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World Health Organization Collaborating Centre for Population Salt Reduction

Enabling students to apply their understanding of global health and sustainability by designing an evaluation of a global health initiative.

High blood pressure is a risk factor for cardiovascular disease which is a major contributor to the global burden of disease. Excess dietary salt intake is well established as a leading cause of high blood pressure and associated cardiovascular disease, yet current salt intake in most populations worldwide is approximately 9–12 grams per day, in excess of WHO recommendations. Salt reduction is emerging as one of the most cost-effective, feasible, and affordable strategies for control of blood pressure and cardiovascular disease prevention globally which would see a potential 1.65 million cardiovascular disease-related deaths prevented each year worldwide.

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Identify a global initiative to reduce sodium consumption. Examples include the commitment of the Government of India to achieving a 30 per cent reduction in salt intake by 2025, the UK Food Standards Agency salt reduction strategy, and the WHO SHAKE technical package for salt reduction. Any global initiative to reduce sodium consumption can be used.

Choose one initiative. Plan an evaluation of the initiative.

Key features to include in your evaluation plan should include the following:

  1. Problem definition
    • Define what the global health problem is
  2. Solution generation (describe initiative)
    • Describe the initiative to address this problem; outline how it may be used to change policy/practice.
    • Create a logic model to explore the inputs, outputs, and impact of the initiative.
  3. Resource mobilisation
    • Describe what potential barriers/enablers could influence the implementation of the initiative.
    • Detail the strategies that could be used to identify these barriers/enablers.
  4. Implementation/outcome assessment
    • Choose a qualitative or quantitative study design that would be most appropriate to evaluate the initiative.
    • Describe which outcomes would be used to examine the impact of the initiative on the health priority area.
    • Describe how these outcomes would be assessed.
  5. Dissemination
    • Describe which strategies you would use to disseminate the outcomes of the public health initiative.

Suggested readings:

1) Nutbeam D Evaluating health promotion: progress, problems and Solutions Health Promotion International 1998 13(1)

2) Land et al Salt consumption by Australian adults: a systematic review and meta-analysis Med J Aust 2018; 208 (2): 1. doi: 10.5694/mja17.00394

3) World Health Organization Collaborating Centre for Population Salt Reduction (WHO CC SALT)

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