Oral health policymaking challenges in Iran: a qualitative approach

Abstract

Background 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 low-income developing country. Methods This 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. Results The 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. Conclusion The 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.

Provision of dental services for vulnerable groups: a scoping review on children with special health care needs

“…According to the present results, review findings, need assessment is an important input for policy advice. Evidence shows that those countries that suffer apparent and need-based policies in the area of oral and dental health, specialy for the high-risk groups can not achieve the oral health goals for the whole community in general and the high-risk groups in a particular perspective [ 64 ]. Ghanbarzadegan et al, (2021) have mentioned policy formulation and policy implementation as two determinants of inequality in the provision of dental services.…”

Socioeconomic Disparities in Iranians’ Preferences toward Dental Care Services: A Population-Based Survey

“…As mentioned, insurance coverage and health insurance plans affect the patient oral health utilization. Some developed countries have uniform tariff policies in the private and public sectors, and their insurance plans cover various dental services, which significantly promote dental care utilization [ 14 ].…”

“…Income and knowledge about preventive services associated with their preferences [ 15 ]. Preventive care is often ignored in low-income and developing countries, posing a tremendous economic burden [ 14 ]. There is no comprehensive evidence on patient preferences for dental care in Iran, and several questions have remained unanswered.…”

What makes inequality in the area of dental and oral health in developing countries? A scoping review

“…According to what was said, although the indications of inequality in dental services has been reported in many communities, the challenge is much more highlighted among low- and middle-income countries. According to the evidences, many inconsistency and knowledge gaps are obvious in the area of oral policies among these countries [ 11 , 12 ] that make the national, local and regional policy makers pay more attention to this area. In another words, to the best of our knowledge, although many contents are considered a single or multiple cause of inequality in the area of oral and dental health, a scoping review in the context of low and middle income developing countries is not presented.…”