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Evaluating the Tobacco Control Policies and MPOWER Package Of Evaluation of tobacco control policies and programmes including implementation of the WHO MPOWER technical package in SEAR Member States Regional Office for South-East Asia (WHO-SEARO) World Health Organization Evaluation Report ACT for Performance and MDF July 10, 2018 ACT FOR PERFORMANCE BV HNK Ede Horapark Bennekomseweg 41 6717 LL, Ede, The Netherlands + 31 (0)615094443 + 31 (0)8008098 ACT FOR PERFORMANCE SARL 16, Immeuble le Palmier Avenue Lukusa, Commune de Gombe Kinshasa, Democratic Republic of Congo + 243 819009055 + 243 990065532 ACT FOR PERFORMANCE INC 1330 Lajoie, Montréal, Canada H2V 1P5 + 1 514 923-4992 www.mdf.nl HNK Ede Horapark Bennekomseweg 41 6717 LL, Ede, The Netherlands MDF Office network: Bangladesh, Belgium, D.R. Congo, Ghana, Indonesia, Kenya, Myanmar, Sri Lanka, and Vietnam Table of contents List of Acronyms ................................................................................................................................................................................. I Acknowledgments ............................................................................................................................................................................. II EXECUTIVE SUMMARY ................................................................................................................................................................... III 1 EVALUATION MANDATE, SCOPE AND OBJECTIVES..................................................................................................... 1 1.1 INTRODUCTION .................................................................................................................................................................................................. 1 1.2 EVALUATION OBJECTIVES AND SCOPE ............................................................................................................................................................ 2 2 POLICY AND PROGRAM SOLUTIONS OFFERED BY WHO AND THE MEMBER STATES .................................... 3 2.1 ROLE OF THE WHO IN THE IMPLEMENTATION OF TOBACCO CONTROL POLICIES .............................................................................. 3 2.2 EXISTING TOBACCO CONTROL ACHIEVEMENTS ........................................................................................................................................ 4 2.3 PROGRESS OF THE MEMBER STATES ON ACHIEVING THE NCD ACTION PLAN TARGETS ................................................................. 4 3 EVALUATION APPROACH ..................................................................................................................................................... 6 3.1 EVALUATION QUESTIONS ....................................................................................................................................................................... 6 3.2 EVALUATION APPROACH ....................................................................................................................................................................... 7 3.3 CONSTRAINTS AND LIMITATIONS ......................................................................................................................................................... 9 4 EVALUATION FINDINGS ...................................................................................................................................................... 10 4.1 RELEVANCE ........................................................................................................................................................................................... 10 4.1.1 Relevance of the mechanisms and policies for tobacco control in SEAR countries .......................................... 10 4.1.2 Relevance of the WHO support to Member states .........................................................................................................12 4.2 EFFICIENCY ........................................................................................................................................................................................... 15 4.2.1 Efficiency of the implementation of tobacco control policies and the MPOWER package ............................ 15 4.2.2 Efficiency of the WHO’s support on Tobacco control in SEAR Member States ................................................... 18 4.3 EFFECTIVENESS .................................................................................................................................................................................... 22 4.3.1 Effectiveness of the implementation of the MPOWER package ................................................................................22 4.3.2 Effectiveness of the implementation of tobacco control policies .............................................................................27 4.3.2 Effectiveness of the WHO support ........................................................................................................................................30 4.4 IMPACT ................................................................................................................................................................................................... 31 4.4.1 Impact of tobacco control policies on tobacco use prevalence rates ..................................................................... 31 4.4.2 Impact of tobacco control policies in reducing risk of premature mortality from target NCDs ................. 38 4.4.3 Role/contribution of WHO in reducing prevalence of tobacco use .........................................................................38 4.5 SUSTAINABILITY ................................................................................................................................................................................... 39 4.5.1 Sustainability of the existing tobacco control policies and programmes.................................................................... 39 4.5.2 The WHO’s role to support sustainable tobacco control measures and policies ............................................... 40 5 CONCLUSIONS ......................................................................................................................................................................... 43 5.1 CONCLUSION #1 RELEVANCE .................................................................................................................................................................. 43 5.2 CONCLUSION #2 EFFICIENCY: ................................................................................................................................................................. 43 5.3 CONCLUSION #3 EFFECTIVENESS ........................................................................................................................................................... 44 5.4 CONCLUSION #4 IMPACT .......................................................................................................................................................................... 47 5.5 CONCLUSION #5 SUSTAINABILITY .......................................................................................................................................................... 48 6 RECOMMENDATIONS ........................................................................................................................................................... 49 6.1 RECOMMENDATIONS FOR WHO ............................................................................................................................................................. 49 6.1.1 Approach ........................................................................................................................................................................................49 6.1.2 Institutional strengthening.....................................................................................................................................................49 6.1.3 Management and governance ...............................................................................................................................................51 6.2 RECOMMENDATIONS FOR THE SEAR COUNTRIES ................................................................................................................................ 51 ANNEX A SPECIFIC COUNTRY FINDINGS .......................................................................................................................... 54 BANGLADESH .......................................................................................................................................................................................................... 54 BHUTAN ................................................................................................................................................................................................................... 56 DEMOCRATIC PEOPLE’S REPUBLIC OF KOREA .................................................................................................................................................. 59 INDIA ........................................................................................................................................................................................................................ 60 INDONESIA .............................................................................................................................................................................................................
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