ArticleHealth promotion perspectives2025
Revolutionizing healthcare: Unleashing the power of regulatory measures to enforce smoke-free policies in Indonesian medical facilities.
Article in Health promotion perspectives, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: The global challenge of tobacco usage poses significant hurdles in policy implementation. Local governments' smoke-free policies have struggled with optimal enforcement, hampering effective smoking control. This study evaluates smoke-free zone implementation in healthcare services within Muaro Jambi, Indonesia. Methods: This convergent mixed-methods study collected data from June to December 2023. The quantitative phase entailed a spatial survey across 74 healthcare facilities (hospitals, community health centers, and clinics), facilitated by the KoboToolbox application. Data were analyzed using SPSS 16.0 for descriptive statistics and QGIS 3.30.2 for spatial mapping. The qualitative component employed content analysis of in-depth interviews with 31 purposively selected informants representing healthcare facilities and policymakers. Interviews were conducted by trained enumerators, transcribed verbatim, and analyzed using conventional content analysis techniques following Bengtsson's methodology. Results: Most healthcare facilities (74.3%, 95% CI: 62.8-83.8%) failed to implement smoke-free areas effectively, with hospitals and community health centers showing 100% non-compliance and clinics at 61.2%. Key barriers included inconsistent policy socialization, inadequate leadership enforcement, absence of sanctions, and cultural acceptance of smoking in outdoor areas. Effective implementation correlated with strong leadership commitment and consistent rule enforcement. Conclusion: The effectiveness of smoke-free policies in Indonesian healthcare facilities hinges on robust regulatory measures and consistent oversight from local governments. Leaders and staff serve as role models, ensuring compliance through their actions. While regional regulations are critical for tobacco control, their success depends on unwavering support from local and organizational leaders, emphasizing the need for active involvement from decision-makers and stakeholders.
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