Devolving tobacco control legislation to local governments for enhanced capacity in tobacco control advocacy and implementation

Background and challenges to implementation Kenya inaugurated a new constitution in 2010 that created a devolved system of government comprising of a National Government and 47 County Governments. This altered the governance structure in all sectors including health, consequently affecting implementation of Tobacco Control (TC). Even though Kenya has Tobacco Control Act, 2007, certain provisions of the Act have to be implemented at the county level. However, the counties had limited awareness and capacity to perform the new roles in TC implementation. Furthermore, Tobacco Industry targeted counties as the next frontier for killing TC. The challenges necessitated technical support and capacity in TC for the counties to develop local legislation. Intervention or response We carried out desk assessment on TC legislation framework to identify gaps to be addressed. Two research studies were done in selected counties to inform advocacy activities. A model county TC Bill benchmarked with the Framework Convention on Tobacco Control (FCTC) was developed for the counties to adapt to their local situations. Key stakeholders were identified- county health executives, assembly members and Civil Society Organisations (CSOs) who were trained on TC legislation development and advocacy. Results and lessons learnt The model law presented to counties how effective TC legislation should be structured. Different approaches worked in different counties; either presenting the law to the County Assembly as a private member's bill or using county health executives to front the bill. Through the project, awareness on TC at the counties increased, capacities enhanced and interest on the topic generated that made the process demand-driven by county stakeholders. Conclusions and key recommendations TC legislation established at the county level, local capacities on TC built and TC implementation devolved to the local level. Such an approach can be applied in other areas of public health, where local governments are given power to develop and enforce laws suiting their situations.