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Published in: BMC Oral Health 1/2020

Open Access 01-12-2020 | Research article

Oral health policymaking challenges in Iran: a qualitative approach

Authors: Mohammadtaghi Mohammadpour, Peivand Bastani, David Brennan, Arash Ghanbarzadegan, Jamshid Bahmaei

Published in: BMC Oral Health | Issue 1/2020

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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.
Footnotes
1
P1 stands for participant number 1. We use the numbers to maintain participant confidentiality
 
Literature
1.
go back to reference Dental, N.I.o. and C. Research, Oral health in America: a report of the Surgeon General. 2000: US public health service, Department of Health and Human Services. Dental, N.I.o. and C. Research, Oral health in America: a report of the Surgeon General. 2000: US public health service, Department of Health and Human Services.
2.
go back to reference Vos T, et al. Global, regional, and national incidence, prevalence, and years lived with disability for 328 diseases and injuries for 195 countries, 1990–2016: a systematic analysis for the global burden of disease study 2016. Lancet. 2017;390(10100):1211–59.CrossRef Vos T, et al. Global, regional, and national incidence, prevalence, and years lived with disability for 328 diseases and injuries for 195 countries, 1990–2016: a systematic analysis for the global burden of disease study 2016. Lancet. 2017;390(10100):1211–59.CrossRef
3.
go back to reference Sajadi FS, Mosharafian S, Torabi M, Hajmohamadi S. Evaluation of DMFT index and significant caries index in 12-year-old students in Sirjan, Kerman. Isfahan Dentistry School J. 2014;10(4):290–8 [In Percian]. Sajadi FS, Mosharafian S, Torabi M, Hajmohamadi S. Evaluation of DMFT index and significant caries index in 12-year-old students in Sirjan, Kerman. Isfahan Dentistry School J. 2014;10(4):290–8 [In Percian].
4.
go back to reference Jadidfard M-P, Yazdani S, Khoshnevisan M-H. Social insurance for dental care in Iran: a developing scheme for a developing country. Oral Health Dent Manag. 2012;11(4):189–98.PubMed Jadidfard M-P, Yazdani S, Khoshnevisan M-H. Social insurance for dental care in Iran: a developing scheme for a developing country. Oral Health Dent Manag. 2012;11(4):189–98.PubMed
5.
go back to reference Bastani P, et al. Qualitative analysis of national documents on health care services and pharmaceuticalspurchasing challenges: evidence from Iran. BMC Health Serv Res. 2018;18(1):410.CrossRef Bastani P, et al. Qualitative analysis of national documents on health care services and pharmaceuticalspurchasing challenges: evidence from Iran. BMC Health Serv Res. 2018;18(1):410.CrossRef
6.
go back to reference Association, L.G. Tackling poor oral health in children. London: Local Government Association; 2016. Association, L.G. Tackling poor oral health in children. London: Local Government Association; 2016.
7.
go back to reference Locker D. Measuring oral health: a conceptual framework. Community Dent Health. 1988;5:3–18. Locker D. Measuring oral health: a conceptual framework. Community Dent Health. 1988;5:3–18.
8.
go back to reference Patrick, D.L., et al. Reducing oral health disparities: a focus on social and cultural determinants. In BMC oral health. 2006. BioMed Central. Patrick, D.L., et al. Reducing oral health disparities: a focus on social and cultural determinants. In BMC oral health. 2006. BioMed Central.
9.
go back to reference Newton JT, Bower EJ. The social determinants of oral health: new approaches to conceptualizing and researching complex causal networks. Community Dent Oral Epidemiol. 2005;33(1):25–34.CrossRef Newton JT, Bower EJ. The social determinants of oral health: new approaches to conceptualizing and researching complex causal networks. Community Dent Oral Epidemiol. 2005;33(1):25–34.CrossRef
10.
go back to reference Azline A, Khairul AA, Iszaid I, Syahira S, Hisham AA. Muhamad Hanafiah Juni. Policy arena of health policy-making process in developing countries. Int J Public Health Clin Sci. 2018;5(3):32–48. Azline A, Khairul AA, Iszaid I, Syahira S, Hisham AA. Muhamad Hanafiah Juni. Policy arena of health policy-making process in developing countries. Int J Public Health Clin Sci. 2018;5(3):32–48.
11.
go back to reference Matus C. Política, planejamento e governo. Brasília: Intituto de Pesquisa Econômica Aplicada. (IPEA); 1996. Matus C. Política, planejamento e governo. Brasília: Intituto de Pesquisa Econômica Aplicada. (IPEA); 1996.
