Questions/Answers

The Good Health Starts Here initiative undertaken by Thai FDA aims to promote good health among Thai people through a novel, proactive approach in the form of a civil state network. The initiative involves transforming instant and convenience food nutrition labels, a readily available health promotion instrument, into a consumer-friendly format that people from all walks of life regardless of age, gender, education, or occupation can easily understand and make use of in choosing the right food to remain healthy. This has led to a decline in the consumption of unhealthy food, particularly those that are sweet, oily, and salty. Incorporating both consumer empowerment and consumer protection approaches that help to create a learning society and enhance health literacy, the initiative has thus far been successful in modifying Thai people’s food consumption behavior as well as playing a part in improving their life quality.

The initiative betters the life quality of Thai people by creating public awareness of the role and importance of self-care in maintaining good health through effective communication. One of the simplest means for accomplishing the mission is to make nutrition labels on instant and convenience food comprehensible to all consumers (see answer to Question 5) in order to enable them to choose the right food given their health conditions. Thus, not only does the initiative have extensive and equitable impacts on modifying instant and convenience food consumption behavior, but it is also participatory and sustainable in nature.

Overconsumption of sweet, oily, and salty food is a major cause of non-communicable diseases (NCDs). Thus, promoting the use of the innovations under the initiative (see answer to Question 5) through a participatory approach incorporating evaluation, follow-up, and revision schemes will improve food consumption behavior and enhance the quality of life among Thai people. Thai FDA has run pilot programs of the initiative on teenagers before extending it to monks and then onto the wider public, taking into account the needs and constraints of different groups of participants. The outcomes demonstrate that the initiative is effective and sustainable.

The initiative of Thai FDA will ultimately help to improve the public health care situation in Thailand. By promoting healthy food consumption behavior, the initiative will reduce new incidences of NCDs and enhance the prognosis of present NCDs patients. If the initiative proves to be successful and can thus be extensively implemented in the long run, the annual expenditure on NCDs treatment from the Universal Coverage (UC) budget, currently standing at THB25,000 million, can be allocated to more necessary causes. In addition to curbing public medical expenditure on NCDs treatment, the initiative can also partly alleviate the public health sector’s problems relating to insufficient human resources and human resources budgets. Instead of relying on permanent, paid staff, the initiative involves collaboration from all the allies in the target communities (see answer to Question 9), such as teachers, students, and Young Thai FDA representatives. As these allies are mainly responsible for operating the initiative, the implementation entails minimal human resources and human resources budgets.

The initiative comprises the following innovations: • ‘Healthier Choice’ logos (Healthy Alternative Logos) . These are labeled on food products with a lower sugar, oil, or sodium content to help consumers make the right purchase choices. • Health reminder talipot fans . Containing four health reminders – ‘Salt is bad,’ ‘Escape fat,’ ‘Turn away from sugar,’ and ‘Read labels first.’ – these are provided to Buddhist monks so they can remind merit makers to reduce the consumption of unhealthy food. • Magic augmented reality (AR) dice. This is an application comprising AR games and 3D health content.

The ‘Healthier Choice’ logos (Healthy Alternative logos) have been adapted from those created in other countries based on their policies or conceptions to suit the specific context of Thailand. In contrast, the health reminder talipot fans and the magic AR dice are original innovations developed by Thai FDA . The former tap into the Thai people’s strong bond with Buddhism and temples, while the latter utilize edutainment, offered via learning media integrated with game applications, to promote good health among a broad base of target groups, including children, teenagers, and adults.

Our initiative has been implemented to promote good health among both children and adults nationwide. For children, the initiative was first launched in four pilot schools in 2015 and has since been extended across the country until it is now being conducted in 3,500 schools covering urban and rural areas. As for adults, the initiative evolved from the Healthy Diet for Monks project, the Food Safety project, and the Health Volunteer project, launched in 2017, into the Health for All project, implemented in four pilot communities in 2018. This will be extended to 25 provinces countrywide in 2019.

