scholarly journals Tobacco intervention research in low- and middle-income countries: lessons learned and future directions

2016 ◽  
Vol 11 (2) ◽  
pp. 61-64 ◽  
Author(s):  
Kenneth D. Ward
Keyword(s):  
Tobacco Control ◽  
Tobacco Use ◽  
Tobacco Cessation ◽  
Tobacco Dependence ◽  
Lessons Learned ◽  
Future Directions ◽  
Middle Income ◽  
Middle Income Countries ◽  
Country Level ◽  
Tobacco Intervention

Treating tobacco dependence is paramount for global tobacco control efforts, but is often overshadowed by other policy priorities. As stated by Jha (2009), “cessation by current smokers is the only practical way to avoid a substantial proportion of tobacco deaths worldwide before 2050.” Its importance is codified in Article 14 of the Framework Convention on Tobacco Control (FCTC), and in the WHO's MPOWER package of effective country-level policies. Unfortunately, only 15% of the world's population have access to appropriate cessation support (WHO, 2015). Moreover, parties to the FCTC have implemented only 51% of the indicators within Article 14, on average, which is far lower than many other articles (WHO, 2014). Further, commenting on the use of “O” measures (Offer help to quit tobacco use) in the MPOWER acronym, WHO recently concluded, “while there has been improvement in implementing comprehensive tobacco cessation services, this is nonetheless a most under-implemented MPOWER measure in terms of the number of countries that have fully implemented it” (WHO, 2015). To the detriment of global tobacco control efforts, only one in eight countries provides comprehensive cost-covered services, only one in four provide some cost coverage for nicotine replacement therapy, and fewer than one third provide a toll-free quit line (WHO, 2015).

scholarly journals Potential for health economics to influence policies on tobacco use during pregnancy in low-income and middle-income countries: a qualitative case study

BMJ Open ◽  
2021 ◽  
Vol 11 (12) ◽  
pp. e045624
Author(s):  
Tuba Saygın Avşar ◽  
Louise Jackson ◽  
Hugh McLeod
Keyword(s):  
Health Economics ◽  
Pregnant Women ◽  
Tobacco Use ◽  
Low Income ◽  
Tobacco Cessation ◽  
Qualitative Case Study ◽  
Middle Income ◽  
Middle Income Countries ◽  
Country Specific

IntroductionTobacco control during pregnancy is a policy priority in high-income countries (HICs) because of the significant health and inequality consequences. However, little evidence exists on interventions to reduce tobacco use in low-income and middle-income countries (LMICs), especially for pregnant women. This study aimed to assess how health economics evidence, which is mainly produced in HICs, could be adopted for tobacco cessation policies for pregnant women in LMICs.MethodsA qualitative case study was conducted in an international public health organisation. The organisation was chosen due to its capacity to influence health policies around the world. Tobacco control experts working in the organisation were identified through purposeful sampling and snowballing. Semistructured interviews were conducted with 18 informants with relevant experience of countries from all of the regions covered by the organisation. Data were analysed using the framework method.ResultsIn practice, tobacco cessation during pregnancy was not viewed as a priority in LMICs despite international recognition of the issue. In LMICs, factors including the recorded country-specific prevalence of tobacco use during pregnancy, availability of healthcare resources and the characteristics of potential interventions all affected the use of health economics evidence for policy making.ConclusionThe scale of tobacco use among pregnant women might be greater than reported in LMICs. Health economics evidence produced in HICs has the potential to inform health policies in LMICs around tobacco cessation interventions if the country-specific circumstances are addressed. Economic evaluations of cessation interventions integrated into antenatal care with a household perspective would be especially relevant in LMICs.

scholarly journals Lessons Learned from Twelve Years of Partnered Tobacco Cessation Research in the Dominican Republic

2016 ◽  
Vol 11 (2) ◽  
pp. 99-107 ◽  
Author(s):  
Deborah J. Ossip ◽  
Sergio Díaz ◽  
Zahira Quiñones ◽  
Scott McIntosh ◽  
Ann Dozier ◽  
...  
Keyword(s):  
Dominican Republic ◽  
Tobacco Control ◽  
Tobacco Cessation ◽  
Early Stage ◽  
Lessons Learned ◽  
Middle Income ◽  
Health Crisis ◽  
Challenges And Opportunities ◽  
Tobacco Epidemic ◽  
The One

Engaging partners for tobacco control within low and middle income countries (LMICs) at early stages of tobacco control presents both challenges and opportunities in the global effort to avert the one billion premature tobacco caused deaths projected for this century. The Dominican Republic (DR) is one such early stage country. The current paper reports on lessons learned from 12 years of partnered United States (US)-DR tobacco cessation research conducted through two NIH trials (Proyecto Doble T, PDT1 and 2). The projects began with a grassroots approach of working with interested communities to develop and test interventions for cessation and secondhand smoke reduction that could benefit the communities, while concurrently building local capacity and providing resources, data, and models of implementation that could be used to ripple upward to expand partnerships and tobacco intervention efforts nationally. Lessons learned are discussed in four key areas: partnering for research, logistical issues in setting up the research project, disseminating and national networking, and mentoring. Effectively addressing the global tobacco epidemic will require sustained focus on supporting LMIC infrastructures for tobacco control, drawing on lessons learned across partnered trials such as those reported here, to provide feasible and innovative approaches for addressing this modifiable public health crisis.

