Comparing oral health systems for children in six European countries to identify lessons learned for universal oral health coverage: A study protocol.

Úna Mcauliffe,Máiréad Harding,Shauna Barrett,Jodi Cronin,Sara Burke,Kenneth Eaton,Helen Whelton,Noel Woods

doi:10.12688/hrbopenres.13458.1

Abstract

Background:Oral diseases have the highest global prevalence rate among all diseases, with dental caries being one of the most common conditions in childhood. A low political priority coupled with a failure to incorporate oral health within broader health systems has contributed to its neglect in previous decades. In response, calls are emerging for the inclusion of oral health within the universal healthcare domain (UHC). This protocol outlines the methodology for a cross-country comparative analysis of publicly funded oral health systems for children across six European countries, reporting on oral health status in line with the indicators for UHC. Methods:This study will follow Yin's multiple case study approach and employ two strands of data collection, analysis, and triangulation: a systematic documentary analysis and semi-structured interviews with elite participants local to each country. The countries chosen for comparison and providing a representative sample of European dental systems are Denmark, Hungary, the Republic of Ireland, Germany, Scotland, and Spain. A systematic search of five electronic databases and four additional electronic resources will be undertaken, in addition to grey literature and other publicly available sources, with the outcomes verified and further informed by local experts. The WHO Universal Health Coverage Cube will be used to guide data collection and analysis. Conclusions:This research will provide policy makers with an in-depth analysis and comparison of publicly funded oral health systems for children in Europe, including consideration of effective preventive strategies, oral health system reform, and indicators of universal oral health coverage. It is anticipated that the outcomes may help in positioning oral health on governmental health agendas and support its integration into wider health systems' reform in an accessible and affordable manner.

Highlights

Oral diseases, despite being largely preventable, are among the most prevalent non-communicable diseases globally (World Health Organization, 2020)
People are impacted from childhood to adolescence, adulthood and into later life with little improvement of the situation over the past two decades (World Health Organization, 2020)
To describe and compare publicly funded oral health systems for children under age 18 across the six chosen countries, each model will be described according to the three core features of the WHO Coverage Cube Framework (World Health Organization, 2010): (i) breadth, i.e., child populations (0–18 years) eligible for publicly funded oral health programs; (ii) depth, i.e., the share of the total costs that are borne by the government/public payer; and (iii) scope, i.e., the range of services covered under publicly funded oral healthcare programs (Figure 1)

Summary

Introduction

Despite being largely preventable, are among the most prevalent non-communicable diseases globally (World Health Organization, 2020). In addition to causing pain and infection, caries significantly impact children’s social and psychological wellbeing, along with their quality of life (BaniHani et al, 2018; Peres et al, 2019). It is associated with reduced school attendance, impaired speech development and can result in lower body weight and height (Jackson et al, 2011; Sheiham, 2006). Calls are emerging for the inclusion of oral health within the universal healthcare domain (UHC) This protocol outlines the methodology for a cross-country comparative analysis of publicly funded oral health systems for children across six European countries, reporting on oral health status in line with the indicators for UHC. A systematic search of five electronic databases and four additional electronic resources will be undertaken, in addition to grey literature and other publicly available sources, with article can be found at the end of the article

Objectives

Methods

Findings

Conclusion