12.
go back to reference Petersen PE. World Health Organization global policy for improvement of oral health-world health assembly 2007. Int Dent J. 2008;58(3):115–21.CrossRef Petersen PE. World Health Organization global policy for improvement of oral health-world health assembly 2007. Int Dent J. 2008;58(3):115–21.CrossRef
13.
go back to reference subcommittee, A.A.o.P.D.C.A.C.-P.T., American Academy on Pediatric Dentistry Council on Clinical Affairs: Guideline on pulp therapy for primary and young permanent teeth. Pediatr. Dent., 2009. 30(7): p. 170–174. subcommittee, A.A.o.P.D.C.A.C.-P.T., American Academy on Pediatric Dentistry Council on Clinical Affairs: Guideline on pulp therapy for primary and young permanent teeth. Pediatr. Dent., 2009. 30(7): p. 170–174.
14.
go back to reference Yamalik N, et al. Oral health workforce planning part 2: figures, determinants and trends in a sample of W orld D ental F ederation member countries. Int Dent J. 2014;64(3):117–26.CrossRef Yamalik N, et al. Oral health workforce planning part 2: figures, determinants and trends in a sample of W orld D ental F ederation member countries. Int Dent J. 2014;64(3):117–26.CrossRef
15.
go back to reference Williams DM, Mossey PA, Mathur MR. Leadership in global oral health. J Dent. 2019;87:49–54.CrossRef Williams DM, Mossey PA, Mathur MR. Leadership in global oral health. J Dent. 2019;87:49–54.CrossRef
16.
go back to reference Montazeri R, Sadeghi F, Heidari A. Parental assessment of access and barriers to access to Oral and dental health Services in Children Referring to dentistry centers inTehran City, 2018,(Iran). Qom University Med Sci J. 2019;13(7):42–52.CrossRef Montazeri R, Sadeghi F, Heidari A. Parental assessment of access and barriers to access to Oral and dental health Services in Children Referring to dentistry centers inTehran City, 2018,(Iran). Qom University Med Sci J. 2019;13(7):42–52.CrossRef
17.
go back to reference Ryan F, Coughlan M, Cornin P. Interviewing in qualitative research: the one to one interview. Int J Ther Rehabil. 2009;16(6):309–14.CrossRef Ryan F, Coughlan M, Cornin P. Interviewing in qualitative research: the one to one interview. Int J Ther Rehabil. 2009;16(6):309–14.CrossRef
18.
go back to reference Gale NK, et al. Using the framework method for the analysis of qualitative data in multi-disciplinary health research. BMC Med Res Methodol. 2013;13(1):117.CrossRef Gale NK, et al. Using the framework method for the analysis of qualitative data in multi-disciplinary health research. BMC Med Res Methodol. 2013;13(1):117.CrossRef
19.
go back to reference Guba EG, Lincoln YS. Competing paradigms in qualitative research. Handbook Qualitative Res. 1994;2(163–194):105. Guba EG, Lincoln YS. Competing paradigms in qualitative research. Handbook Qualitative Res. 1994;2(163–194):105.
20.
go back to reference Etiaba E, et al. Development of oral health policy in Nigeria: an analysis of the role of context, actors and policy process. BMC Oral Health. 2015;15(1):56.CrossRef Etiaba E, et al. Development of oral health policy in Nigeria: an analysis of the role of context, actors and policy process. BMC Oral Health. 2015;15(1):56.CrossRef
21.
go back to reference Kwon S. Health care financing in Asia: key issues and challenges. Asia Pacific J Public Health. 2011;23(5):651–61.CrossRef Kwon S. Health care financing in Asia: key issues and challenges. Asia Pacific J Public Health. 2011;23(5):651–61.CrossRef
22.
go back to reference Tomar SL, Cohen LK. Attributes of an ideal oral health care system. J Public Health Dent. 2010;70:S6–S14.CrossRef Tomar SL, Cohen LK. Attributes of an ideal oral health care system. J Public Health Dent. 2010;70:S6–S14.CrossRef
23.
go back to reference Saekel R. Comparison of oral health status in Asia: results for eight emerging and five high income countries or regions and implications. Chinese J Dental Res. 2016;19(4):191–206. Saekel R. Comparison of oral health status in Asia: results for eight emerging and five high income countries or regions and implications. Chinese J Dental Res. 2016;19(4):191–206.
24.
go back to reference Knevel R, Gussy M, Farmer J. Exploratory scoping of the literature on factors that influence oral health workforce planning and management in developing countries. Int J Dent Hyg. 2017;15(2):95–105.CrossRef Knevel R, Gussy M, Farmer J. Exploratory scoping of the literature on factors that influence oral health workforce planning and management in developing countries. Int J Dent Hyg. 2017;15(2):95–105.CrossRef
