Original Article
Progress on Salt Reduction in the Pacific Islands: From Strategies to Action

https://doi.org/10.1016/j.hlc.2014.11.023Get rights and content

Background

Most populations are consuming too much salt which is the main contributor of high blood pressure, a leading risk factor of cardiovascular disease and stroke. The South Pacific Office of the World Health Organization has been facilitating the development of salt reduction strategies in Pacific Island Countries and areas (PICs). The objective of this analysis was to review progress to date and identify regional actions needed to support PICs and ensure they achieve the global target to reduce population salt intake by 30% by 2025.

Methods

Relevant available national food, health and non-communicable disease (NCD) plans from all 22 PICs were reviewed. NCD co-ordinators provided updates and relayed experiences through semi-structured interviews. All activities were systematically categorised according to an existing salt reduction framework for the development of salt reduction strategies.

Results

Salt reduction consultations had been held in 14 countries and final strategies or action plans developed in nine of these, with drafts available in a further three. Three other countries had integrated salt reduction into NCD strategic plans. Baseline monitoring of salt intake had been undertaken in three countries, salt levels in foods in nine countries and salt knowledge, attitude and behaviour surveys in four countries. Most countries were at early stages of implementation and identified limited resources as a barrier to action. Planned salt reduction strategies included work with food industry or importers, implementing regional salt reduction targets, reducing salt levels in school and hospital meals, behaviour change campaigns, and monitoring and evaluation.

Conclusions

There had been good progress on salt reduction planning in PICs. The need for increased capacity to effectively implement agreed activities, supported by regional standards and the establishment of improved monitoring systems, were identified as important steps to ensure the potential cardiovascular health benefits of salt reduction could be fully realised in the region.

Section snippets

Background

Most populations are consuming too much salt which is a significant risk for ill-health. High salt intake is one of the main contributors to high blood pressure, which increases the risk of cardiovascular disease and stroke. Reducing salt intake has been identified as a cost-effective measure for improving population health, with the potential to save millions of lives worldwide each year [1], [2], [3]. Several countries, including Finland, the UK and France, have already demonstrated a fall in

Methods

This study reviews progress on salt reduction in PICs between June 2010 and September 2013. All documents relating to salt in the region were collated and reviewed, including reports of national consultations, salt action plans, Food Security plans and NCD Crisis Response plans. NCD co-ordinators were then contacted to provide updates and information on experiences through semi-structured interviews either face-to-face at the 4th and 5th Pacific NCD Forums in 2012 and 2013, or over the

Mobilisation

Salt reduction consultation meetings had been held in 14 PICs (Table 1). The first took place in Fiji, in June 2010, chaired by the Health Minister. In each country stakeholders were brought together to raise awareness about salt and ill health and to develop action plans to reduce salt intake, based on international best practice experience. Many countries also secured media coverage helping to disseminate information about the health problems of excess sodium intake.

Governance and Strategy Development

Consultations and

Discussion

The injection of resources to raise awareness about the links between salt and ill health and to facilitate PICs to develop salt reduction strategies had stimulated considerable activity. The majority of PICs are aware of the importance of reducing salt intake and more than half have strategies in place and were taking action to raise awareness and change behaviour. That said, implementation overall is fairly patchy and there is still an absence of reliable salt intake monitoring data upon

Conclusion

There had been substantial progress on salt reduction efforts in the Pacific Islands in the three years following the Pacific Food Summit. Most countries now recognise the importance of reducing salt to lower the risk of cardiovascular disease and have highlighted this as a priority in their NCD prevention and control planning. However, many face competing priorities in terms of implementation. Designation of national salt reduction program coordinators can help ensure appropriate attention is

Competing interests

JW is Director of the World Health Organization Collaborating Centre on Population Salt Reduction in the Food Policy Division at the George Institute for Global Health. No other authors have any competing interests to declare.

Acknowledgements

JW was supported during the time of this work by a National Heart Foundation and Stroke Foundation Postdoctoral research fellowship. JW has also received funding from the World Health Organization Representative Office of the South Pacific to support the development of salt reduction strategies in the Pacific Islands

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