School of Nursing

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Browsing School of Nursing by Author "Assah, Felix"

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    Influence of The WHO Framework Convention on Tobacco Control on Tobacco Legislation and Policies in Sub-Saharan Africa
    (BMC Public Health, 2018-08) Kyobutungi, Catherine; Wisdom, Jennifer P.; Juma, Pamela A.; Mwagomba, Beatrice Matanje; Ndinda, Catherine; Mapa-Tassou, Clarisse; Assah, Felix; Nkhata, Misheck; Mohamed, Shukri F.; Oladimeji, Oladepo; Oladunni, Opeyemi; Oluwasanu, Mojisola; Sanni, Saliyou; Mbanya, Jean-Claude
    Background The World Health Organization’s Framework Convention on Tobacco Control, enforced in 2005, was a watershed international treaty that stipulated requirements for signatories to govern the production, sale, distribution, advertisement, and taxation of tobacco to reduce its impact on health. This paper describes the timelines, context, key actors, and strategies in the development and implementation of the treaty and describes how six sub-Saharan countries responded to its call for action on tobacco control. Methods A multi-country policy review using case study design was conducted in Cameroon, Kenya, Nigeria, Malawi, South Africa, and Togo. All documents related to the WHO Framework Convention on Tobacco Control and individual country implementation of tobacco policies were reviewed, and key informant interviews related to the countries’ development and implementation of tobacco policies were conducted. Results Multiple stakeholders, including academics and activists, led a concerted effort for more than 10 years to push the WHO treaty forward despite counter-marketing from the tobacco industry. Once the treaty was enacted, Cameroon, Kenya, Nigeria, Malawi, South Africa, and Togo responded in unique ways to implement tobacco policies, with differences associated with the country’s socio-economic context, priorities of country leaders, industry presence, and choice of strategies. All the study countries except Malawi have acceded to and ratified the WHO tobacco treaty and implemented tobacco control policy. Conclusions The WHO Framework Convention on Tobacco Control provided an unprecedented opportunity for global action against the public health effects of tobacco including non-communicable diseases. Reviewing how six sub-Saharan countries responded to the treaty to mobilize resources and implement tobacco control policies has provided insight for how to utilise international regulations and commitments to accelerate policy impact on the prevention of non-communicable diseases.
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    Two Decades of Tobacco Use Prevention and Control Policies in Cameroon: Results From the Analysis of Non-Communicable Disease Prevention Policies in Africa
    (BMC Public Health, 2018) Tassou, Clarisse Mapa; Bonono, Cecile Rénée; Assah, Felix; Wisdom, Jennifer; Juma, Pamela A.; Katte, Jean-Claude; Njoumemi, Zakariaou; Zogo, Pierre Ongolo; Fezeu, Leopold K.; Sobngwi, Eugene; Mbanya, Jean Claude
    Background: Tobacco use is the leading cause of preventable death in the world today. In 2010, the World Health Organization (WHO) proposed efficient and inexpensive “best buy” interventions for prevention of tobacco use including: tax increases, smoke-free indoor workplaces and public places, bans on tobacco advertising, promotion and sponsorship, and health information and warnings. This paper analyzes the extent to which tobacco use prevention policies in Cameroon align with the WHO tobacco “best buy” interventions. It further explores the context, content, formulation and implementation level of these policies. Methods: This was a case study combining a structured review of 19 government policy documents related to tobacco use and prevention, in-depth interviews with 38 key stakeholders and field observations. The Walt and Gilson’s policy analysis triangle was used to describe and interpret the context, content, processes and actors during the formulation and implementation of tobacco prevention and control policies. Direct observations ascertained the level of implementation of some selected policies. Results: Twelve out of 19 policies for tobacco use and prevention address the WHO “best buy” interventions. Cameroon policy formulation was driven locally by the social context of non-communicable diseases, and globally by the adoption of the WHO Framework Convention on Tobacco Control. These policies incorporated at a certain level all four domains of tobacco use “best buy” interventions. Formulating policy on smoke-free areas was single-sector oriented, while determining tobacco taxes and health warnings was more complex utilizing multisectoral approaches. The main actors involved were ministerial departments of Health, Education, Finances, Communication and Social Affairs. The level of implementation varied widely from one policy to another and from one region to another. Political will, personal motivation and the existence of formal exchange platforms facilitated policy formulation and implementation, while poor resource allocation and lack of synergy constituted barriers.