Development of oral health policy in Nigeria: an analysis of the role of context, actors and policy process

Etiaba, Enyi; Uguru, Nkoli; Ebenso, Bassey; Russo, Giuliano; Ezumah, Nkoli; Uzochukwu, Benjamin; Onwujekwe, Obinna

doi:10.1186/s12903-015-0040-8

Cited by 27 publications

(34 citation statements)

References 22 publications

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“…These factors, which have been reported in other studies [25], are essential in the development of policies for NCDs because they may improve adoption and implementation of policies [26, 27]. The strong political will exhibited for the development of the NCD strategic plan could have been as a result of the international commitments that Zambia signed to such as the Political Declaration of 2011 and local evidence of an emerging problem similar to what has been observed in other countries [19, 28, 29].…”

Section: Discussionsupporting

confidence: 69%

Responding to non-communicable diseases in Zambia: a policy analysis

Mukanu

Zulu

Mweemba

et al. 2017

Health Res Policy Sys

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BackgroundNon-communicable diseases (NCDs) are an emerging global health concern. Reports have shown that, in Zambia, NCDs are also an emerging problem and the government has begun initiating a policy response. The present study explores the policy response to NCDs by the Ministry of Health in Zambia using the policy triangle framework of Walt and Gilson.MethodsA qualitative approach was used for the study. Data collected through key informant interviews with stakeholders who were involved in the NCD health policy development process as well as review of key planning and policy documents were analysed using thematic analysis.ResultsThe government’s policy response was as a result of international strategies from WHO, evidence of increasing disease burden from NCDs and pressure from interest groups. The government developed the NCD strategic plan based on the WHO Global Action Plan for NCDs 2013–2030. Development of the NCD strategic plan was driven by the government through the Ministry of Health, who set the agenda and adopted the final document. Stakeholders participated in the fine tuning of the draft document from the Ministry of Health. The policy development process was lengthy and this affected consistency in composition of the stakeholders and policy development momentum. Lack of representative research evidence for some prioritised NCDs and use of generic targets and indicators resulted in the NCD strategic plan being inadequate for the Zambian context. The interventions in the strategic plan also underutilised the potential of preventing NCDs through health education. Recent government pronouncements were also seen to be conflicting the risk factor reduction strategies outlined in the NCD strategic plan.ConclusionThe content of the NCD strategic plan inadequately covered all the major NCDs in Zambia. Although contextual factors like international strategies and commitments are crucial catalysts to policy development, there is need for domestication of international guidelines and frameworks to match the disease burden, resources and capacities in the local context if policy measures are to be comprehensive, relevant and measurable. Such domestication should be guided by representative local research evidence.

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Section: Discussionsupporting

confidence: 69%

Responding to non-communicable diseases in Zambia: a policy analysis

Mukanu

Zulu

Mweemba

et al. 2017

Health Res Policy Sys

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“…The policy ‘process’, including the strategies for implementation at national and sub-national level, is affected by actors and their values, intentions and expectations; and the ‘content’ of a policy will be the result of any or all of the other dimensions. The model has been applied in analyses of various health policies including factors important in the scale-up of maternal and newborn health interventions [13], the development of oral health policy in Nigeria [14] and strengths and weaknesses of policy processes in maternal health in Vietnam, India and China [15]. In line with recent applications of the framework [16], we conducted a comprehensive analysis exploring the independent and mutual influences of context, actors and process on the development and implementation maternal death review policies in our case study countries.…”

Section: Methodsmentioning

confidence: 99%

Implementing maternal death surveillance and response: a review of lessons from country case studies

Smith

Ameh

Roos

et al. 2017

BMC Pregnancy Childbirth

139

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BackgroundMaternal Death Surveillance and Response (MDSR) implementation is monitored globally, but not much is known about what works well, where and why in scaling up. We reviewed a series of country case studies in order to determine whether and to what extent these countries have implemented the four essential components of MDSR and identify lessons for improving implementation.MethodsA secondary analysis of ten case studies from countries at different stages of MDSR implementation, using a policy analysis framework to draw out lessons learnt and opportunities for improvement. We identify the consistent drivers of success in countries with well-established systems for MDSR, and common barriers in countries were Maternal Death Review (MDR) systems have been less successful.ResultsMDR is accepted and ongoing at subnational level in many countries, but it is not adequately institutionalised and the shift from facility based MDR to continuous MDSR that informs the wider health system still needs to be made. Our secondary analysis of country experiences highlights the need for a) social and team processes at facility level, for example the existence of a ‘no shame, no blame’ culture, and the ability to reflect on practice and manage change as a team for recommendations to be acted upon, b) health system inputs including adequate funding and reliable health information systems to enable identification and analysis of cases c) national level coordination of dissemination, and monitoring implementation of recommendations at all levels and d) mandatory notification of maternal deaths (and enforcement of this) and a professional requirement to participate in MDRs.ConclusionsCase studies from countries with established MDSR systems can provide valuable guidance on ways to set up the processes and overcome some of the barriers; but the challenge, as with many health system interventions, is to find a way to provide catalytic assistance and strengthen capacity for MDSR such that this becomes embedded in the health system.

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“…Of the total number of registered dentists in the country, 86% are in Southern Nigeria compared with 14% in the North, although Northern Nigeria is more populous. This disproportionate distribution of oral health capacity in the country makes oral health awareness poor in Northern Nigeria, causing predilection for the development of preventable dental pathologies.…”

Section: Introductionmentioning

confidence: 99%

Roles of community pharmacists in improving oral health awareness in Plateau State, Northern Nigeria

Taiwo¹,

Panas

2018

International Dental Journal

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Introduction There is poor oral health awareness in Nigeria because of limited access to correct information on oral health as well as a lack of oral health‐care providers. The purpose of this study was to describe the roles of community pharmacists (CPs) in Plateau State, Northern Nigeria, as sources of oral health information in their communities. Methods A quantitative cross‐sectional study on CPs spanning the entire State. Data collection was a survey method using a structured paper‐based self‐administered questionnaire. Analysis, which included t‐tests and binary logistic regression, was carried out using SPSS ver. 23. Results A one‐sample t‐test to assess the attitudes of CPs on oral health showed that they had a very good disposition towards engaging in oral health services [advice, referrals, recommendations and basic treatment (e.g. of pain); mean = 4.54, standard deviation = 0.59, t(111) = 27.8, P < 0.001]. Although CPs presently provide some services to patients with oral health problems, 94.7% were willing to do more to advance the cause of oral health care. Training of CPs on oral health (32%), removal of restrictive policies in the health bill (1.8%) and sensitising the public (6.3%) were some suggestions on how to improve these services. Conclusion The disposition of CPs towards improving oral health could serve as a platform to help propagate oral health care and awareness in their communities. Engaging the CPs might help to reduce oral health disparities by increasing oral health awareness and improving the quality of life via cost‐effective delivery of pharmacy‐based oral health‐care services.

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Development of oral health policy in Nigeria: an analysis of the role of context, actors and policy process

Cited by 27 publications

References 22 publications

Responding to non-communicable diseases in Zambia: a policy analysis

Responding to non-communicable diseases in Zambia: a policy analysis

Implementing maternal death surveillance and response: a review of lessons from country case studies

Roles of community pharmacists in improving oral health awareness in Plateau State, Northern Nigeria

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