Evaluation of national food and nutrition policy in Albania.

INTRODUCTION
The paper aims to describe the progress that has been made in the implementation of the Albanian food and nutrition policy since 2003, so as to consider its impacts to date, and to identify strategic priorities/critical areas and priorities for Albania's future policy on improving the national food and nutrition situation.

METHODS
In 2011-2012, an expert group applied an intersectoral participatory approach to evaluate the implementation of Food and Nutrition Action Plan 2003-08 in Albania. The experts employed the quantitative method, using a 9 question logical assessment matrix to measure the achievements of the individual goals of the Plan, and a qualitative tool for the interview of an interdisciplinary sample of 68-key informants-persons operating in public health nutrition, food safety and food availability related subfields, from a wide range of pertinent institutions and stakeholders.

RESULTS
The quantitative and qualitative assessment revealed that the implementation process has faced serious barriers linked to the design of the plan, which did not accurately anticipate a theoretical framework, or structured methods for its implementation. Other impeding factors included the lack of institutional/infrastructure support, lack of intersectoral coordination and motivation, as well as insufficient capacities and know-how. Intersectoral response to the multifaceted nature of double burden of malnutrition is of key importance to improve nutritional wellbeing and health outcomes in Albania.

CONCLUSIONS
Participatory approaches that involve all relevant sectors and actors in the development, monitoring and evaluation of the implementation of public health policies based on comprehensive action-oriented assessments are promising and should be further supported.

UVOD
Namen članka je opis napredka pri izvajanju prehranske politike v Albaniji od leta 2003, pregled vplivov prehranske politike do danes ter prepoznavanje strateških prednosti in kriznih področij za prihodnjo politiko Albanije pri izboljševanju prehranskega stanja v državi.

METODE
Strokovna skupina je med letoma 2011 in 2012 izvedla medsektorski pristop s sodelovanjem za ovrednotenje izvajanja Akcijskega načrta za hrano in prehrano 2003–2008 (Food and Nutrition Action Plan 2003-08) v Albaniji. Strokovnjaki so uporabili kvantitativno metodo z uporabo logične ocenjevalne matrice z devetimi vprašanji, ki vrednoti dosežke posameznih ciljev v Načrtu ter kvalitativno orodje za namen intervjuja interdisciplinarnega vzorca 68 ključnih oseb, ki delujejo na področju javnega zdravja, prehrane, varnosti živil in podpodročjih, ki so povezana z razpoložljivostjo hrane – širok izbor med ustreznimi ustanovami in deležniki.

REZULTATI
Kvantitativno in kvalitativno vrednotenje je razkrilo, da so se med postopkom izvedbe pojavile resne ovire, ki so povezane z oblikovanjem načrta, ki ni ustrezno predvideval teoretičnih okvirjev ali strukturiranih metod za izvedbo. Ostali oviralni dejavniki so bili tudi pomanjkanje podpore s strani institucij in infrastrukture, pomanjkanje medsektorske koordinacije in motivacije kot tudi nezadostne kapacitete in znanje. Medsektorski odziv na večstransko naravo dvojnega bremena pri neustrezni prehranjenosti je ključna zadeva pri izboljševanju prehranske blaginje in zdravstvenih izidov v Albaniji.

ZAKLJUČEK
Pristopi s sodelovanjem, ki vključujejo vse pomembne dejavnike in akterje pri razvoju, nadzoru in ovrednotenju izvedbe politike javnega zdravja na podlagi celostne in akcijske ocene, so obetavni in jih je treba podpirati tudi v prihodnje.