25.
go back to reference McHarg J, Kay E. The anatomy of a new dental curriculum. Br Dent J. 2008;204(11):635.CrossRef McHarg J, Kay E. The anatomy of a new dental curriculum. Br Dent J. 2008;204(11):635.CrossRef
26.
go back to reference McHarg J, Kay E. Designing a dental curriculum for the twenty-first century. Br Dent J. 2009;207(10):493.CrossRef McHarg J, Kay E. Designing a dental curriculum for the twenty-first century. Br Dent J. 2009;207(10):493.CrossRef
27.
go back to reference Addo, M., P. Batchelor, and A. Sheiham, Options for types of dental health personnel to train for Ghana. Ghana Med J, 2006. 40(3). Addo, M., P. Batchelor, and A. Sheiham, Options for types of dental health personnel to train for Ghana. Ghana Med J, 2006. 40(3).
28.
go back to reference Peeran SW, et al. Oral health in Libya: addressing the future challenges. Libyan J Med. 2014;9(1):23564.CrossRef Peeran SW, et al. Oral health in Libya: addressing the future challenges. Libyan J Med. 2014;9(1):23564.CrossRef
29.
go back to reference Fu Y, et al. Perspectives on dental education in mainland China. Int Dent J. 2006;56(5):265–71.CrossRef Fu Y, et al. Perspectives on dental education in mainland China. Int Dent J. 2006;56(5):265–71.CrossRef
30.
go back to reference Services, I.o.M.D.o.H.C., Public policy options for better dental health: report of a study. Vol. 80. 1980: National Academies. Services, I.o.M.D.o.H.C., Public policy options for better dental health: report of a study. Vol. 80. 1980: National Academies.
31.
go back to reference Zaitsu T, Saito T, Kawaguchi Y. The Oral Healthcare System in Japan. Healthcare (Basel, Switzerland). 2018;6(3):79. Zaitsu T, Saito T, Kawaguchi Y. The Oral Healthcare System in Japan. Healthcare (Basel, Switzerland). 2018;6(3):79.
32.
go back to reference Šiljak S, et al. Dental service utilisation among adults in a European developing country: findings from a national health survey. Int Dent J. 2019. Šiljak S, et al. Dental service utilisation among adults in a European developing country: findings from a national health survey. Int Dent J. 2019.
33.
go back to reference Bhatti T, Rana Z, Grootendorst P. Dental insurance, income and the use of dental care in Canada. J Can Dent Assoc. 2007;73(1):57.PubMed Bhatti T, Rana Z, Grootendorst P. Dental insurance, income and the use of dental care in Canada. J Can Dent Assoc. 2007;73(1):57.PubMed
34.
go back to reference Folayan MO, et al. Screening children for caries: an ethical dilemma in Nigeria. New Bioethics. 2018;24(2):135–49.CrossRef Folayan MO, et al. Screening children for caries: an ethical dilemma in Nigeria. New Bioethics. 2018;24(2):135–49.CrossRef
35.
go back to reference Freitas DJ, et al. Oral health and access to dental care among older homeless adults: results from the HOPE HOME study. J Public Health Dent. 2019;79(1):3–9.CrossRef Freitas DJ, et al. Oral health and access to dental care among older homeless adults: results from the HOPE HOME study. J Public Health Dent. 2019;79(1):3–9.CrossRef
36.
go back to reference Daly B, et al. Oral health care needs and oral health-related quality of life (OHIP-14) in homeless people. Community Dent Oral Epidemiol. 2010;38(2):136–44.CrossRef Daly B, et al. Oral health care needs and oral health-related quality of life (OHIP-14) in homeless people. Community Dent Oral Epidemiol. 2010;38(2):136–44.CrossRef
37.
go back to reference AbouZahr C, Boerma T. Health information systems: the foundations of public health. Bull World Health Organ. 2005;83:578–83.PubMedPubMedCentral AbouZahr C, Boerma T. Health information systems: the foundations of public health. Bull World Health Organ. 2005;83:578–83.PubMedPubMedCentral
38.
go back to reference Tahani B. Stewardship of National Oral Health system in Iran: its strengths and weaknesses. Archives Iran Med. 2013;16(12):717. Tahani B. Stewardship of National Oral Health system in Iran: its strengths and weaknesses. Archives Iran Med. 2013;16(12):717.
Metadata
Title
Oral health policymaking challenges in Iran: a qualitative approach
Authors
Mohammadtaghi Mohammadpour
Peivand Bastani
David Brennan
Arash Ghanbarzadegan
Jamshid Bahmaei
Publication date
01-12-2020
Publisher
BioMed Central
Published in
BMC Oral Health / Issue 1/2020
Electronic ISSN: 1472-6831
DOI
https://doi.org/10.1186/s12903-020-01148-w

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