FOOD AND NUTRITION POLICY Syllabus

222.657.01 | AY 2013-2014 - 1st Term | 2 Credit(s)
M 3:30:00 PM
  • Course Learning Objectives

    Upon successfully completing this course, students will be able to:

    • identify food and nutrition problems amenable to policy intervention
    • define criteria of effective food or nutrition policies
    • critique a specific food and/or nutrition policy with respect to its evidence-base, adequacy of implementation, nutritional impact and forces which hinder or help the implementation of the specific policy
  • Course Description
    Examines major governmental, bilateral, and multilateral agency food and nutrition policies and programs that directly or indirectly affect 1) the availability and quality of food and 2) the health and nutrition of populations. Examples are drawn from developing and developed countries. Discussions are led by faculty and guest lecturers with diverse experience in developing and implementing food and nutrition policies.

    Additional Faculty Notes:

    The purpose of this course is to familiarize and engage the student in the steps and dynamics of policy making processes that address nutrition problems and issues. An underlying tenant is that, wherever nutrition problems exist, policy and program options may be enacted to address the problem directly (e.g. food subsidies to the poor) and/or indirectly (e.g. income generation or job creation). For the purpose of this course, nutrition and food policy is viewed as a specific set of decisions with related actions, established by a government and often supported by special legislation, which address a nutrition or food problem or set of problems. We realize that the lack of an explicit government policy may represent an implicit “hands off” policy; however, in this course we want to focus on explicit government policies. Effective policies include actions that enable policy goals to be achieved, and therefore should include a means of translating policy decisions into effective programs. Policies that have not been realized through program implementation represent failures and should stimulate interest in understanding why the policies have remained barren. Good programs are the best measure of good policies and we therefore include programs in our broad definition of policy. Once a problem is defined with respect to "what, who, when, where and why," we then ask whether the problem requires or is amenable to a policy solution. If so, what are the best options? Who are the stakeholders? Who will support or resist the policy? Who pays for its implementation? What impact is expected? How is it evaluated? Traditionally, nutritional policies have been realized through programs that deliver, enable access, or encourage consumption of food or supplements; obviously, problems associated with over-nutrition will require a different approach. Nutrition policies should be evidence-based and purposeful, aiming to meet nutritional needs; the same is not necessarily true of food policies, although they frequently will have nutritional effects. As background we discuss the evidence base of policies, but assuming the evidence base is sound, more important are: i) the contexts (nutritional, political, economic, cultural, etc.) in which policies are developed, ii) the processes and interaction of stakeholders which lead to policy decisions, iii) the translation of policies into feasible programs, iv) the evaluation of nutritional and other impacts (intended and unintended, positive and negative, measurable or not), and v) an assessment of the forces which hinder or help the implementation of the policy. We evaluate policies on the extent to which they meet these criteria. We recognize that implemented policies rarely play out so systematically, but we believe that these criteria are useful in understanding existing policies and designing new ones.

  • Intended Audience
    Masters and doctoral students in Dept. of International Health and other departments.
  • Methods of Assessment
    Based on class participation and term paper.

    Additional Faculty Notes:

     

    Grading Policy

    There will be four “Readiness Exercises”, one Food or Nutrition Problem and Policy Statement, one Stakeholder Analysis, and a final project which is either a "policy critique" or a “policy brief”.  No fixed formula applies and every student's unique circumstances are considered; the general principles include mastery of the material and relative performance, with each type of work counting for the following number of points:

     

    Readiness Exercise 1-4 (10 pt each)

    40

    Nutrition/Food Problem (10 points) and Policy Statement and Stakeholder Analysis (10 points)

    20

    Attendance and Participation

    10

    Policy Critique Paper or Policy Brief

    30

    Total

    100

     

    Assignments: 

    1.    Four Readiness Exercises (10 points per Readiness Exercise).  There are four (4) “readiness exercises”.  They will be available online through Courseplus.  They will cover assigned reading for that week and consist of 5 questions (true/false, multiple choice, and/or short answer).  You will be given 20 minutes to complete each exercise.  Feel free to refer back to articles when completing exercise, although it may be difficult for you to complete the exercise in time if you have not read the articles in advance.  Each “readiness exercise” opens Friday, closes Monday at noon.  They begin on week 2. Each will be graded on a 10 point scale.  

