Suchergebnisse

Many low-income and middle-income countries (LMICs) are unlikely to achieve Sustainable Development Goal 3.4 to reduce premature deaths from non-communicable diseases (NCDs) by one-third by 2030. For some, the prospect is receding: between 2010 and 2020, the decline in premature deaths for the major NCDs slowed compared with the prior decade. Barriers to implementing effective strategies are well known, yet the value of tailored technical support to countries has been overlooked and downplayed. Tailored technical support is specialist guidance for country-specific application of technical tools, and capacity enhancement when needed, that enables an LMIC to advance its NCD priorities and plans. We present a model identifying pivotal junctures where tailored technical support can help surmount implementation obstacles. We draw on our experience preparing NCD investment cases with health ministries, development partners and technical agencies. National investment cases produce evidence based, locally tailored and costed packages of NCD interventions and policies appropriate to national needs and circumstances. They can include analysis of financing needs and point towards sustainable funding mechanisms. Enhancing the NCD-specific knowledge of government and Civil Society Organization leads can capitalise on existing expertise, aid integrative health system developments and unlock capabilities to use global tools and guidance. Investment cases form a platform to develop or review NCD plans and (re)prioritise action, then apply implementation science to trouble-shoot obstacles. Partnering national stakeholders with technical support in this process is critical to develop and implement effective NCD strategies.

Concerted efforts by government officials and technical assistance from the World Health Organization (WHO) Framework Convention on Tobacco Control (FCTC) Secretariat Knowledge Hub on Tobacco Taxation and Illicit Trade, resulted in an increase in tobacco taxation in Saint Helena during 2019. This formed part of a broader package of Tobacco Control measures to reduce the burden of noncommunicable diseases (NCD) on the island. We elaborate on key contextual and contributing factors that resulted in positive policy change in a relatively short period of time. These included political support for a strategic approach to address prevalent NCD in the context of an ageing population, high overseas health care costs and Overseas Development Aid dependency. Previous experience of impact from sugar-sweetened beverage taxation when combined with wider system measures, and the similar accompaniment of the tobacco taxation proposals with wider measures, encouraged policymakers to use tobacco taxation to curb cigarette consumption. These factors created readiness, and tailored technical assistance from an international, donor-funded partner and specifically modelling to provide evidence-based predictions of impact augmented confidence of policy benefit and enabled passage. This experience may serve as a point of reference for other countries that wish to implement similar policy changes.

The MPOWER policy package enables countries to implement effective, evidence-based strategies to address the threat posed to their population by tobacco. All countries have challenges to overcome when implementing tobacco control policy. Some are generic such as tobacco industry efforts to undermine and circumvent legislation; others are specific to national or local context. Various factors influence how successfully challenges are addressed, including the legal-political framework for enforcement, public and administrative attitudes towards the law, and whether policy implementation measures are undertaken. This paper examines District Tobacco Control Taskforces, a flexible policy mechanism developed in Bangladesh to support the implementation of the Smoking and Tobacco Products Usage (Control) Act 2005 and its 2013 Amendment. At the time of this study published research and/or data was not available and understanding about these structures, their role, contribution, limitations and potential, was limited. We consider Taskforce characteristics and suggest that the "package" comprises a distinctive tobacco control implementation model. Qualitative data is presented from interviews with key informants in ten districts with activated taskforces (n = 70) to provide insight from the perspectives of taskforce members and non-members. In all ten districts taskforces were seen as a crucial tool for tobacco control implementation. Where taskforces were perceived to be functioning well, current positive impacts were perceived, including reduced smoking in public places and tobacco advertising, and increased public awareness and political profile. In districts with less well established taskforces, interviewees believed in their taskforce's 'potential' to deliver similar benefits once their functioning was improved. Recommendations to improve functioning and enhance impact were made. The distinctive taskforce concept and lessons from their development may provide other countries with a flexible local implementation model ...

Contents -- Preface -- Introduction: The Paradox of Peripherality -- 1. Perceptions from the Periphery: The Experience of Wales -- 2. PACE: Guiding Rural Tourism Development in a Fragile Area -- 3. Peripheries, Artificial Peripheries and Centres -- 4. Tourist Perceptions of the Ultimate European Periphery -- Maps -- 5. Farm Accommodation and Agricultural Heritage in Orkney -- 6. The Fall and Rise of Peripherality: Tourism and Restructuring on Bute -- 7. The Evolution of Tourism in the Tärna Mountains: Arena and Actors in a Periphery -- 8. Tourism's Role in New Rural Policy for Peripheral Areas: The Case of Arjeplog -- Index