Multilevel intervention in reducing in-home secondhand smoke exposure among pregnant woman in North Lombok district, Indonesia

Background and challenges to implementation SHS exposure among pregnant women is highly correlated with low birth weight (LBW). SHS exposure in homes can be reduced by a package of "smoke-free home" interventions, particularly in the high prevalence of LBW area as North Lombok, Indonesia. Evidence from previous research showed that smoke free home could change smoking behavior among men in Yogyakarta, Indonesia. However, different condition, site and culture may bring different approach to implement smoke free home for protecting the health of pregnant mother. Intervention or response Smoke free home interventions consisted of three activities; 1) media campaign (above and below the line), 2) individual contract (each husband signed contract for not smoking at home while his wife pregnant) and 3) community commitment to make all pregnant mother house become smoke free home. We collaborated with district health office in distributing media campaign, including working with midwifes association to reach pregnant woman. We advocated the head of districts and sub district in West Nusa Tenggara for developing community commitment to make smoke free home village. Primary health care officer were actively involved in facilitating smoke free home village commitment. Results and lessons learnt Majority of pregnant women husband signed the individual contract for not smoking at home and media were distributed widely. The activity was worked well by involving health care providers. It was challenging to have people gathering since they have not had existing group meeting. Therefore, we carried out formal meeting with head of village and community leaders. Conclusions and key recommendations Message through media campaign increasing awareness of husbands to protect their wife from passive smoking by signing individual contract. Community commitment of smoke free home supported individual contract. In a country that have limited tobacco control policy, community and individual based intervention are needed