     

    2.    Food/Nutrition and Policy Statement (10 points). This is a one-page statement on the food and/or nutrition problem and policy that you plan to use for your final project (i.e. policy critique or policy brief).  Avoid a policy that has not been thought through or is too general to be defined in concrete terms.  In NO MORE than a single-page, briefly:

     

    ·              characterize the nutrition or food problem (i.e. its extent, severity, health/nutritional consequences, risk group(s), geographical distribution, causes)

    ·              describe the relevant policy that you plan to critique or recommend

    ·              list 5 scholarly references you intend to use for your policy critique or policy brief

     

    3.    Stakeholder Analysis (10 points).  Using the food or nutrition policy that you plan to critique or recommend, undertake a stakeholder analysis using the following 4 steps:

    3.1. List important stakeholders (i.e. actors who are likely to have an interest in the selected policy and that could benefit or be negatively affected by the policy).  Specific stakeholders can be identified from the following sectors:  International/donors, national political (legislators, governors), public (Ministries of Health, Agriculture, Finance, Communication), labor (unions, consumer associations), commercial/private for-profit, and non-profit (non-governmental organizations), media, consumers.

    3.2. Categorize the stakeholders listed above into:

    3.2.1.   High power/influence: These are stakeholders have high interest and power, are the “movers and shakers” of things to happen, and are in a position of leadership and power that will be most able to influence (move or block) policy change.

    3.2.2.   Medium power/influence: These stakeholders may have high interest but only medium power to influence policy change.

    3.2.3.   Low power/influence:  These stakeholders have low power or influence on whether a policy gets changed, and depend on the influence and support from other key stakeholders.

    3.3. Identify whether the stakeholder would support, oppose or be neutral to the policy (i.e. Which ones will be resistant to the policy or difficult to engage in policy change?; Who would support the policy and is in a position to help bring about the policy change? Who has a vested interest in maintaining the status quo [no change]?  List the advantages or disadvantages that the policy will bring to the stakeholder or his/her organization.

    3.4. Complete the matrix below (based on your analysis above)

     

     

     

    Stakeholder Position on the Policy

     

     

    Supporter

    Neutral

    Opponent

    Stakeholder
     Power/
    Influence

    High

     

     

     

    Medium

     

     

     

    Low

     

     

     

     

     Attendance and Participation (10 points): Participation is strongly encouraged. Participation includes asking relevant questions during class, posting relevant items of the Courseplus bulletin and discussion board, and actively participating in group discussions.  Attendance is required.  You must sign your name on the Attendance Sheet that will be available in each class session.  If a student must miss a class, he/she should submit a request to the TA requesting the date and reason for the planned absence prior to the class.  Requests will be considered on a case-by-case basis.

     

    Final Project (30 points):  You will have a choice between writing a Policy Critique or a Policy Brief.  Whichever option you chose, it will count for 30 points towards your final grade.  Below are guidelines for each type of project.

     

    Option 1.  Policy Critique:  This assignment will help you build your ability to find trustworthy sources, read critically, think for yourself and communicate your ideas in writing.  These skills are important for policy-related work, but also for your professional success.  We hope this assignment will be very interesting in and of itself, and it could be very useful as a writing sample for job applications or other uses.  Ideally, homework assignments 2 and 3 should have helped you identify an interesting food or nutrition problem and policy response, as well as help identify the policy context and stakeholders benefiting from, being hurt or not being affected by the policy.   

         Sources:  An important part of this assignment is identifying suitable sources.  Those pertaining to evidence for food or nutrition problem and the basis of the policy you plan to critique, the adequacy of its implementation, its cost effectiveness and its impact should be articles and books provide evidence using scientific methods.   Those pertaining to the political actors, social and economic context, and stakeholder interests are likely to be found in the "grey literature", newspaper articles or other sources that are not part of the peer-reviewed scientific literature.  

