Community action to reduce harmful use of alcohol: a pilot study in the remote villages of eastern Bhutan

Introduction: As per the Annual Health Bulletin, 2017, alcohol related liver disease is the leading cause of death in Bhutan. There were 190 deaths due to harmful use of alcohol in 2016 and alcohol liver disease (ALD) incidence was 46 per 10,000 people. Community action to reduce harmful use of alcohol in the communities is one of the strategies being implemented in Bhutan. However, the impact of such community action is not assessed in the country. Therefore, this pilot study was conducted in two gewogs (sub-district) of Trashiyangtse dzongkhag to assess the short-term effects of this community action to reduce alcohol use. Methods: This pilot study involved one intervention and one control community. The interventions were developed and implemented in consultation with the community by empowering them for monitoring to ensure effectiveness of the intervention. The data were collected pre and post-intervention in both the gewogs through repeated cross-sectional surveys. Results: The practice of offering tshogchang decreased from about 99% to about 50% after the intervention. Practice of children drinking alcohol decreased by 6.83%. The average monthly spending on alcohol reduced from about Nu. 418 to about Nu. 97, and the amount of grains used for brewing decreased from about 34 Kg to 18 Kg, after the intervention. Conclusion: This study found that the community action is effective in bringing positive impacts in reducing harmful use of alcohol in community. Therefore, expansion of such community action in other communities in Bhutan with similiar context is strongly recommended..