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Mentoring Cambodian and Lao health professionals in tobacco control leadership and research skills

¹ Department of Preventive Medicine and Family Medicine, Loma Linda University School of Medicine; Department of Health Promotion, School of Public Health, Loma Linda, California, USA
² Departments of Global Health, Epidemiology and Biostatistics, Loma Linda University School of Public Health
³ Department of Epidemiology and Biostatistics, Loma Linda University School of Public Health

Correspondence to:
Linda Hyder Ferry
MD, MPH, Loma Linda University School of Public Health, Nichol Hall, Room 2003, Loma Linda, CA 92350, USA; lferry{at}llu.edu

Design: The aim of the programme was to ultimately affect public health practice and policy in the Kingdom of Cambodia and Lao People’s Democratic Republic (Lao PDR) by training key health professionals to conduct tobacco control research.

Setting: Encouraged by the World Health Organization’s Framework Convention on Tobacco Control, a global partnership formed to build effective leadership to develop and guide national tobacco control agendas. The partners were the Ministries of Health (Cambodia and Lao PDR), non-government organisations (Adventist Development and Relief Agency in Cambodia and Laos) and an academic institution (Loma Linda University, Loma Linda, California, USA).

Subjects: 16 health professionals, 10 from Cambodia and 6 from Lao PDR, were selected by local advisory committees to enter a two-year, intensive tobacco research graduate certificate and research training programme.

Intervention: We developed a "Global Tobacco Control Methods" (GTCM) 28 unit certificate programme that was offered in five sessions from September 2003 to September 2005 at the National Institute of Public Health, Phnom Penh, Cambodia. As part of their coursework, the 16 trainees actively participated in the development and implementation of two research projects. In the first project, "Healthy Doc Healthy Patient" (HDHP), trainees adapted an existing, self-administered questionnaire designed to assess health practices and beliefs of medical students in Cambodia and Lao PDR. The second project involved the design of a national prevalence of tobacco use and health beliefs study in Cambodia using a multi-stage, cluster sample method. Trainees were sponsored to attend and present at international tobacco control conferences to enhance their awareness of the tobacco epidemic.

Results: As of September 2005, 14 trainees (8 from Cambodia and 6 from Lao PDR) completed the courses in the GTCM certificate programme. The HDHP study sampled four medical school classes (years 3, 4, 5 and 6) in both Cambodia (n = 330, 71.1% response rate) and Lao PDR (n = 386, 87.3% response rate). As part of the Cambodian adult tobacco prevalence study in Cambodia, 13 988 adults (ages 18 years) were interviewed from all 22 provinces during the summer of 2005. Over the two years, more than half of the trainees participated substantially in local and regional tobacco control and research activities. Programme challenges included the trainees’ limited English language and computer proficiency skills, both of which improved during the two years.

Conclusions: With the successful completion of the certificate programme, the remaining two years of the grant will be used to prepare the trainees for positions of leadership within their Ministries of Health and other agencies to implement effective tobacco control policies based on locally-derived research findings.

Abbreviations: ADRA, Adventist Development and Relief Agency; FCTC, Framework Convention on Tobacco Control; GTCM, Global Tobacco Control Methods; HDHP, Healthy Doc Healthy Patient; Lao PDR, Lao People’s Democratic Republic; LLU SPH, Loma Linda University School of Public Health; MOH, Ministry of Health; NGO, non-government organisation; NIH, National Institutes of Health; WHO, World Health Organization

Keywords: tobacco control; capacity building; health professional education; Kingdom of Cambodia; Lao People’s Democratic Republic