Alcohol policy in a Russian region: a stakeholder analysis.
BACKGROUND
Male life expectancy in the Russian Federation, at 60 years, is the lowest in Europe. Several factors contribute to this situation, but hazardous consumption of alcohol is especially a key factor.


METHODS
We undertook a stakeholder analysis in a typical Russian region located on the western side of the Urals. Organizations with a stake in alcohol policy in the region were identified by snowball sampling and information on their position and influence on alcohol policy was elicited from interviews with key informants. Their interests and influence were mapped and their relationships plotted.


RESULTS
Twenty-nine stakeholder organizations were identified and 43 interviews were conducted with their staff. The most influential actors were the Federal and regional governments, large beer producers and manufacturers of strong alcohols. However, the majority of organizations that might be expected to play a role in developing or implementing alcohol control policies were almost entirely disengaged and fragmented. No evidence was found of an existing or emerging multi-sectoral coalition for developing alcohol policy to improve health. Organizations that might be expected to contribute to tackling hazardous drinking had little understanding of what might be effective.


CONCLUSIONS
While stakeholders with an interest in maintaining or increasing alcohol consumption are engaged and influential, those who might seek to reduce it either take a very narrow perspective or are disengaged from the policy agenda. There is a need to mobilize actors who might contribute to effective policies while challenging those who can block them.
Gil
Artyom
A
I.M. Sechenov Moscow Medical Academy, 8-2 Trubetskaya street, Moscow, Russia. artyom.gil@lshtm.ac.uk
Polikina
Olga
O
Koroleva
Natalia
N
Leon
David A
DA
McKee
Martin
M
D000428:Alcohol Drinking / Q000331:legislation & jurisprudence / Q000517:prevention & control*; D000434:Alcoholic Beverages; D003132:Commerce; D006076:Government; D006291:Health Policy; D006801:Humans; D007221:Industry; D007407:Interviews as Topic; D012426:Russia