healthcare facility smoke-free ... implementing smoke-free policies for workplaces and health care facilities ... Regulations and laws on smoke-free environments.
Developing workplace and healthcare facility smoke-free policy environments in Uganda DK Sekimpi, D. Nkonge, and L. Caceres Prepared for the Canadian Public Health Association Conference Edmonton, June 14, 2012
Plan 1.
Recognize global health concern: tobacco use in developing countries
2.
Identify sources of best practices, activities, and approaches for implementing smoke-free policies for workplaces and health care facilities
3.
Collect information and apply best practices for policy development and information on tobacco use
4.
Analyse information to determine appropriate implications, uses, gaps and limitation of survey data and literature review
5.
Determine the meaning of information, considering the current ethical, political, scientific, socio-cultural and economic contexts
6.
Recommend specific actions based on the analysis of information and disseminate and report results
Adapted from: Public Health Agency of Canada (2007). Core Competencies for Public Health in Canada (http://www.phac-aspc.gc.ca/php-psp/ccph-cesp/stmts-enon-eng.php#2)
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Harmful effects of tobacco use pose an imminent threat to the health of African people
Text and Picture Source: Drope, J. (2011). Tobacco Control in Africa: People, Politics, and Policies. Internat’l Dev’t Research Centre: Ottawa.
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Uganda smoking prevalence rate is rising and youth are exposed to second-hand smoke
Source: Mackay, J. et al. (2012). The tobacco atlas – 4th edition. American Cancer Society: Atlanta (www.TobaccoAtlas.org)
• Signed the Framework Convention on Tobacco Control in March 2004 and ratified in June 2007
• Regulations and laws on smoke-free environments exist and address provisions of Article 8 of the FCTC but progress is slow and laws are weak
1. Advocating for National and Sub-National Smoke-Free Workplaces Policies in Uganda
Budget: Duration: Area:
$26,500 CAD Oct. 1, 2010 – Feb. 29, 2012 Kampala, Jinja and Wakiso Districts
2. Developing Policy Recommendations and Guidelines for Smoke Free Health Care Facilities in Uganda
Budget: Duration: Area:
$12,500 CAD Nov. 15, 2011 – March 17, 2012 Butabika Nat’l Mental Referral Hosp.
Identifying Sources and Stakeholders
Identifying Sources and Stakeholders
Analyse Workplace Survey Data Issue
Result
Laws and Regulations
33 (85%) knew about laws or regulations on tobacco control 9 (23%) know about the FCTC 8 (21%) knew that Uganda had ratified the FCTC No workplaces mentioned FCTC provision of protection from secondhand smoke
Workplace Smoking
Smoking in the workplace was reported by 28 (72%) of respondents 17 (44%) said smokers smoke from outside of workplaces 5 (13%) said smokers smoke from designated zones 5 (13%) said smokers hide within the workplace to smoke.
IEC Materials
27 (69%) reported having NO SMOKING signs in the workplace 16 (41%) reported having posters on dangers of smoking in their workplaces
Policy Environment
None of the 15 participating workplaces had a written tobacco control policy; however 19 (49%) respondents reported some form of workplace tobacco control action in place
Analyse Health Care Facilities Survey Data Standard
Result
Commitment
• No sponsorship or support is accepted from the tobacco industry • Tobacco products banned within & near the hospital premises
Communication
• Workers and patients informed about “No tobacco smoke” hospital practice
Education and Training
• There is currently no specific education and training for staff and patients, except staff at the alcohol and drug unit
Tobacco Control
• Hospital grounds were however, not completely tobacco free packets of cigarettes always seized from patients, their relatives and visitors • No signage
Interpretation • Greater educational, sensitization, training, and awareness efforts required • Need to work at both local and national levels • Emphasize economic and public health benefits to frame policy issue
Actions • • • • •
Formation of committees Monthly meetings to ensure buy-in Development of smoke-free policies Identification of champion Approaching new stakeholders
Results • 3 workplaces developed definitive policies (signed by management)
• 4 workplaces developed draft policies (awaiting signing by management)
• 3 are still in process of policy development • Draft policy developed for hospital (awaiting signature by management)
Challenges Limited financial resources Some initial workplaces opting out Delays by internal consultations Lack of a comprehensive legal framework • Reluctance by senior management to approve policy • • • •
Conclusion
Thank you!
Website: www.unacoh.org
Vision: A Healthy Productive Ugandan Population. Mission: To promote a positive health culture and influence healthy public policies through the principles of Primary health Care, emphasising advocacy for health and community mobilisation, participation and empowerment for health action Goal: To promote health as a Human Right, and as a tool and measure of development through evidence based health communications and other interventions
