Abstract
BackgroundHarmful use of alcohol is one of the most common risk factors for Non-Communicable Diseases and other health conditions such as injuries. World Health Organization has identified highly cost-effective interventions for reduction of alcohol consumption at population level, known as “best buy” interventions, which include tax increases, bans on alcohol advertising and restricted access to retailed alcohol. This paper describes the extent of inclusion of alcohol related “best buy” interventions in national policies and also describes the application of multi-sectoral action in the development of alcohol policies in Malawi.MethodsThe study was part of a multi-country research project on Analysis of Non-Communicable Disease Preventive Policies in Africa, which applied a qualitative case study design. Data were collected from thirty-two key informants through interviews. A review of twelve national policy documents that relate to control of harmful use of alcohol was also conducted. Transcripts were coded according to a predefined protocol followed by thematic content analysis.ResultsOnly three of the twelve national policy documents related to alcohol included at least one “best buy” intervention. Multi-Sectoral Action was only evident in the development process of the latest alcohol policy document, the National Alcohol Policy. Facilitators for multi-sectoral action for alcohol policy formulation included: structured leadership and collaboration, shared concern over the burden of harmful use of alcohol, advocacy efforts by local non-governmental organisations and availability of some dedicated funding. Perceived barriers included financial constraints, high personnel turnover in different government departments, role confusion between sectors and some interference from the alcohol industry.ConclusionsMalawi’s national legislations and policies have inadequate inclusion of the “best buy” interventions for control of harmful use of alcohol. Effective development and implementation of alcohol policies require structured organisation and collaboration of multi-sectoral actors. Sustainable financing mechanisms for the policy development and implementation processes should be considered; and the influence of the alcohol industry should be mitigated.
Highlights
Harmful use of alcohol is one of the most common risk factors for Non-Communicable Diseases and other health conditions such as injuries
This paper describes the inclusion of alcohol related “best-buy” interventions and the extent of multi-sectoral action (MSA) in national alcohol control policies in Malawi
The study analyzed all NCD risk factors, this paper is only reporting findings from the alcohol related policy analysis which was more comprehensive than all other NCD risk factor areas that were analysed for Malawi
Summary
Harmful use of alcohol is one of the most common risk factors for Non-Communicable Diseases and other health conditions such as injuries. A 2012 field-based survey found that 14.5% of Malawians (27.3% of men and 1.6% of women) aged 18 years or older drank alcohol in the 12 months preceding the survey [4]. Among those who consume alcohol, 40.8% (51.4% of males and 13.1% of females) are heavy episodic drinkers and total per capita alcohol consumption (for persons aged 15 years and above) is estimated at 15.9 l of pure alcohol per person per year among males and 4.6 l among females [5]. The high abstention rate contrasted with high total consumption rate in Malawi suggests that those who are drinkers have risky drinking patterns
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