Study design: policy landscape analysis for sugar-sweetened beverage taxation in seven sub-Saharan African countries

ABSTRACT

This paper reports on the design of a study to examine the policy landscape relevant to sugar-sweetened beverage taxation in seven sub-Saharan African countries. The study responds to the need for strong policy to address the rising burden of non-communicable diseases in the region. Sugar-sweetened beverage taxation has been widely recommended as a key component of a comprehensive policy approach to NCD prevention. However, it has proved a contentious policy intervention, with industry strongly opposing the introduction of such taxes.

The aim was to identify opportunities to strengthen sugar-sweetened beverage taxation-related policy for the prevention of nutrition-related NCDs in a subset of Eastern and Southern African countries: Kenya, Tanzania, Botswana, Rwanda, Namibia, Zambia, Uganda. The study was conducted as a collaboration by researchers from nine institutions; including the seven study countries, South Africa, and Australia. The research protocol was collaboratively developed, drawing on theories of the policy process to examine the existing availability of evidence, policy context, and stakeholder interests and influence.

This paper describes the development of a method for a policy landscape analysis to strengthen policies relevant to NCD prevention, and specifically sugar-sweetened beverage taxation. This takes the form of a prospective policy analysis, based on systematic documentary analysis supplemented by consultations with policy actors, that is feasible in low-resource settings. Data were collected from policy documents, government and industry reports, survey documentation, webpages, and academic literature. Consultations were conducted to verify the completeness of the policy-relevant data collection. We analysed the frames and beliefs regarding the policy ‘problems’, the existing policy context and understandings of sugar-sweetened beverage taxation as a potential policy intervention, and the political context across relevant sectors, including industry interests and influence in the policy process.

This study design will provide insights to inform public health action to support sugar-sweetened beverage taxation in the region.

KEYWORDS:

• Noncommunicable disease
• tax
• sugar-sweetened beverage
• political economy
• policy

Responsible Editor

Jennifer Stewart Williams

Responsible Editor

Jennifer Stewart Williams

Acknowledgments

The authors gratefully acknowledge the generosity of the study participants and those consulted in all countries, in participating in and informing the research. We also acknowledge technical and advisory support from the International Development Research Centre.

Author contributions

The study was conceptualized by KH, AMT, and AE. The study protocol was developed by all authors. Data were collected and analysed by MM, GA, MW, HA, GA, RMC, TN, LG, AMT, and SAK. AMT led the drafting of the paper, with input from all authors. All authors read and approved the final version.

Disclosure statement

No potential conflict of interest was reported by the authors.

Ethics and consent

N/A.

Paper context

Sugar-sweetened beverage taxes are recommended as part of comprehensive action to prevent non-communicable diseases, but so far there has been limited uptake in sub-Saharan Africa, despite rising non-communicable disease prevalence in the region. This paper describes the collaborative development of a method for prospective policy analysis, a ‘landscape analysis’, conducted in seven sub-Saharan African countries in 2018–19. The analysis is based on systematic documentary analysis supplemented by consultations, and is feasible in low-resource settings.

Additional information

Funding

This work was carried out with support from the International Development Research Centre, Ottawa Canada under grant number 108648-001. The views expressed herein do not necessarily represent those of IDRC or its Board of Governors.