Skip to main content
Top
Published in: BMC Public Health 1/2018

Open Access 01-08-2018 | Research

Assessment of the multi-sectoral approach to tobacco control policies in South Africa and Togo

Authors: Saliyou Sanni, Charles Hongoro, Catherine Ndinda, Jennifer P. Wisdom

Published in: BMC Public Health | Special Issue 1/2018

Login to get access

Abstract

Background

Tobacco use is the world’s leading preventable cause of illness and death and the most important risk factor for non-communicable diseases (NCDs), particularly cardiovascular and chronic respiratory diseases (heart attack, stroke, congestive obstructive pulmonary disease, and lung cancer). Tobacco control is one of the World Health Organization’s “best-buys” interventions to prevent NCDs. This study assessed the use of a multi-sectoral approach (MSA) in developing and implementing tobacco control policies in South Africa and Togo.

Methods

This two-country case study consisted of a document review of tobacco control policies and of key informant interviews (N = 56) about the content, context, stakeholders, and strategies employed throughout policy formulation and implementation in South Africa and Togo. To guide our analysis, we used the Comprehensive Framework for Multi-Sectoral Approach to Health Policy, which is built around four major constructs of context, content, stakeholders and strategies.

Results

The findings show that the formulation of tobacco control policies in both countries was driven locally by the political, historical, social and economic contexts, and globally by the adoption WHO Framework Convention on Tobacco Control (FCTC). In both countries, the health department led policy formulation and implementation. The stakeholders involved in South Africa were more diverse, proactive and dynamic than those in Togo, whereas the strategies employed were more straightforward in Togo than in South Africa. The extent of understanding and use of MSA in both countries consisted of an inter-sectoral action for health, whereby the health department strove to collaborate with other sectors within and outside the government. Consequently, information sharing was identified as the main outcome of the interactions between institutions and interest groups within and across three critical sectors of the state, namely the public (government), the private and the civil society.

