Community of practice on tobacco control to health inspectors of Brazilian Sanitary Surveillance System: a capacity-building strategy to strengthen tobacco control policies in Brazil

摘要

Background and challenges to implementation: Brazil ratified the World Health Organization Framework Convention on Tobacco Control in 2005. Regulation of tobacco products, promotion of smoke-free environments (SFE), and actions related to advertising, promotion and sponsorship (TAPS) of tobacco products are under Brazilian Sanitary Surveillance System (SNVS) responsibilities. Since Brazil has a large territorial extension, including 5,570 municipalities and heterogeneous structure in local health surveillance services, the need to strengthen knowledge and improve health inspectors' skills for the verification and monitoring of regulations related to tobacco control is a challenge. Intervention or response: A community of practice in the form of distance learning was identified as a strategy capable of strengthening tobacco control policies in Brazil. Community of practice is a learning space that facilitates the sharing of experiences among participants on topics of their interests. The virtual platform was developed by Oswaldo Cruz Foundation, in partnership with Brazilian Health Regulatory Agency and with the support of The Union. It was structured in 5 modules: Tobacco Epidemic; Inspection routine; TAPS, and SFE. Results and lessons learnt: Training program was offered three times during December 2015 and December 2016. It was attended by 777 health inspectors from three levels of SNVS (federal, state and municipal). The evaluation process showed that 64% of the participants completed at least one module. According to the knowledge gain assessment, 94% of participants stated that they had sufficient knowledge about the tobacco control policies in force in Brazil to carry out their work activities. Before attending training, 55% made this statement. After attending training, 86% health inspectors stated to feel themselves able to carry out health surveillance actions related to tobacco control in all its dimensions (tobacco products regulation, TAPS, and SFE). Before training, 44% made this statement. Conclusions and key recommendations: This training strategy showed its high potential to strengthen tobacco control policies in large countries, covering many professionals in short time.