Table 5 Codes derived from stakeholder interviews

Problem stream (context)

Ideas and frames -

Current health problems

Respondent comments on the nature of the ‘health problem’ in Fiji, e.g., explanations of prevalence, what the major diseases are etc. This may include gender-specific issues or disease risks.

Respondent comments on the nature of COVID responses towards NCDS and food and nutrition security

Current economic problems

Respondent comments on the nature of economic problems and concerns in Fiji, e.g., explanations of challenges or problems faced by the population that are of an economic nature.

Respondent comments on the nature of COVID and its impact on Fiji’s economy.

Current other problems (e.g., Inequality, gender issues, equity, natural disasters, climate change etc.)

Respondent comments defining other problems and concerns in Fiji that may impact policy effectiveness.

Respondent comments on the nature of COVID and the concernsrelating to other issues beyond health and economic development (e.g., Employment, agriculture, gender issues, etc).

Frames, beliefs, and ideas about the problem (or framing for the challenges and barriers to implementation of NCD policy interventions)

E.g., Economic concerns, awareness, imported foods, cross-sector collaboration, industry tactics and/or corporate political activity, gender equality, etc. This is related to policy process issues in relation to implementation (not policy problems).

Issue characteristics features of the problem: clear measures that show the severity of the problem and which can be used to monitor progress, the size of the health burden and the extent to which the proposed intervention is explained, understood, effective, simple, and inexpensive to implement

Beliefs for root causes of unhealthy dietary behaviours

Respondent comments for perceptions, beliefs and understanding of the root causes of unhealthy diets in Fiji (e.g., apathy, expense, education, imported foods, culture, religion, industry tactics and corporate political activity, gender inequality, conflicting priorities, etc.).

Actor power - This describes policy community coherence, leadership, guiding institutions and civil society mobilisation. It describes the strength of the individuals and networks concerned with the issue, effectiveness of organizations or coordinating mechanisms and the degree of grass-roots support policy actions.

Actor power

Comments on which actors hold power considering different types - formal authority (e.g., govt), informal meetings (potentially relating to industry and corporate political activity) resource-based power (e.g., donors, industry), ideological power (e.g., international organizations, industry) and also how they exercise this power.

Actor influence

Participants comment on which actors are influential in the development and implementation of NCD policies in Fiji and how they exert their influence (e.g., government ministries, industry, NGOs, FBOs, CSO, etc). In the specific case of industry, it may relate to any of the following:

i.     Information and messaging e.g.,. lobbying, framing the debate)

ii.    Financial incentives (e.g., funding political parties/major events)

iii.   Constituency building (e.g., establishing relationships with key leaders/organizations/media/community)

iv.    Legal strategies (e.g., legal action - or threat of – regarding public policies)

v.     Policy substitution (e.g., self-regulation or reformulation but on the least consumed products)

vi.    Questioning the basis of policy or developing different sub-groups with different interests

Actor interests

Participants comment on what they perceive to be main interests of the various stakeholders involved in the development and implementation of NCD policies in Fiji.

Policy stream

Current health policy priorities

Current health priorities in Fiji and also comments related to the political priority given to NCDs and nutrition in Fiji.

Current public policy priorities

Current policy priorities in Fiji.

Current other policy priorities

Current policy priorities competing for attention and resources.

Current policy commitments

Current policy commitments that may impact attention and resources for health and nutrition policy.

Policy responsibilities

Respondent comments on why NCDs should be addressed by government and also, which sectors are responsible.

Perceived political commitment to NCDs

Respondent comments on, from their perspective, the level of political commitment to NCDs relative to other policy responsibilities (e.g., climate change or economic development).

Perceptions about strengthening the policy or solution (opportunities for strengthened policy implementation)

e.g., focussing on gender issues, youth; awareness through health promotion; education; community involvement; targeting imported food and beverages.

Use of each intervention/policy: Diet-related taxes

Respondent comments on all the commentary on awareness, effectiveness of existing policies and challenges specific to diet-related polices.

Restrictions on unhealthy food marketing to children

Respondent comments on all the commentary on awareness, effectiveness of existing policies and challenges specific to restrictions on unhealthy food marketing to children.

Interpretive nutrition labelling on packaged food

Respondent comments on all the commentary on awareness, effectiveness of existing policies and challenges specific to interpretive nutrition labelling on packaged food.

Restrictions on school-based food policies

Respondent comments on all the commentary on awareness, effectiveness of existing policies and challenges specific to restrictions on school-based food policies.

Education and awareness campaigns

Respondent comments on all the commentary on awareness, effectiveness of existing policies and challenges specific to education and awareness campaigns.

Agriculture policies to promote healthy food production

Respondent comments on all the commentary on awareness, effectiveness of existing policies and challenges specific to agriculture policies to promote healthy food production.

Political stream

Shiffman’s (political) Context - The environments in which actors operate. Policy windows: political moments when conditions align favourably for an issue, presenting opportunities for advocates to influence decision makers.

Governance structure: the degree to which norms and institutions operating in a sector provide a platform for effective collective action.

Institutional structures

Participants comment on the coherence and coordination of multi-sector actions for the implementation and enforcement of NCD interventions in Fiji.

Political context

Respondent comments or reflects on significant political events, paradigms or persuasions that are relevant to or affecting nutrition policy.

Policy entrepreneurs

Policy Champions or advocates taking the policy environment forward in favourable moments such as policy windows

Policy champions

Participants identify specific players they perceive driving nutrition policy in Fiji forward.

Resources

Use of resources

Perceived awareness.

Perceptions and beliefs on use of donor resources.