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Challenges in Expanding the Role of Health Care Providers and Delivering Treatment in Africa -- Lekan Ayo-Yusuf, D.D.S., M.P.H., Ph.D.
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Challenges in Expanding the Role of Health Care Providers and Delivering Treatment in Africa -- Lekan Ayo-Yusuf, D.D.S., M.P.H., Ph.D.


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Presentation by Lekan Ayo-Yusuf, D.D.S., M.P.H., Ph.D., regional director of the Global Bridges African region, at the Global Bridges Preconference at the 15th World Conference on Tobacco OR Health in …

Presentation by Lekan Ayo-Yusuf, D.D.S., M.P.H., Ph.D., regional director of the Global Bridges African region, at the Global Bridges Preconference at the 15th World Conference on Tobacco OR Health in Singapore.

Published in: Health & Medicine

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  • 1. Global Bridges Afro Region Lekan Ayo-Yusuf, DDS, MPH, PhD 15th WCTOH Preconference Workshop March 19, 2012
  • 2. Context: Weak tobacco control in Africa
  • 3. OBJECTIVE 1 To create and mobilize a globalnetwork of HCPs and organizations dedicated to advancing effectivetobacco dependence treatment and advocating for effective tobacco control policy
  • 4. Network membership  The following 27countries areFrom a base of14, over 360 represented: Tunisia(175 trained) Morocco Algeriamembers joined Libya Egyptover 15 months! Cape Verde Mauritania Mali Niger Chad Sudan Eritrea Senegal Djibouti Burkinavia existing Faso The Gambia Guinea Nigeria Somalia Ghana Ethiopia Guinea-Bissau Côte Central Africanhealth networks dIvoire Cameroon Republic Sierra Leone Liberia Togo Benin Uganda Equatorial Gabon Congo Kenya Tobacco use Guinea DR Congo Rwanda prevalence estimatesthrough training Burundi Seychelles São Tomé Tanzania No Data Malawi and Príncipeworkshops Comoros <10% Angola Zambia 10-19% Mozambiquethrough RFA for Zimbabwe Madagascar Africa >=20% Namibia Botswana MauritiusACS tobacco South Africa Swazilandcontrol masters Lesothoprogramme
  • 5. Collaborations with other organizations1. National Council Against Smoking (NCAS), South Africa2. Public Health Association of South Africa (PHASA)3. Democratic Nursing Organization of South Africa (DENOSA)4. Africa Tobacco Control Regional Initiative (ATCRI), Nigeria5. Africa Tobacco Control Consortium (ATCC), Togo6. Programme National de Lutte Contre les Toxicomanies et les Substances Toxiques (PNLCT), Democratic Republic of Congo7. Framework Convention Alliance (FCA), Democratic Republic of Congo8. Centre for Tobacco Control in Africa (CTCA), Uganda
  • 6. Challenges - 1 Challenging to engage all recruited while running training Networking to make GB known through key actors in the region and country No website activities were available for most part of active recruitment period to sustain interest from members Diversity of culture and language
  • 7. OBJECTIVE 2To provide state-of-the-art, evidence- based training in treatment and advocacy to network members
  • 8. Policy & Treatment conceptual framework
  • 9. Tobacco cessation training workshopsAdapted ATTUD format (Aware → knowledgeable→ Proficient):one day of didactic teaching followed by more interactiveskills-building in counselling (motivational interviewing) on day2Dates Location # of participants Length of training (hrs)August 16-18 Abadan, Nigeria 25 19August 23-25 Pretoria, South Africa 29 19September 23, 26, 27 Lagos, Nigeria 29 20October 27-29 Lusaka, Zambia 22 20November 7-8 Kinshasa, DRC 33 12November 28-30 Johannesburg, South Africa 37 8
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  • 13. Challenges - 2 Training has been face-to-face as there is limited technology and in- country capacity to kick start tobacco treatment. Trainees have expectations to have more training and follow-up visits by facilitators Health system is currently overburdened and integration of treatment is seen as a challenge in several centers. 1
  • 14. OBJECTIVE 3To facilitate the implementation of Article 14 in every nation 1
  • 15. News on the advancement of Article 14Measures to increase demand fortreatment–Nigeria: the National Tobacco Control Bill was passedon the 15 March 2011 – still awaiting president’sascent.–Uganda: Launch of the CTCA - a support from Gatesthrough the WHO–Pilot of feasibility of treatment support to publicservants in South Africa – a partnership between thePublic Service Admin & Health ministries and majorhealth insurer 1
  • 16. Challenges - 3 Tobacco control is pretty much in infancy in the region Strong leadership from advocacy organizations and little involvement from health providers makes it more challenging. Treatment (A14) has not been prioritized due to lack of effective implementation of other key provisions of FCTC – smoke-free laws, taxation and health warnings. 1
  • 17. Challenges - 3 Seniors at work places have not embraced tobacco cessation treatment—no champions Training non-medical personnel e.g. social workers likely to advance Tx, but has implication for curriculum design Lack of funding for future work to sustain current advances. Treatment is not covered by health insurance 1
  • 18. Conclusions Popularity of the training has increased, even among non- health care professionals involved in tobacco control policy An instrument to measure the progress of trained HCPs who offer tobacco use treatment to their patients needs to be developed Build follow-up surveys to measure commitment of HCPs a year after they have received training into our training plan Network members need to be actively engaged after their recruitment to retain interest Train only candidates who commit to sending quarterly reports on patient encounters. Spend more time in engaging network members by posting relevant resource materials on the Global Bridges website and listserv 1
  • 19. Planned meetings Upcoming 2-day GB tobacco cessation workshops: –Tanzania/Kenya –Enugu, Nigeria Pre-conference workshops: –WFPHA; Addis Ababa, Ethiopia; 23-27 April 2012 –PHASA Conference; Bloemfontein, South Africa; 5-7 September 2012 1
  • 20. Acknowledgements Global Bridges for funding the project Key network partners for been ambassadors of GB and co-facilitating training UP, UCH,LUTH, UNZ, FCA-DRC and PHASA for hosting the workshops Network members for their valuable input 2