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. 2018 Aug 15;18(Suppl 1):961.
doi: 10.1186/s12889-018-5825-7.

Non-communicable disease prevention policy process in five African countries

Pamela A Juma  1 , Shukri F Mohamed  2 , Beatrice L Matanje Mwagomba  3 , Catherine Ndinda  4 , Clarisse Mapa-Tassou  5   6 , Mojisola Oluwasanu  6 , Oladimeji Oladepo  7 , Opeyemi Abiona  7 , Misheck J Nkhata  8 , Jennifer P Wisdom  9 , Jean-Claude Mbanya  5   6
Affiliations

Non-communicable disease prevention policy process in five African countries

Pamela A Juma et al. BMC Public Health. .

Erratum in

Abstract

Background: The increasing burden of non-communicable diseases (NCDs) in sub-Saharan Africa is causing further burden to the health care systems that are least equipped to deal with the challenge. Countries are developing policies to address major NCD risk factors including tobacco use, unhealthy diets, harmful alcohol consumption and physical inactivity. This paper describes NCD prevention policy development process in five African countries (Kenya, South Africa, Cameroon, Nigeria, Malawi), including the extent to which WHO "best buy" interventions for NCD prevention have been implemented.

Methods: The study applied a multiple case study design, with each country as a separate case study. Data were collected through document reviews and key informant interviews with national-level decision-makers in various sectors. Data were coded and analyzed thematically, guided by Walt and Gilson policy analysis framework that examines the context, content, processes and actors in policy development.

Results: Country-level policy process has been relatively slow and uneven. Policy process for tobacco has moved faster, especially in South Africa but was delayed in others. Alcohol policy process has been slow in Nigeria and Malawi. Existing tobacco and alcohol policies address the WHO "best buy" interventions to some extent. Food-security and nutrition policies exist in almost all the countries, but the "best buy" interventions for unhealthy diet have not received adequate attention in all countries except South Africa. Physical activity policies are not well developed in any study countries. All have recently developed NCD strategic plans consistent with WHO global NCD Action Plan but these policies have not been adequately implemented due to inadequate political commitment, inadequate resources and technical capacity as well as industry influence.

Conclusion: NCD prevention policy process in many African countries has been influenced both by global and local factors. Countries have the will to develop NCD prevention policies but they face implementation gaps and need enhanced country-level commitment to support policy NCD prevention policy development for all risk factors and establish mechanisms to attain better policy outcomes while considering other local contextual factors that may influence policy implementation such as political support, resource allocation and availability of local data for monitoring impacts.

Keywords: Africa; Non- communicable disease; Policy.

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Conflict of interest statement

Ethics approval and consent to participate

The study was approved by relevant ethical boards/committees in each country including the National Ethics Committee for Health Research on Humans of the Ministry of Health of Cameroon; Kenya Medical Research Institute; University of Ibadan/University College Hospital Ethical Review Committee; Human Science Council Research Ethics Committee in South Africa: Malawi’s National Health Science and Research Committee. One case study that compared two countries was reviewed by three committees; in Togo by Togo Comite de Bioethique Pour la Recherche en Sante) and in South Africa by Human Sciences Research Council Research Ethics Committee, and University of Pretoria Health Sciences Research Ethics Committee. All country research teams followed appropriate safeguards to protect the research subjects, including participant privacy and confidentiality, voluntary participation, the risks and benefits of research and how research findings would be shared. Participants provided verbal or written documentation of consent to participate.

Consent for publication

Not applicable.

Competing interests

The authors have no competing interest.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

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