        You will need to examine the scientific literature to critically assess the strength of evidence for the nutrition or food problem and its policy "solution", as well as evidence of its effective implementation and impact.  But you will also need to examine non-scientific sources to understand the context (political, social, economic, etc) in which a policy was formulated and implemented.  

        Policy Choices:   You are free to write on any food and nutrition policy you choose provided it addresses a food and/or nutrition problem that is of public health significance.  Your topic can, and mostly will, evolve as you read and discover the nutrition problems and policies that are addressed by the literature.    Here are a few tips to guide you:

    ·         Choose a nutrition or food problem and policy that is interesting and useful to you.  Samples are provided below.

    ·         Chose a nutrition or food problem and policy on which scholarly/scientific research is available.  Some issues may not be feasible because there is inadequate scientific evidence or literature for you to critique.

    ·         Choose a general topic within the first two weeks of class, and refine it as you search the literature, examine the evidence and think about the topic.  The Food/Nutrition and Policy Statement assignment is intended to get you "jump started" with examining the scientific literature about a nutrition or food problem and policy that interests you and can contribute to your policy critique.  The stakeholder analysis assignment is intended to help you search for and examine contextual information about stakeholders and can also contribute to your policy critique.

    ·         Choose a nutrition and food problem and policy that you can understand and explain. 

    ‚Äč    Format and Length of Policy Critique:  6 pages (maximum) plus a one-paragraph Abstract.  Double spaced, 12 point font text.  Additional tables, figures and references as required to support the basic thesis of the paper and to be referenced in the text, but not counted within the 6-page limit.  No more than 6-pages of double-spaced text and the one-paragraph Abstract will be read by the reviewers for grading.  The reason for keeping the critique brief is to help you focus on highlighting key points.  Most policy makers will not have time to read more than a few pages which is why we want you to practice writing a thoughtful and pithy critique highlighting your critical review of the evidence.

        Components of a Policy Critique:   Please use the following components as a guide for phrasing the sub-headings of your critique.

        1.   Abstract:  This should be a short summary (approx 150-200 words) of the purpose, content and recommendations of your critique.  It typically appears single-spaced on the cover of a position paper.

        2.   Statement of the Nutrition or Food Problem Addressed by the Policy:  Briefly describe the nutritional problem being addressed by the policy--its extent, severity, health/nutritional consequences, risk group(s), geographical distribution, causes.

        3.  Policy/Program:  Briefly describe the specific policy being reviewed.

        4.  Policy Making Process:  Describe and critique the process by which the policy came into being.  How did the nutrition or food problem make it on the policy agenda?  How strong was/is the evidence under-pinning the food or nutrition problem?  How strong was/is the evidence for the policy choices made?  How was the policy formulated and decided upon?  What role did evidence play in the final policy decision?  What were other factors (cultural, political, economic and social factors that influenced the policy decision?  Who were the key stakeholders and what role did they play in promoting or opposing the policy?  

        5.  Policy Implementation:  How was the policy implemented?  What is/was adequate and inadequate with its implementation, based on what evidence?  

        6.  Policy Impact: What impact has the policy had on the nutrition or food problem?  How was impact assessed?  If it was not assessed, why not and how should it be assessed?

        7.  Conclusions and Recommendations:  Based on your critique, what are the strengths and limitations of the policy/program choice, process, implementation and impact?  Offer suggestions on what could be done to improve the policy’s design, implementation and impact.

         8.   References: Cite references in text using number in () and list in back of paper. References may include reports, scientific literature (e.g. using PubMed or other search engines), UN Agency survey reports, government, multi- and bi-lateral agency reports, as needed and required to support your paper. Materials obtained on the web should be cited in a format similar to journal articles, books, etc.

    Note: Please be fully informed about, and adherent to, the School’s Code of Ethics with respect to referencing the work of others. Plagiarism in any way from any source, including web-based sources of information, for any portion of the term paper will not be tolerated.    

