Ethiopian health care delivery system's responsiveness to smoking cessation therapy and its predictors: a mixed method study in Ethiopia

Abstract

Background: Tobacco is one of the leading public health burdens, killing six million people globally each year. The health system and healthcare providers can play a major role in promoting smoking cessation by providing either behavioral and/or pharmacological smoking cessation interventions to their patients. However, the level of responsiveness of the Ethiopian health system and the knowledge, attitude and practice of health professionals towards smoking cessation therapy is not well understood. This study was aimed to assess health care delivery system's responsiveness to smoking cessation services and its associated factors among health care providers in Ethiopia. Method(s): A cross sectional study was employed both quantitative and qualitative methods. The quantitative study was used to determine knowledge, attitude, and practice towards smoking cessation therapy of the health workers. For these 323 participants were selected from five health professional groups. Self-administered questionnaires were used for data collection and descriptive statistics, bivarate and multivariate analysis were done in SPSS. In the qualitative study twelve Key informants from central, regional, zonal and district levels were selected to respond on health systems responsiveness. Then the qualitative data was transcribed, translated and thematized. Result(s): Majority 306(97.5%) health care providers had below average level of practicing smoking cessation intervention, 70.4% and 86% had poor knowledge and negative attitude towards smoke cessation therapy respectively. In the multivariate analysis; being female, receiving training, having good knowledge score and having positive attitude were associated with the above average practice level of smoking cessation intervention. During key informant interviews, absence of well-organized and established system in smoking cessation intervention in Ethiopia was observed towards cessation intervention. Conclusion(s): The Ethiopian health delivery system's responsiveness for the provision smoking cessation intervention is premature. There is no well-organized system throughout. The health care providers (HCPs) were with poor knowledge, negative attitude and below average practice level.