ArticleGlobal health action2023
The role of principled engagement in public health policymaking: the case of Zambia's prolonged efforts to develop a comprehensive tobacco control policy.
Article in Global health action, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 1 of them a synthesis that pooled it.
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5 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Tobacco smoking in Sub-Saharan Africa: A systematic review and meta-analysis.Drug and alcohol review · 2025Pooled it
- Factors that shape the integration of HIV and TB services in Zomba District, Malawi.BMC health services research · 2025Article
- Collaborative dynamics and shared motivation: exploring tobacco control policy development in Zambia.Health policy and planning · 2024Article
- Collaborative governance of an integrated system for collecting contributions for social health insurance, pension, and taxes from the informal sector: a synthesis of stakeholder perspectives.BMC health services research · 2024Article
- Halting and re-issuing of the Zambia community health strategy (2017-2021): a retrospective analysis of the policy process and implications for community health systems.BMC health services research · 2024Article
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Abstract
backgroundThe Framework Convention on Tobacco Control (FCTC) requires countries to develop and implement multi-sectoral tobacco control strategies, including policies and legislation. Zambia, potentially faced by a rising problem of tobacco smoking, signed the FCTC in 2008 but has been unable to enact a tobacco policy for over a decade.
objectiveThis study explores the role of 'principled engagement', a key element of the theoretical framework for collaborative governance, in Zambia's delayed success to develop a comprehensive tobacco control policy.
methodsThis was a qualitative case study of key stakeholders in the collaborative process of trying to develop a tobacco policy in Zambia. Participan-ts were sampled from across various sectors, including government departments and civil society, comprising anti-tobacco activists and researchers. A total of 27 key informant interviews were undertaken. We supplemented the interview data with a document review of relevant policies and legislation. Data were analysed using thematic analysis.
resultsSeveral factors hindered efforts to attain principled engagement, including the adverse legal and socioeconomic environment in which the collaborative regime evolves; poor planning of meetings and frequent changes in tobacco focal point persons; lack of active and meaningful participation; and communication challenges among the key stakeholders. These collaborative dynamics, coupled with the opposition to tobacco control efforts from within some government departments, revealed the inadequacy of the current collaborative governance regime to facilitate enactment of a comprehensive tobacco control policy in Zambia.
conclusionEfforts to develop a comprehensive tobacco control policy in Zambia will require addressing challenges such as disagreements, communication, and leadership at engagement level across interested sectors. We further argue that principled engagement has a greater role to play in unlocking these efforts and should therefore be embraced by those entrusted to lead the process to develop tobacco policy in Zambia.
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