     

    Option 2.  Policy Brief.  This option is geared toward students who want to write from the point of view of being an advisor to a policy-maker on a food or nutrition policy.  The following description and guideline for writing a Policy Brief has been lifted or slightly modified from Tsai (May 2006).Guidelines for Writing a Policy Brief [PDF Document].  Retrieved http://www.rhsupplies.org/fileadmin/user_upload/toolkit/B_Advocacy_for_RHS/Guidelines_for_Writing_a_Policy_Brief.pdf and Young, E and Quinn L (n.d.). The Policy Brief [PDF Document]. Retrieved from http://www.policy.hu/ipf/fel-pubs/samples/PolicyBrief-described.pdf

    What is a Policy Brief?   It is a short, neutral summary of what is known aout a particular issue or problem.  Policy briefs are a form of report designed to facilitate policy making.  The main purpose is to succinctly evaluate policy options regarding a specific issue for a specific policy-maker audience (e.g. health and nutrition officials, politicians, bureaucrats, food and nutrition practitioners).  Policy-makers need to make practical decisions under time-constraints, so the brief should provide evidence and actionable recommendations.

    The issue brief distils or synthesizes a large amount of complex detail, so the reader can easily understand the “meat” of the issue, its background, the “actors” or “players” (i.e. “stakeholders”) and any recommendations, or even educated guesses about the future of the issue. 

    Format and Length of Policy Critique:  6 pages (maximum) plus a one-paragraph Executive Summary.  Double spaced, 12 point font text.  Additional tables, figures and references as required to support the basic arguments of your policy brief and to be referenced in the text, but not counted within the 6-page limit.  No more than 6-pages of double-spaced text and the one-paragraph Abstract will be read by the reviewers for grading.  The reason for keeping the critique brief is to help you focus on highlighting key points.  Most policy makers will not have time to read more than a few pages which is why we want you to practice writing a thoughtful and pithy brief highlighting your arguments and recommendations.

    Components of a Policy Brief:

    Executive Summary:  The executive summary aims to convince the reader that the brief is worth reading.  It is especially important for an audience that is short of time to clearly see the relevance and importance of the brief by reading the executive summary.  The executive summary commonly includes:

    ·         A description of the problem being addressed

    ·         A statement on why the current policy option needs to be changed

    ·         Your recommendations for action.

    Background:  The purpose of this component is to convince the target audience that a current and urgent problem exists which requires them to take action.  The context and importance of the problem is both the introductory and first building block of the brief.  It usually includes:

    ·         A clear statement of the problem or issue in focus, its root causes and the policy implications and importance.  Include only the essential facts that a decision maker “needs to know” to understand the context of the problem.  Assume you have been hired to filter through reams of information on behalf of a very busy and sleep-deprived person.  Be clear, precise, and succinct.

    Statement of your organization’s interests in the policy or program:  This is meant to remind the reader of why the issue matters for the country/group/organization you are advising.

    Pre-existing Policies:  This summarizes what has been done (by others and the entity that you represent) about the problem thus far.  Inform the reader of policy options that have already been pursued, if any, their shortcomings of the current approach or options being implemented and what/where/how/why change is needed.

    Policy Options: This section delineates the possible course of action or inaction that your organization may pursue.  Please provide the decision maker with at least three potential courses of action but no more than five.

    Advantages and Disadvantages of Each Policy Option:  Write this section from the perspective of the organization that you represent.  You may present the pros and cons of the options in bullet points or outline format. 

    Your Recommendation:  After prioritizing the relative pros and cons of the above options, please recommend on option to the policy maker.  Provide a detailed and convincing proposal of how the shortcomings or failings of the current or proposed policy(ies) will be addressed by your recommendation.  Propose a breakdown of the specific practical steps or measures that need to be implemented.

    Appendices.   Although the brief is a short and targeted document, authors sometimes decide that their argument needs further support and include tables or graphs in an appendix

    References.    Cite references in text using number in ( ) and list in back of paper. References may include reports, scientific literature (e.g. using PubMed or other search engines), UN Agency survey reports, government, multi- and bi-lateral agency reports, as needed and required to support your  arguments. Materials obtained on the web should be cited in a format similar to journal articles, books, etc.

