https://orcid.org/0000-0001-7234-3510
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ABSTRACT
Background
The 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.
Objective
This 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.
Methods
This 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.
Results
Several 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.
Conclusion
Efforts 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.
Responsible editor
Maria Nilsson
Responsible editor
Maria Nilsson
Acknowledgements
We acknowledge the support from the Zambia national health research authority (ZNHRA) as well as the Ministry of Health for facilitating the data collection for the publication of this paper. Many thanks to Umeå University as well as the University of Zambia for supporting Adam Silumbwe’s PhD process.
Author contributions
AS conceived the study, conducted the data collection and analysis with the supervision of the authorship team. AS drafted and revised the manuscript. MS, JMZ, CM and KJ provided guidance on various aspects of scientific writing, reviewed and provided feedback on the draft manuscript throughout the process. KJ provided overall oversight on the writing process and gave a final go-ahead to submit the manuscript. All authors read and approved the final manuscript.
Disclosure statement
No potential conflict of interest was reported by the author(s).
Ethics and consent
Ethical approval was sought from the Excellence in Research Ethics and Science (ERES) Converge ethics committee as well as the Zambia National Health Research Authority (ZNHRA) (ref. no. 2019-Dec-007). During data collection, participants were provided with relevant information about the study, ensuring clarity about possible benefits and risks, so they could make informed decisions about whether or not to participate, and consent was sought from them. Most of the interviews were carried out at participants’ workplace, so no transport refunds were provided. All study participants were de-identified by providing them with participant codes during both data collection and analysis to ensure confidentiality. Data collected were treated with utmost privacy and securely stored on a password-protected hard drive. This research was performed in accordance with the Declaration of Helsinki [Citation34].
Paper context
In Zambia, efforts to come up with a tobacco policy have been ongoing for over a decade and the country is not yet close to developing one. Few studies have explored the collaborative dynamics within the tobacco policy process and the potential role of principled engagement. This paper posits that principled engagement is a vital activity that sets in motion collaboration and is responsible for the success of any collaborative undertaking of the tobacco policy process.