Regulating alcohol packaging and supply to protect health in Sub-Saharan Africa: evidence from policy systems in Malawi and Uganda

规范酒精包装和供应以保护撒哈拉以南非洲地区的健康：来自马拉维和乌干达政策​​体系的证据

• 批准号: MR/V015257/1
• 负责人: Isabelle Uny
• 金额: $ 25.11万
• 依托单位: University of Stirling
• 依托单位国家: 英国
• 项目类别: Research Grant
• 财政年份: 2022
• 资助国家: 英国
• 起止时间: 2022 至 无数据
• 项目状态: 未结题
• 来源: https://gtr.ukri.org/projects?ref=MR%2FV015257%2F1
• 关键词: Regulating; alcohol; packaging; supply; protect

Consuming alcohol ('drinking') causes cancers and other NCDs globally and more than 3 million people died due to harmful use of alcohol in 2016 (1 in 20 deaths). It has impacts on economic productivity and can lead to addiction, violent behaviours, injuries, and road-traffic collisions. It also impacts on health systems, particularly in low and middle income countries (LMIC) where those system already face significant challenges. Drinkers in Africa consume 21% more alcohol per day than the global average. Small disposable plastic sachets which contain alcohol or spirits have led to significant alcohol abuse amongst the most vulnerable and poorest communities in Malawi and Uganda, particularly the young. As a result Malawi and Uganda placed national bans on sachets of alcohol in Malawi (2016) and Uganda (2019), but those may not have had the impact anticipated. In March 2019, we organised a workshop with researchers from 6 LMICs including Malawi and Uganda to discuss issues around alcohol consumption and what research could be done to supports effective policies to control the supply of alcohol. The issue of the alcohol sachets and the policies to ban them was raised by Malawi and Uganda colleagues, who felt it was needed to study the implementation of the bans, to compare both countries and to see what lessons could be learnt.Our aims with this study are to understand why the bans were adopted and how they were presented, what mechanisms for implementation were proposed and put in place, how the bans were enforced in practice, and what unintended consequences may have occurred. We will do this through interviews with policy makers and major stakeholders, and also, through interviews with district and local stakeholders in enforcement and trade. We will also conduct focus group discussions with men and women, health staff from local health centres and with traditional/ church leaders and school headteachers, to explore the perceived impact of the ban on harmful forms of alcohol consumption and any unintended consequences of the bans (e.g. increased consumption of home brews). We will also examine perceptions of changes in harmful drinking within the community and amongst young people; and whether local health facility staff have seen changes in terms of addiction and harm at facility level because of the bans. We will share our results with stakeholders at special events in Malawi and Uganda.To achieve our aims we have assembled a team of seven highly experienced researchers from different disciplines (social science, epidemiology, psychology, population, and public health). Four of them are based in Uganda and Malawi where they will lead the research and two in South Africa. We will recruit full-time researchers in Uganda and Malawi to carry out the work and will train them to have the confidence to carry out alcohol research which can influence policy and help reduce alcohol-related harms. We have also assembled an international advisory group with 2 experts from high income countries and 7 from African low and middle income countries networks on alcohol We will work closely with stakeholders in each country and other African and global networks from start to finish, to give them an opportunity to understand our findings in their context, so they can use those findings in policy development, for advocacy, and to support further research.

全球饮酒（“饮酒”）引起癌症和其他NCD的原因，并因2016年有害使用酒精而死亡（20人死亡）。它对经济生产力产生了影响，并可能导致成瘾，暴力行为，伤害和人流碰撞。这也会影响卫生系统，尤其是在低收入和中等收入国家（LMIC），这些国家已经面临重大挑战。非洲的饮酒者每天的饮酒量比全球平均水平高21％。包含酒精或烈酒的小型一次性塑料袋已导致马拉维和乌干达最脆弱，最贫穷的社区，尤其是年轻人，导致大量酒精滥用。结果，马拉维和乌干达在马拉维（2016）和乌干达（2019）中将国家禁令对酒精进行了禁令，但这些可能没有产生预期的影响。 2019年3月，我们与来自马拉维和乌干达在内的6个LMIC的研究人员组织了一个研讨会，讨论有关饮酒的问题，以及可以采取哪些研究来支持控制酒精供应的有效政策。马拉维和乌干达的同事提出了酒精包和禁止它们的政策问题，他们认为需要研究禁令的实施，比较两国的实施，并了解可以学习的课程。我们的目标与这项研究的目标是了解为什么要采用禁令，并施加了什么机制，并施加了什么机制，并施加了什么机制，并将其定义为实施，以及在施加了什么机制，以及如何实施，构成了企业的实施，该机制是如何实施的，该企业是构成的。可能发生了。我们将通过对政策制定者和主要利益相关者的访谈，以及通过对执法和贸易方地区和当地利益相关者的访谈。我们还将与男女进行焦点小组讨论，当地卫生中心的卫生人员以及传统/教会领导人和学校校长，以探讨禁令对饮酒形式的看法影响以及禁令的任何意外后果（例如，增加家庭啤酒的消费）。我们还将研究社区内和年轻人中有害饮酒变化的看法；以及由于禁令，当地医疗机构工作人员是否在设施水平上的成瘾和危害方面发生了变化。我们将在马拉维和乌干达的特别活动中与利益相关者分享我们的结果。为了实现我们的目标，我们组建了一个由来自不同学科（社会科学，流行病学，心理学，人口和公共卫生）的七名经验丰富的研究人员组成的团队。其中四个位于乌干达和马拉维，他们将领导研究，两人在南非。我们将招募乌干达和马拉维的全日制研究人员进行工作，并将训练他们，有信心进行酒精研究，这可以影响政策并有助于减少与酒精有关的危害。我们还与来自高收入国家的2位专家组成了一个国际咨询小组，来自非洲低收入和中等收入国家的7个有关酒精网络的网络我们将与每个国家以及其他非洲和其他非洲和全球网络的利益相关者紧密合作，从头到尾，他们有机会在其上下文中了解我们的发现，因此他们可以在政策发展中利用这些发现，并支持倡导的研究，并支持进一步的研究。