Abstract
BackgroundAs the strategies proposed for oral health improvement in developed countries are not adapted for developing ones, this study aimed to identify the challenges of oral health policy implementation in Iran as a low-income developing country.MethodsThis qualitative study was conducted in 2019 in Iran as a middle-eastern developing country. The study population consisted of experts who had experience in oral health and were willing to participate in the study. Snowball sampling was used to select 12 participants for semi-structured interviews and saturation was achieved after 16 interviews. Guba and Lincoln criteria including credibility, transferability, confirmability and dependability were used to determine reliability and transparency, and finally a five-step framework analysis method was used to analyze the data.ResultsThe analysis of the interviews resulted in identification of 7 main themes that were categorized into 5 problems of policy implementation as proposed by the Matus framework. The main themes of executive and preventive challenges to implement oral health policies were categorized as organizational problems, the main themes of educational and resource challenges were situated as material problems, and the main themes of insurance, policy making and trusteeship challenges were considered as legal, policymaking and perspective.ConclusionThe implementation of oral health policies has faced some challenges. It seems that the national coverage of oral health and integration of these services in prevention and serious attention to the private sector can be considered as the most important strategies for achieving improved oral health in Iran.
Highlights
In spite of the World Health Organization (WHO) report for everyone’s health by 2000 as well as significant progress in many fields of public health, there has been little success in the prevention and improvement of oral health and the burden of diseases is increasing; this is referred to as the silent epidemic [1]
The present data analysis extracted from the interviews identified 7 main themes that are situated in the framework (Fig. 1)
The main themes of executive and preventive challenges to implement oral health policies were categorized as organizational problems, the main themes of educational and resource challenges were situated as material problems, and the main themes of insurance, policy making and trusteeship challenges were considered as the legal, policymaking and perspective categories according to the Matus framework (Fig. 1)
Summary
In spite of the World Health Organization (WHO) report for everyone’s health by 2000 as well as significant progress in many fields of public health, there has been little success in the prevention and improvement of oral health and the burden of diseases is increasing; this is referred to as the silent epidemic [1]. A study on the burden of diseases in 2017 showed that oral diseases affect. According to the latest National Oral Health Survey in 2012, the number of Decayed, Missed and Filled Teeth (DMFT) in children aged 5–6 years was 5.16 in the whole country. This index has been reported to be 4.94 and 5.78 in urban and rural areas, respectively [2]. Another national report showed that Iranian school children’s DMFT was twice the world’s standard [3]. As the strategies proposed for oral health improvement in developed countries are not adapted for developing ones, this study aimed to identify the challenges of oral health policy implementation in Iran as a lowincome developing country
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