Health System Preparedness for Tobacco Control: Situational Analysis of Existing Health Programs in Andhra Pradesh, India

Abstract

Andhra Pradesh (AP) is one of the largest tobacco producing states in India. About 29% of adults in AP currently use tobacco in some form. Almost 24% of males and 4% of females are smokers. The prevalence of tobacco use in the state is higher than the national average of 15% for male and 2% for female smokers. However, few attempts have been made to understand the current situation of tobacco control resources, activities and strategies in the context of such a high tobacco prevalence state. The present study aimed to identify the gaps in existing tobacco control program and areas where tobacco control efforts can be integrated. Data were collected using both quantitative and qualitative methods. Semi-structured interviews were undertaken with a total of 95 key officials of state health departments, program managers, and project directors in six districts to understand ongoing tobacco control efforts. To facilitate the interviews, semi-structured guides were developed. Simple descriptive statistical analysis was conducted on the quantitative data using SPSS version 17. The results of the situational analysis suggest that a sufficient health workforce and infrastructure with the potential to integrate tobacco control activities is available in the surveyed districts. However, lack of integration of the tobacco control program intothe tuberculosis control program and the National Rural Health Mission was observed. Information, education and communication activities were lacking at block level health facilities. Our findings indicate that lack of trained health professionals, paucity of dedicated funds, lack of information, education and communication materials and low priority given to tobacco control activities are some of the factors which impede integration of tobacco control into existing health and developmental programmes in the districts of Andhra Pradesh, India.