RT Journal Article
SR Electronic
T1 Advancing whole-of-government approaches to tobacco control: Article 5.3 and the challenge of policy coordination in Bangladesh, Ethiopia, India and Uganda
JF Tobacco Control
JO Tob Control
FD BMJ Publishing Group Ltd
SP s46
OP s52
DO 10.1136/tobaccocontrol-2021-057154
VO 31
IS Suppl 1
A1 Rachel Ann Barry
A1 S M Abdullah
A1 Aastha Chugh
A1 Selamawit Hirpa
A1 Praveen Kumar
A1 Denis Male
A1 Rob Ralston
A1 Tracey Wagner-Rizvi
A1 Jeff Collin
YR 2022
UL http://tobaccocontrol.bmj.com/content/31/Suppl_1/s46.abstract
AB Introduction Despite an extensive evidence base on the diverse economic, environmental and social benefits of tobacco control, difficulties in establishing coordinated national approaches remain a defining challenge for Framework Convention on Tobacco Control (FCTC) implementation. Minimising tobacco industry interference is seen as key to effective coordination, and this paper analyses implementation of Article 5.3 guidelines, exploring implications for whole-of-government approaches to tobacco control in Bangladesh, Ethiopia, India and Uganda.Methods Based on 131 semistructured interviews with government officials and other key stakeholders, we explore barriers and facilitators for promoting: (1) horizontal coordination across health and other policy spheres, and (2) vertical coordination across national and subnational governments on Article 5.3 implementation.Results Our analysis identifies common barriers to coordination across diverse geographical contexts and varying approaches to implementation. They highlight broadly shared experiences of limited understanding and engagement beyond health agencies; restricted responsibility and uncertainty amid conflicting mandates; tensions with wider governance practices and norms; limited capacity and authority of coordination mechanisms; and obstacles to vertical coordination across local, state and national governments. Interview data also indicate important opportunities to advance coordination across sectors and government levels, with Article 5.3 measures capable of informing changes in practices, building support in other sectors, allowing for ‘bottom-up’ innovation and being shaped by engagement with civil society.Conclusion Supporting effective implementation of Article 5.3 is key to advancing multisectoral approaches to FCTC implementation and tobacco control’s contributions to global health and sustainable development.No data are available.