Abstract
BackgroundThere is limited understanding of the complexities surrounding public oral health service delivery in South Africa and the resulting impact on oral health outcomes.AimThis study aimed to identify the strengths and challenges in oral health decision-making within the public health sector and to propose a conceptual framework to guide oral health service delivery in the province.SettingThis study was performed in the Limpopo province.MethodsNational and provincial health policy documents were reviewed to identify statements on oral health service delivery. A face-to-face, semi-structured interview was conducted with the Limpopo Provincial Manager of Department of Health, Oral Health Services. Data were collected on oral health policies and the organisational structure of public oral health services. A self-administered questionnaire was completed by five district managers of public oral health services to obtain data on the delivery of public oral health services in Limpopo province.ResultsThe results indicated that oral healthcare was not explicitly mentioned, included or referred to in the examined health policy documents. The interviews indicated that public oral health services do not have a dedicated budget and were not considered a priority. The questionnaire results revealed challenges in infrastructure, human resources and perceived marginalisation from the healthcare services. Participants agreed that there was a need for oral health to be clearly expressed and prioritised in health policy statements.ConclusionThis study proposed a framework that incorporated the identified core components that influenced oral health services provision in Limpopo province.
Highlights
BackgroundDespite the provision of free public oral health services in primary healthcare facilities within the Department of Health in Limpopo Province, South Africa (Department of Health 2015), common oral diseases, such as dental caries and periodontal disease, continue to impact the general health of individuals (Van Wyk & Van Wyk 2004)
The results suggested a non-prioritisation of oral health, lack of implemented oral health policy and lack of dedicated budget for oral health
This finding is consistent with Singh et al (2010), who reported that oral health policy, planning and implementation were not consistent in all provinces in South Africa
Summary
Despite the provision of free public oral health services in primary healthcare facilities within the Department of Health in Limpopo Province, South Africa (Department of Health 2015), common oral diseases, such as dental caries and periodontal disease, continue to impact the general health of individuals (Van Wyk & Van Wyk 2004). The oral health implications of communicable and non-communicable diseases are well documented, the resulting effect being an increased burden on public health services (Petersen 2008). The Limpopo Provincial Health Department has made concerted efforts through policy and planning endeavours to improve oral health services, and there is commitment to ensure the availability of health services that are closely located to the communities served (Department of Health 2015); many challenges still exist. There is limited understanding of the complexities surrounding public oral health service delivery in South Africa and the resulting impact on oral health outcomes
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