Implementing Evidence-Based Tobacco Use Treatment in Community Health Centers in Vietnam

2018 ◽  
Author(s):  
Mark Parascandola ◽  
Donna Shelley
Keyword(s):  
Tobacco Control ◽  
Tobacco Use ◽  
Community Health Centers ◽  
Evidence Based ◽  
Middle Income ◽  
Global Epidemic ◽  
Middle Income Countries ◽  
Tobacco Control Policies ◽  
Policies And Programs

Although tobacco use has been declining in most high-income countries, it has remained constant or increased in other areas of the world, shifting to low- and middle-income countries (LMICs). The Framework Convention on Tobacco Control (FCTC) was adopted in 2003 to address the growing global epidemic of tobacco use. The 181 countries that are parties to the treaty are required to adopt a range of evidence-based tobacco control policies and programs, including access to tobacco use treatment. This case study provides an overview of the progress and gaps in implementing the FCTC and demonstrates the application of implementation science methods to identify and address barriers to implementing a cessation interventions in the context of a health system in an LMIC.

scholarly journals Global challenges in tobacco control

10.21149/8076 ◽  
2017 ◽  
Vol 59 ◽  
pp. 5 ◽  
Author(s):  
Kerstin Schotte ◽  
Alison Commar ◽  
Evan Blecher ◽  
Vinayak Prasad
Keyword(s):  
Tobacco Control ◽  
Tobacco Use ◽  
Control Strategies ◽  
Noncommunicable Diseases ◽  
The European Union ◽  
Middle Income ◽  
The Sustainable Development ◽  
Middle Income Countries ◽  
Development Goals ◽  
High Level

The last decade has seen unprecedented achievements in global tobacco control. These include the entry into force of the WHO Framework Convention on Tobacco Control (WHO FCTC) and 179 states, as well as the European Union, becoming Parties to the Treaty,leading to an increased global cognizance of the negative health and economic impact of tobacco use. Governments around the world continue to adopt and implement effective tobacco control strategies and financial contributions from major philanthropies have increased the levels of financial support for tobacco control efforts in low- and middle-income countries. The UN high-level summit on Noncommunicable Diseases (NCDs) in 2011 and the 2015 adoption of the Sustainable Development Goals (SDGs), in which NCDs and acceleration of implementation of WHO FCTC are included as specific targets, represent an increased global recognition of theneed to address tobacco use prevalence as a key element of NCD interventions...

scholarly journals Tobacco Dependence Treatment Grants: A Collaborative Approach to the Implementation of WHO Tobacco Control Initiatives

2018 ◽  
Vol 2018 ◽  
pp. 1-9 ◽  
Author(s):  
Margaret B. Nolan ◽  
Katherine E. Kemper ◽  
Thomas J. Glynn ◽  
Richard D. Hurt ◽  
J. Taylor Hays
Keyword(s):  
Tobacco Control ◽  
Healthcare Providers ◽  
Tobacco Dependence ◽  
Direct Result ◽  
Grant Funding ◽  
Middle Income ◽  
Tobacco Dependence Treatment ◽  
Middle Income Countries ◽  
The World ◽  
Low And Middle Income

The number of global tobacco-related deaths is projected to increase from about 6 million to 8 million annually by 2030, with more than 80% of these occurring in low- and middle-income countries (LMICs). The World Health Organization Framework Convention on Tobacco Control (FCTC) came into force in 2005 and Article 14 relates specifically to the treatment of tobacco dependence. However, LMICs, in particular, face several barriers to implementing tobacco dependence treatment. This paper is a descriptive evaluation of a novel grant funding mechanism that was initiated in 2014 to address these barriers. Global Bridges. Healthcare Alliance for Tobacco Dependence Treatment aims to create and mobilize a global network of healthcare professionals and organizations dedicated to advancing evidence-based tobacco dependence treatment and advocating for effective tobacco control policy. A 2014 request for proposals (RFP) focused on these goals, particularly in LMICs, where funding for this work had been previously unavailable. 19 grants were awarded by Global Bridges to organizations in low- and middle-income countries across all six WHO regions. Virtually all focused on developing a tobacco dependence treatment curriculum for healthcare providers, while also influencing the political environment for Article 14 implementation. As a direct result of these projects, close to 9,000 healthcare providers have been trained in tobacco dependence treatment and an estimated 150,000 patients have been offered treatment. Because most of these projects are designed with a “train-the-trainer” component, two years of grant funding has been a tremendous catalyst for accelerating change in tobacco dependence treatment practices throughout the world. In order to foster such exponential growth and continue to maintain the impact of these projects, ongoing financial, educational, and professional commitments are required.

scholarly journals Predictors of Contemporary under-5 Child Mortality in Low- and Middle-Income Countries: A Machine Learning Approach

2021 ◽  
Vol 18 (3) ◽  
pp. 1315
Author(s):  
Andrea Bizzego ◽  
Giulio Gabrieli ◽  
Marc H. Bornstein ◽  
Kirby Deater-Deckard ◽  
Jennifer E. Lansford ◽  
...  
Keyword(s):  
Machine Learning ◽  
Child Mortality ◽  
Learning Approach ◽  
Unique Contribution ◽  
Middle Income ◽  
Middle Income Countries ◽  
Country Level ◽  
Machine Learning Approach ◽  
Operational Information ◽  
Low And Middle Income

Child Mortality (CM) is a worldwide concern, annually affecting as many as 6.81% children in low- and middle-income countries (LMIC). We used data of the Multiple Indicators Cluster Survey (MICS) (N = 275,160) from 27 LMIC and a machine-learning approach to rank 37 distal causes of CM and identify the top 10 causes in terms of predictive potency. Based on the top 10 causes, we identified households with improved conditions. We retrospectively validated the results by investigating the association between variations of CM and variations of the percentage of households with improved conditions at country-level, between the 2005–2007 and the 2013–2017 administrations of the MICS. A unique contribution of our approach is to identify lesser-known distal causes which likely account for better-known proximal causes: notably, the identified distal causes and preventable and treatable through social, educational, and physical interventions. We demonstrate how machine learning can be used to obtain operational information from big dataset to guide interventions and policy makers.

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