    Note: Please be fully informed about, and adherent to, the School’s Code of Ethics with respect to referencing the work of others. Plagiarism in anyway from any source, including web-based sources of information, for any portion of the term paper will not be tolerated.    

    As with all good marketing tools, the key to success is targeting the particular audience for your message. The most common audience for a policy brief is the decision-maker but, it is also not unusual to use the document to support broader advocacy initiatives targeting a wide but knowledgeable audience (e.g. decision makers, journalists, diplomats, administrators, researchers). In constructing a policy brief that can effectively serve its intended purpose, it is common for a brief to be:

    ·         Focused – all aspects of the policy brief (from the message to the layout) need to strategically focus on achieving the intended goal of convincing the target audience. For example, the argument provided must build on what they do know about the problem, provide insight about what they don’t know about the problem and be presented in language that reflects their values, i.e. using ideas, evidence and language that will convince them.

    ·         Professional, not academic –The common audience for a policy brief is not interested in the research/analysis procedures conducted to produce the evidence, but are very interested to know the writer’s perspective on the problem and potential solutions based on the new evidence.

    ·         Evidence-based – The policy brief is a communication tool produced by policy analysts and therefore all potential audiences not only expect a rational argument but will only be convinced by argumentation supported by evidence that the problem exists and the consequences of adopting particular alternatives.

    ·         Limited – to provide a adequately comprehensive but targeted argument within a limited space, the focus of the brief needs to be limited to a particular problem or area of a problem.  

    ·         Succinct – The type of audiences targeted commonly do not have the time or inclination to read an in-depth 20 page argument on a policy problem. Therefore, it is common that policy briefs do not exceed 6-7 pages in length (i.e. usually less than 3,000 words).

    ·         Understandable – This not only refers to using clear and simple language (i.e. not the jargon and concepts of an academic discipline) but also to providing a well explained and easy to follow argument targeting a wide but knowledgeable  audience.

    ·         Accessible – the writer of the policy brief should facilitate the ease of use of the  document by the target audience and therefore, should subdivide the text using  clear descriptive titles to guide the reader.

    ·         Promotional – the policy brief should catch the eye of the potential audience in  order to create a favorable impression (e.g. professional, innovative etc).  In this  way many brief writers many of the features of the promotional leaflet (use of  color, use of logos, photographs, slogans, illustrative quotes etc).

    ·         Practical and feasible – the policy brief is an action-oriented tool targeting policy practitioners. As such the brief must provide arguments based on what is actually happening in practice with a particular policy and propose recommendations  which seem realistic to the target audience.

    Example of a policy brief can be found at : http://ceep.indiana.edu/projects/PDF/PolicyBrief_Childhood_Obesity.pdf

  • Prerequisites

    Additional Faculty Notes:

    There are no formal prerequisites for taking the course; however, students are expected to be familiar with the basic principles of nutrition. Students are strongly encouraged to broaden their reading in the subjects related to the nutritional problems and policies that are addressed in the course in order to fully participate in class discussions and in order to prepare a paper critiquing a specific food or nutrition policy.

  • Required Text(s)

    Additional Faculty Notes:

    We will post course readings, notes, PowerPoint presentations and announcements online through the school’s online Courseplus resource system. Please refer to it regularly. You must use your eLearning username and password to log in to CoursePlus. An eLearning account can be set up quickly, and the same information can be used to access both online courses and CoursePlus sites at JHSPH.

  • Course Schedule

    Please see the course Session for a full list of dates and items for this course.

  • Academic Ethics Code

    Students enrolled in the Bloomberg School of Public Health of The Johns Hopkins University assume an obligation to conduct themselves in a manner appropriate to the University's mission as an institution of higher education. A student is obligated to refrain from acts which he or she knows, or under the circumstances has reason to know, impair the academic integrity of the University. Violations of academic integrity include, but are not limited to: cheating; plagiarism; knowingly furnishing false information to any agent of the University for inclusion in the academic record; violation of the rights and welfare of animal or human subjects in research; and misconduct as a member of either School or University committees or recognized groups or organizations.