The implementation of the initiative involves human resources and financial resources. As for human resources, the initiative mainly taps into the readily available human capital, drawing on collaboration with all the allies in the target communities (see answer to Question 9). As for financial resources, the initiative has received continual, albeit small, budget allocations from Thai FDA . However, since its inception, the initiative has met with positive feedback and consequently been given financial support from the local administration organizations. All this ensures sustainability of the project, as is evidenced by the success in all the four pilot communities.

Thai FDA ’s campaign to promote the ‘Healthier Choice’ logos has widened healthy food choices containing lower sugar, oil, and/or sodium content for consumers and created public awareness of health care through healthy food consumption behavior. In addition to playing a part in setting such a health care trend, Thai FDA is also determined to expand the types and varieties of healthy food choices in the market. Amazon Coffee, for instance, has embraced our effort, adding to its menu beverages granted the ‘Healthier Choice’ logos. Furthermore, 2,344 branches of leading retail businesses and over 10,000 convenience stores nationwide have also cooperated with us by selling or promoting food products with the ‘Healthier Choice’ logos. Our success in enhancing the quality of life of Thai people through social and economic mechanisms as well as in creating an environment where they find it easier to remain in good health indicates that our initiative is sustainable in nature.

Yes

Evaluation of the initiative has been conducted formally by independent researchers and informally by all the parties and sectors involved, such as school principals, teachers, provincial health officers, lecturers, community leaders, and individuals from all age groups. The initiative was also externally evaluated by the Office of the Public Sector Development Commission and the Office of the Basic Education Commission (OBEC). Due to its extraordinary accomplishments, the initiative won the 2017 Public Sector Excellence Awards for Extraordinary Service Improvement and the 2017 OBEC Awards for Distinguished Public Service.

The main indicators used for the evaluation were healthy food consumption behavior as well as nutrition label reading and use behavior in percentage values. The important findings are as follows. • Children. In 2015, healthy food consumption behavior increased significantly from 68.5% to 75.5%. • Senior citizens. In 2017, nutrition label reading behavior rose significantly from 45.5% to 80.6% among the participants in our nutrition label education program. • Buddhist monks. In 2017, healthy food consumption behavior increased to 73.7%. • Participants in pilot communities. In 2018, all participants in the pilot communities demonstrated nutrition label reading and use behavior.

The outcome of the evaluation was healthier food consumption behavior, i.e. scrutinizing and making use of nutrition labels on food products, such as GDA labels, to reduce the consumption of sweet, oily, and salty food; looking out for the ‘Healthier Choice’ logos prior to making food purchase choices; avoiding unhealthy food products, such as snacks, soda, colored food, and fried, roasted or grilled food; and lowering the use of seasoning ingredients, such as fish sauce, sauce, and seasoning powder.

Our initiative has been driven by collaboration between all sectors, namely the religious sector, such as Buddhist monks, chaplains, and imams; the education sector, such as Young Thai FDA representatives as well as teachers and students in schools including those in non-formal and informal education centers; the public health and administration sectors, such as provincial governors, district chief officers, and municipality chief officers. These allies would formulate the strategies for achieving the goals of our initiative, conducting a SWOT analysis of their area, and mapping out the action plans for implementing our initiative, with Thai FDA and provincial health offices serving as mentors providing academic and information support. Then they would collaborate in pursuing such strategies and action plans with our researchers helping in the process of designing and carrying out the evaluation. In addition, they would take part in identifying the outcomes and key lessons learned. Apart from such allies, we have also networked with restaurants, convenience stores, and grocery stores in raising awareness of the ‘Healthier Choice’ logos. Throughout all stages, we have welcomed suggestions and provided health knowledge through a variety of channels, such as http://healthierlogo.com, the @FDAThai Line@, the FDAThai Facebook fanpage, and YouTube channel.

A paradigm shift from a centralized system where the public sector determines the operations of an initiative to a participatory one that fosters engagement in all stages from the formation of a civil state network to the evaluation stage will ensure a match between an initiative and the local culture and ultimately sustainable success. Additionally, recognition of the value of an initiative will enhance its credentials – an important mechanism for extending the initiative onto national, regional, and international levels. Thus, winning the 2019 United Nations Public Service Awards will greatly help us pave the way for achieving that goal.