Assessing Malawi’s recent development of a National Oral Health Policy – learning for the future

Abstract

Background Policymakers in many low- and middle-income countries do not prioritize oral health and are inadequately informed about the burden of oral and maxillofacial problems, their connection with systemic health and the possible threat to human life. In Africa, the absence of oral health policies is a key problem contributing to increased oral disease burden, health workforce shortage, and inadequate oral health service provision. Context-relevant policies and research to determine needs and monitor progress are key components in eradicating oral health inequalities. This paper focuses on the work of Malawi to follow the direction of travel outlined at the 2021 World Health Assembly by developing its first National Oral Health Strategy and Implementation Plan. Methods A case study approach examined the processes followed by Malawi to develop its National Oral Health Policy, launched in April 2022. The aim was to understand how oral health policy is being developed within the context of an African country. Specifically, the objectives were to identify how oral health policy was being developed in Malawi and the contributors to the development of that policy. Qualitative data were collected from semi-structured interviews (n=8) of purposively selected key informants from the Malawi National Oral Health Policy Taskforce team involved in the policy creation. Data were analyzed in the thematic areas within the Health Policy Triangle of actors, context, processes, and content. Results The policy development process was guided by Malawi’s Ministry of Health and involved a diverse group of actors, both local and international. The funding of the policy development process by the Scottish Government and Borrow Foundation provided critical support. Five groups of stakeholders have conducted the relevant background investigations and written the Oral Health Policy: international development partners, academics, policy experts, dental practitioners, and civil society organizations. The partnership skill-sharing and well-managed dynamics of the group, together with the reliable funding base, all contributed to a successful outcome. Conclusions A multisectoral approach was used. Malawi is uniquely placed in its oral health policy development, having a solid stakeholder base (local and international) and resources to support the policy development and, partly, its implementation.

Barriers to and facilitators for the creation, dissemination, implementation, monitoring, and evaluation of oral health policies in the WHO Africa region: A scoping review protocol

“… 22 Our findings can also assist in designing cost-effective initiatives to overcome the barriers, optimizing resource utilization, and enabling the effective adoption and implementation of the WHO Global Oral Health Strategy. 23 …”

“…22 Our findings can also assist in designing cost-effective initiatives to overcome the barriers, optimizing resource utilization, and enabling the effective adoption and implementation of the WHO Global Oral Health Strategy. 23 Some limitations of this review relate to the complexity in nature, design, and availability of articles to be retrieved. For example, preliminary piloting of potentially eligible articles proved that barriers and facilitators are widely reported, often not explicitly labeled as such, and rarely supported with references or data.…”