Background
Interim evaluations of long-term, multi-faceted salt reduction strategies can help identify areas for enhancement and adaptation during the life of the program
The interim evaluation of Malaysia’s salt reduction strategy informed the initiatives of a successful grant proposal
In Malaysia, the amount of sodium consumed (mostly in the form of salt) is well above the recommended level, causing raised blood pressure- the leading risk factor for death in Malaysia.
The Government of Malaysia has developed a five-year Salt Reduction Strategy to Prevent and Control NCD for Malaysia (2015–2020) with a view to lowering population salt intake by 15% by 2020.
In 2018, the World Health Organization and Ministry of Health Malaysia engaged the George Institute to conduct a mid-term evaluation of the Salt Reduction Strategy in Malaysia, with a view to generating recommendations for strengthening the interventions in the next two years of the program.
Aim
To conduct a process evaluation of Malaysia’s salt reduction strategy to understand the progress of implementation to date (2018), and the barriers and facilitators affecting the implementation of interventions, and attainment of the outcome (salt reduction).
Generate recommendations on the activities that need be prioritised, the barriers that need to be overcome and the opportunities that should be leveraged during the last two years of the Salt Reduction Strategy.
Develop a methodology and framework for other countries to use to conduct interim or process evaluations of their salt reduction strategies.
Research Methodology
The UK’s Medical Research Council guidance on process evaluation of complex interventions was used to guide the mid-term evaluation
A mixed methods approach was used comprising desk review, key stakeholder interviews and focus groups using the nominal group technique to understand the reach, dose (delivered and received), adoption and fidelity of the salt reduction interventions; as well as the contextual factors affecting implementation and the outcome to date.
Impact
Six key recommendations were generated to guide the salt reduction activities in final two years of Malaysia’s salt reduction strategy.
Full report of the mid-term evaluation of Malaysia’s salt reduction strategy and the framework for interim or process evaluations for countries to follow was published by the Ministry of Health Malaysia (Found here).
The George Institute, in collaboration with Ministry of Health Malaysia, WHO Malaysia, and University of Malaysia, successfully achieved a two-year (2020-21) LINKS grant from Resolve to Save Lives to support the implementation of half of the recommended activities, including:
- survey of salt content in street foods,
- strengthen the communication strategy,
- accelerate mandatory sodium labelling for packaged foods, and
- engage food industries product high-salt foods in reformulation.
Outputs
Reducing salt intake in Malaysia: an interim evaluation of what works report (Found here)
Published Conference abstract: Midterm Evaluation of Malaysia’s National Salt Reduction Strategy – Lessons Learned on Adapting Salt Reduction ‘Best Buys’ to the Local Context (Found here)