Conclusion

Tobacco control policies in South Africa and Togo were formulated and implemented from an inter-sectoral approach perspective, which relied heavily on information transfer between stakeholders and less on collaborative problem-solving approach. Incorporation of multiple stakeholders allowed both countries to formulate policies to meet FCTC goals for tobacco control and NCD reduction.
Literature
1.
go back to reference World Health Organization. Global status report on non-communicable diseases. Geneva: WHO; 2014. World Health Organization. Global status report on non-communicable diseases. Geneva: WHO; 2014.
2.
go back to reference Peter J. Analysing public policy. London, UK: Pinter; 1998. Peter J. Analysing public policy. London, UK: Pinter; 1998.
3.
go back to reference Assembly UG. Political declaration of the high-level meeting of the general assembly on the prevention and control of non-communicable diseases. New York: United Nations; 2011. Assembly UG. Political declaration of the high-level meeting of the general assembly on the prevention and control of non-communicable diseases. New York: United Nations; 2011.
4.
go back to reference Peake S, Gallagher G, Geneau R, Smith C, Herel M, Fraser H, et al. Health equity through intersectoral action: an analysis of 18 country case studies. Ottawa: Public Health Agency of Canada. And: World Health Organization; 2008. Peake S, Gallagher G, Geneau R, Smith C, Herel M, Fraser H, et al. Health equity through intersectoral action: an analysis of 18 country case studies. Ottawa: Public Health Agency of Canada. And: World Health Organization; 2008.
5.
go back to reference Kickbusch I. Healthy societies: addressing 21st century health challenges. Government of South Australia: Adelaide; 2008. Kickbusch I. Healthy societies: addressing 21st century health challenges. Government of South Australia: Adelaide; 2008.
8.
go back to reference Ståhl T, Wismar M, Ollila E, Lahtinen E, Leppo K. Health in all policies: prospects and Potentials Helsinki: Finnish Ministry of Social Affairs and Health. 2006. Ståhl T, Wismar M, Ollila E, Lahtinen E, Leppo K. Health in all policies: prospects and Potentials Helsinki: Finnish Ministry of Social Affairs and Health. 2006.
9.
go back to reference Sanni S, Wisdom J, Ayo-Yusuf O, Hongoro C. Multi-sectoral approach to non-communicable disease prevention policy in sub-Saharan Africa: a conceptual framework for analysis. IJHS. 2018; Sanni S, Wisdom J, Ayo-Yusuf O, Hongoro C. Multi-sectoral approach to non-communicable disease prevention policy in sub-Saharan Africa: a conceptual framework for analysis. IJHS. 2018;
10.
go back to reference Juma PA, Mohamed SF, Wisdom J, Kyobutungi C, Oti S. Analysis of non-communicable disease prevention policies in five sub-Saharan African countries: study protocol. Arch Public Health. 2016 Jun 22;74:25.CrossRefPubMedPubMedCentral Juma PA, Mohamed SF, Wisdom J, Kyobutungi C, Oti S. Analysis of non-communicable disease prevention policies in five sub-Saharan African countries: study protocol. Arch Public Health. 2016 Jun 22;74:25.CrossRefPubMedPubMedCentral
11.
go back to reference Yin RK, editor. Case study research: design and methods. London: Sage; 2013. Yin RK, editor. Case study research: design and methods. London: Sage; 2013.
12.
go back to reference Boyatzis RE. Transforming qualitative information: thematic analysis and code development. London: Sage; 1998. Boyatzis RE. Transforming qualitative information: thematic analysis and code development. London: Sage; 1998.
13.
go back to reference Peters D, Harting J, van Oers H, Schuit J, de Vries N, Stronks K. Manifestations of integrated public health policy in Dutch municipalities. Health Promot Int. 2016;31(2):290–302.CrossRefPubMed Peters D, Harting J, van Oers H, Schuit J, de Vries N, Stronks K. Manifestations of integrated public health policy in Dutch municipalities. Health Promot Int. 2016;31(2):290–302.CrossRefPubMed
14.
go back to reference Srivastava A, Thomson SB. Framework analysis: a qualitative methodology for applied policy research. Journal of Administration and Governance. 2009;72 Srivastava A, Thomson SB. Framework analysis: a qualitative methodology for applied policy research. Journal of Administration and Governance. 2009;72
15.
go back to reference Giorgi A. Phenomenology and psychological research. Pittsburgh, Pa.: Duquesne: University Press; 1985. Giorgi A. Phenomenology and psychological research. Pittsburgh, Pa.: Duquesne: University Press; 1985.
16.
go back to reference World Health Organization. WHO framework convention on tobacco control. Geneva: WHO; 2005. World Health Organization. WHO framework convention on tobacco control. Geneva: WHO; 2005.
17.
go back to reference Malan M, Leaver R. Political change in South Africa: new tobacco control and public health policies. Tobacco control policy strategies, successes, and setbacks. 2003:121–53. Malan M, Leaver R. Political change in South Africa: new tobacco control and public health policies. Tobacco control policy strategies, successes, and setbacks. 2003:121–53.
18.
go back to reference Galambos L, Sturchio JL. Addressing the gaps in global policy and research for non-communicable diseases. Baltimore: Johns Hopkins University; 2012. Galambos L, Sturchio JL. Addressing the gaps in global policy and research for non-communicable diseases. Baltimore: Johns Hopkins University; 2012.
20.
go back to reference Beaglehole R, Bonita R, Alleyne G, Horton R, Li L, Lincoln P, et al. UN high-level meeting on non-communicable diseases: addressing four questions. Lancet. 2011;378(9789):449–55.CrossRefPubMed Beaglehole R, Bonita R, Alleyne G, Horton R, Li L, Lincoln P, et al. UN high-level meeting on non-communicable diseases: addressing four questions. Lancet. 2011;378(9789):449–55.CrossRefPubMed
21.
go back to reference Nutbeam D. Health promotion glossary1. Health Promot Internation. 1998;13(4) Nutbeam D. Health promotion glossary1. Health Promot Internation. 1998;13(4)
22.
go back to reference Kickbusch I. Health in all policies: the evolution of the concept of horizontal health governance. Implementing health in all policies. Government of South Australia: Adelaide; 2010. Kickbusch I. Health in all policies: the evolution of the concept of horizontal health governance. Implementing health in all policies. Government of South Australia: Adelaide; 2010.
23.
go back to reference Koivusalo M. The state of health in all policies (HiAP) in the European Union: potential and pitfalls. J Epidemiol Community Health. 2010;64(6):500–3.CrossRefPubMed Koivusalo M. The state of health in all policies (HiAP) in the European Union: potential and pitfalls. J Epidemiol Community Health. 2010;64(6):500–3.CrossRefPubMed
24.
go back to reference United Nations. Department of Economic and Social Affairs. Transforming our world: the 2030 agenda for sustainable development. New York: United Nations; 2015. United Nations. Department of Economic and Social Affairs. Transforming our world: the 2030 agenda for sustainable development. New York: United Nations; 2015.
Metadata
Title
Assessment of the multi-sectoral approach to tobacco control policies in South Africa and Togo
Authors
Saliyou Sanni
Charles Hongoro
Catherine Ndinda
Jennifer P. Wisdom
Publication date
01-08-2018
Publisher
BioMed Central
Published in
BMC Public Health / Issue Special Issue 1/2018
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/s12889-018-5829-3

Other articles of this Special Issue 1/2018

BMC Public Health 1/2018 Go to the issue