  • Contact Information
    Faculty
    Rolf Klemm
    Keith West
  • Welcome Message

    It has been said that food and nutrition policies are like sausage--you don't want to see how they are made.  Yet, most researchers would like to believe that the work they produce will influence practice and policy and consequently lead to actual improvements in the nutrition and well-being of people.  Researchers and policy makers seem to live in parallel universes, with different agendas, processes, stakeholders, and requirements for level of rigor and timeliness of data.  This course uses cases studies to explore the elements of the policy-making process and how scientific findings are or are not used to help shape rational decision-making on food and nutrition polices. 

  • Course topics
     

     

    Week

    Date

    Topic

    Instructor

    Assignments Due/Exams

    1

    Sep 9

    Part A-Course Introduction

    Part B-Overview: Policy Definition, Framework, Food & Nutrition Problems, Principles/constructs  

    Rolf Klemm

    Keith West

     

    2

    Sep 16

    Part 1: Brief Introduction to Policy Frameworks andTools

    Part 2: US Food and Nutrition Policy-The Actors, Structures and Instruments

    Rolf Klemm

    Readiness Exercise 1

    (Due Sep 16)

    3

    Sep 23

    Part 1: Obesity Prevention Policies

    Part 2: Mock Senate Hearing

    Rolf Klemm 

     

    Readiness Exercise 2

    (Due Sep 23)

    4

    Sep 30

    US Food Aid

    Rachel Grant (USAID Food for Peace Office)

    Nutrition/Food Problem and Policy Statement and Stakeholder Analysis

    (Due Sep 30)

    5 Oct 1-12:15-1:15 pm Trials and Tribulations in Using Evidence to Influence Food and Nutrition Policies Linda Meyers (former Director, Food and Nutrition Board)  

    6

    Oct 07

    Special Supplemental Nutrition Program for Women Infants, and Children (WIC) 

    David Paige

    Readiness Exercise 3

    (Due Oct 07)

    7

    Oct 14

    Economic Tools of Policy Making

    Keven Frick

    Readiness Exercise 4

    (Due Oct 14)

    8

    Oct 21

    Student Presentations and Concluding Thoughts

    ~5 student "volunteers"

    Rolf Klemm

    Policy Critique or Policy Brief

    (Due Oct 20)

     

  • Teaching Assistants

    Bess Lewis
    Email: blewis@jhsph.edu
    Office: TBD

    Bess is entering her 4th year as a doctoral student in the Human Nutrition Program, and is currently involved in research relating to biofortification, food security and dietary variety among households in rural Zambia.  Her background is in international development, including service with the Peace Corps in Niger and a M.S. in International Agricultural Development from the University of California, Davis.  Her goal as a researcher is to inform nutrition-friendly agricultural and economic development policy through studies on the determinants of food security and dietary quality and food- or agriculture-based nutrition interventions to address micronutrient deficiencies.  

     

    Muzi Na
    Email: mna@jhsph.edu
    Office: TBD

    Muzi is a PhD student in Human Nutrition. Her research interest is food security and maternal/ child health in rural Bangladesh. She enjoys applying her multi-disciplinary background, including medicine, economics, biostatistics and nutrition, in her policy-related experiences, such as economic analysis for the HarvestPlus project with International Food Policy Research Institute, field research for an iron fortification program in rural China with the Chinese CDC. She benefits a lot from taking the Food and Nutrition Policy course and expects to learn more as a TA for this course. 

     

  • Course Objectives(from old syllabus)

     

    At the end of this course a successful student will:

    1. identify food and nutrition problems amenable to policy intervention;
    2. define criteria of effective food or nutrition policies;
      1. understand selected contemporary US and global food and nutrition policies (food laws, dietary guidance, and instruments for food and nutrition policy; obesity; food assistance and nutrition programs; food aid)
      2. utilize stakeholder analysis to assess stakeholder interests and influence
    3. practice writing a policy critique or policy brief
  • Disability Support Services
    If you are a student with a documented disability who requires an academic accommodation, please contact the Office of Student Life Services at 410-955-3034 or via email at dss@jhsph.edu.