Criteria, Condition, and Methods of the Display of “Healthier Choice” Nutrition Symbol on Food Label for Each Food Category (No.2)
12. Notification of the Ministry of Public Health (No.394)  (B.E. 2561) (2018) Issued by virtue of the Food Act B.E. 2522 (1979) Re: Food products Required to bear Nutrition Labelling and Guideline Daily Amounts, GDA Labelling
13. Notification of the Food and Drug Administration Re. Explanation of Notification of the Ministry of Public Health (No.394) (B.E. 2561) (2018) Issued by virtue of the Food Act B.E. 2522 (1979) Re: Food products Required to bear Nutrition Labelling and Guideline Daily Amounts, GDA Labelling

1.-13. Ministry of Public Health

Action 35 Restriction of all forms of marketing, advertising and in-store promotions of HFSS foods

NA

NA

Action 36 Zoning laws 

NA

NA

Action 37 Safety regulations, surveillance mechanisms and protocols 

National Food Committee Act B.E. 2551 (2008)

Ministry of Public Health

Area 9 Education and public awareness

Action 38 Nutrition education, food literacy and skills training 

Nutrition Literacy Promotion Program, Bureau of Nutrition

Ministry of Public Health

Action 39 Dietary counselling to women during antenatal care and pregnancy

Antenatal care Clinic (ANC) Well Child Clinic (WCC)

Ministry of Public Health

Action 40 Mass media and behavior change communication campaigns 

1. Eating salty food: How dangerous is it? “Less Salt, Less diseases” campaign under the Strategic Plan to Reduce Salt Consumption (Sodium) in Thailand B.E. 2559-2568 (2016-2025)
2. FoodChoice Application

1.-2. Ministry of Public Health

Action 41 Traditional food cultures 

Provision of research funding on traditional food cultures, including food registration by province.

Ministry of Culture

Area 10 National guidelines

Action 42 Alignment of all food systems policies and programs with food-based dietary guidelines

1. National Strategy B.E. 2561-2580 (2018-2037)
2. Strategies of Food Management System of Thailand
3. Food Security Strategy, Ministry of Agriculture and Cooperatives (B.E. 2560–2564) (2017-2021)

1. Office of the National Economic and Social Development Council
2. National Food Committee
3. Food Security Strategy, Ministry of Agriculture and Cooperatives (B.E. 2560–2564)

NA = not available

DISCUSSION

This study reviewed and analysed the presence and absence of government policies and actions for improving food systems for healthier diets for all populations in Thailand compared with the framework of FSD recommendations. Overall, the implementation of the Thai governments covered the majority (74%) of the recommended actions in each policy area. A major implementation gap was identified in particular in policy areas on international trade.

The Thai Government’s policy performance was best for the policy areas ‘Agriculture,’ ‘Supply chain infrastructure,’ ‘Public institution,’ ‘Education and public awareness,’ and ‘National guidelines.’ All the recommended actions in these areas were being implemented in Thailand. This performance on supply chain infrastructure, in particular, can be explained partly by the impact of the implementation of the 20-year National Strategy (2018-2037), which places sustainability of national biodiversity, environmental quality, and natural resource among national development priorities (National Strategy Secretariat Office, 2018). The national strategy focused on developing high-quality infrastructures to connect Thailand with the world through creating seamless transport networks. Land, water, and transport and infrastructure networks should be more developed to accommodate transportation and logistics along the regional supply chain. The strategy also places the importance on developing skilled local manpower, especially the skills of local entrepreneurs and enterprise groups required by the labour market in each area, such as food value chain management and marketing.

Encouraging zero-waste targets and total and sustainable waste management was another priority action for the national strategy to create eco-friendly water, energy, and agricultural security in the country. With this comprehensive strategic plan for actions toward achieving the country’s development goal, as such, responsible government agencies are mandated to develop actions aligned with the national strategy and plan. Accelerating government actions toward sustainable, nutrition-friendly and consumer-focused food systems, gaining a balance among agrifood systems, environment and natural resources is needed. Strong governance capacity of the government organisations is also essentially required for carrying out their responsibilities effectively in the long run.

The Thai government performed well in the policy area on education and public awareness. This was not surprising as Thailand has apparently more downstream (individual-level behavioral approach) policy actions than upstream (affecting large populations) policies. Actions on nutrition education, food literacy and skills training, and mass media and communication campaigns were partly under the Department of Health’s mandate to public health and nutrition education and were also delivered through the existing formal education system as part of Health Education subject. Action on dietary counselling to women during antenatal care and pregnancy was part of actions under the Thai Universal Health Coverage policy (Prakongsai P, Limwattananon S, & Tangcharoensathien V, 2009). However, increasing the effectiveness of public awareness and learning activities to reach a level where people can change their behaviour is always challenging. This requires a long and arduous journey that hangs on mobilising around the provision of education, training and information that requires institutional support, especially in financial resources, and periodic evaluation, which is always at the heart of policy implementation challenges (OECD, 2020) to improve the government performance in informing and educating citizens.

Thailand reported no action on the trade policies to prioritize the supply of nutritious foods. The evidence suggests that trade policies such as modern trade agreement affects or create tensions that potentially constrain policy space for creating or enforcing policy for public health nutrition outcomes (Thow et al., 2018; Thow et al., 2015). Actors in trade policy prioritize the outcomes of economic growth for exporting nations and food security and food safety for importers over public health nutrition. This can pose a challenge to the Thai national government in advancing the trade policies toward supporting the supply of nutritious foods, similar to previous research in another context (Harris et al., 2022). In addition, the trade policies involve cross-border actions, which strongly require cooperation and harmonization of the cross-country policies and actions, especially at a regional level. This will help to avoid weakening national restrictions and will strengthen government efforts to address population nutrition in trade space.

This study has some limitations. Firstly, the study obtained data based on publicly available information using documentary review and thus may have missed some information that is not publicly available or accessible. This may, therefore, affect the analysis results of policies and actions. Secondly, the study may have missed other policies and actions that are beyond the FSD recommendations, such as local level policies and actions that play a critical role in improving local or community food systems and thus country food systems. Lastly, this study did not aim to provide an in-depth understanding of current level of implementation of the policies and their effectiveness, although that is of importance for policy improvement. However, this study provided a starting point to determine issues needed for further in-depth investigation.

 

CONCLUSIONS

An important step in orienting food systems toward healthy diets in Thailand is to understand the government’s performance and progress against policy areas and policy actions in order to identify rooms for improvement. This study found that the Thai Government’s implementation of policy policies and actions is in line with the majority of FSD recommendations. The study identified the good government performance in the upstream food systems, including agricultural production, food processing, transportation and distribution, and a lack of international trade policies. Continued attention to promoting policies and actions related to sustainable agriculture as part of a healthy diet policy is important. This should include gaining a balance in agriculture, environment, and natural resources. Together, the government needs to build the strong governance capacity of the responsible organisations to carry out their responsibilities effectively in the long run. A robust M&E system for tracking progress on policy performance and targeted outcomes is essentially required. The cooperation of the cross-country policies and actions, particularly at a regional level, is needed in putting the international trade policies for nutrition outcomes in place.

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