Summary
Mohamed, S. F., Juma, P., Asiki, G., & Kyobutungi, C. (2018). Facilitators and barriers in the formulation and implementation of tobacco control policies in Kenya: A qualitative study. BMC Public Health, 18(1), 1-14.Â
Institutional Support
The Research Ethics Board of Kenya Medical Research Institute approved the study. The Ministry of Health (MOH) of Kenya and other departments within the health sector produced participants for the research. The International Development Research Centre (IDRC) was at the center of several parts of the study; it wrote the article; thus, presenting the research to the public. It also funded the analysis of Non-Communicable Disease (NCD) policies in Africa; by grant # 107209â001 through the Africa Population Health Research Center (APHRC) in Nairobi, Kenya. Furthermore, it paid the publication charges for the article; therefore, it was the primary financier for the research publication.
The explicit objective was to explore Kenyan policies regarding tobacco and show the factors progressing or disadvantaging them. The implicit goal was to show that proper tobacco control through objective procedures could minimize the number of deaths caused by excessive tobacco consumption. The institutions mentioned above impacted the implicit and explicit purposes of the research. The Ministry of Health (MOH), for instance, provided enough information and experts to aid the study. The IDRC, in conjunction with the Africa Population Health Research Center (APHRC), funded the publication of the research findings, therefore, promoting its publicity. Essentially, it facilitated the production of the article, and by doing so, promoted its implicit research of illustrating the adverse effects of tobacco use.
Research Design
The study used a case-study methodology (CSM) to integrate its two qualitative data sources; the data sources were 39 in-depth interviews, an evaluative review of policy documents, 24 reports between 2004 and 2017, and published articles. The study sourced participants from units responsible for tobacco management and control. The participants were from sectors such as the Kenyan government, private industry, various fields of research and academia, non-governmental organizations (NGOs), and civil societies. The case study design facilitated an inquiry into the subject matter over a period and used various sources to discover factors of the study that are substantially accurate.
Many limitations hinder the case study research design; thus, rendering it partially defective. It is time-consuming; it usually needs a lot of time to review all selected cases. For instance, it took the researchers a long to interview all the participants in private and check all the relevant tobacco control policy documents. The methodology also lacks generalizability, for its findings could be biased to only the selected population.
Selection Strategy
The researchers invited individuals they discovered to be active participants in tobacco policy-making processes or those who appear to have been part of policy formulation or implementation. They initially selected participants to vary policy formulation roles and organizational representation. In addition, they used snowball sampling with initial participants to remain with those still in the office positions where they had participated in tobacco control policy-making. Review of tobacco control policy documents aided the selection of informants; the research mainly used interviews of key informants. The main aim of primary interviews was to gain more insight into tobacco events and understand the intervieweesâ views on policy processes that concern the use and misuse of tobacco. The data gathered from the informantsâ interviews included tobacco policy development, their content and context, policy enforcement, actors in policy formulation, promoters and barriers in policy formulation, and proposals to improve tobacco control. The selection strategy has some limitations; the population used for the research is not representative of all of Kenyaâs tobacco control population. It is also selective, for it does not include all stakeholders, for instance, grassroots tobacco users.
Key Concepts
Reading through the article on tobacco control, several key concepts emerged. The first aspect is research validity; ideally, any proper research proves that it was scientific. The study employed thematic content analysis for the data analysis process. The researchers used Gilsonâs policy triangle framework, concentrating on the factors of process, context, content, and actors who focus on policy formulation. They entered interview transcripts into NVivo 10 systems which aided in proper management of data ideas, visualization, queries, and reporting. In addition, two researchers independently checked transcripts; they found four coded and discovered 83 percent inter-coder reliability, confirming the processâs sufficiency. The other key concept was the necessity of crucial stakeholders in tobacco control to formulate and implement policies that would be efficient in controlling tobacco use and sensitizing the general public on its effects on their health. The generalization of these concepts is not wholly sufficient, for they are obtained from a specific population that might not represent the entire population.
Research Implementation
Document review provided a historical perspective on the issue of tobacco control. It also gave the research a foundational background; the researchers assessed documents that contained information on tobacco. They browsed Google and PubMed using search items coupled with combinations of essential keywords such as âtobacco control policies + Kenya + tobacco use + barriers + facilitatorsâ (Mohamed et al., 2018). Ideally, the search involved all documents from 2004 when Kenya signed the World Health Organization Framework Convention on Tobacco Control (WHO FCTC) to 2017 to evaluate searched data more thoroughly. To be more comprehensive, they also searched online websites of the Health, Transportation, Education, and Agriculture ministries. Moreover, the research included a manual search for the relevant data; the researchers targeted government offices and libraries, looking for retrospective government directives, laws, acts, guidelines, and strategic plans. They used a data extraction sheet to gather content on the policy, its publication details, policy goals, leading players of the policy process, stakeholder role, and WHOâs crucial interventions resulting from the legislation. Two researchers independently searched, then reconciled, and integrated the explored information on the data extraction sheet.
The research process faces some challenges in its implementation; for example, it took a lot of time to conclude the face-to-face interviews and the policy document review. It took approximately seven months in total. The research was confidential since the researchers interviewed the participants in private, with their details kept secret and general; for instance, the authors write of government officers, but none in particular. The research implementation poses some ethical concerns; the sourcing of details of the tobacco control stakeholders without their consent is unethical.
I believe the study is a reliable source of knowledge, with substantial legitimacy and validity. The International Development Research Centre (IDRC) sponsored its publication, implying its claims are valid since it promotes legal claims. The study observed ethical considerations; the researchers prompted the participants on the nature of their research and their rights, including the right to free withdrawal without any penalty. It is also reliable since its claims are scientific and objective; the findings are reliable, including government documents. Generally, its claims are genuine and can be substantiated; the researchâs conclusions are valid.
Reference
Mohamed, S. F., Juma, P., Asiki, G., & Kyobutungi, C. (2018). Facilitators and barriers in the formulation and implementation of tobacco control policies in Kenya: A qualitative study. BMC Public Health, 18(1), 1-14.