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This chapter analyses the role of policies and financing and their implications for the uptake of skill-mix changes in routine care. In particular, it addresses if and how regulatory or nonregulatory policies can facilitate the skill-mix innovation shift (and so act as a facilitator) or rather hinder the shift from taking place (and so act as a barrier). Further, this chapter addresses the role of financing and payment policies and identifies related common barriers and facilitators to skill-mix reforms. The chapter first presents the evidence from the overview of reviews, and then complements these findings by presenting trends and country examples from different sources.
To assess how the frequency of low fruit and vegetable consumption has changed in countries of the former Soviet Union (FSU) between 2001 and 2010 and to identify factors associated with low consumption.
Cross-sectional surveys. A standard questionnaire was administered at both time points to examine fruit and vegetable consumption frequency. Logistic regression analysis was used to examine the relationship between demographic, socio-economic and health behavioural variables and low fruit and vegetable consumption in 2010.
Nationally representative population samples from Armenia, Azerbaijan, Belarus, Georgia, Kazakhstan, Kyrgyzstan, Moldova, Russia and Ukraine.
Adults aged 18 years and older.
Between 2001 and 2010 notable changes occurred in fruit and vegetable consumption in many countries resulting in a slight overall deterioration in diet. By 2010 in six countries about 40 % of the population was eating fruit once weekly or less often, while for vegetables the corresponding figure was in excess of 20 % in every country except Azerbaijan. A worse socio-economic situation, negative health behaviours (smoking and alcohol consumption) and rural residence were all associated with low levels of fruit and vegetable consumption.
International dietary guidelines emphasise the importance of fruit and vegetable consumption. The scale of inadequate consumption of these food groups among much of the population in many FSU countries and its link to socio-economic disadvantage are deeply worrying. This highlights the urgent need for a greater focus to be placed on population nutrition policies to avoid nutrition-related diseases in the FSU countries.
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