Bahareh Tahani1, Mohammad Hossein Khoshnevisan2, Shahram Yazdani3, Arezoo Ebn Ahmady4, Paul Dugdale5. 1. Department of Community Oral Health, Shahid Beheshti University of Medical Science, Tehran, Iran. Tahani@dnt.mui.ac.ir. 2. Department of Community Oral Health, and Director, Preventive Dentistry Research Center. Shahid-Beheshti University of Medical Sciences, Tehran, Iran. 3. Educational Development Center, Shahid Beheshti University of Medical Science, Tehran, Iran. 4. Department of Community Oral Health, Shahid Beheshti University of Medical Science, Tehran, Iran. 5. Centre for Health Stewardship, Australian National University, Canberra, Australia.
Abstract
AIMS: In this study, we assess the strengths, challenges and opportunities regarding the oral health system stewardship in Iran. METHODS: A mixed methodology was used, comprised of a quantitative questionnaire using the functional standards, semi structured interviews with key stakeholders and document review. The level of current attainments of each standard was determined based on a Likert-type scale. Literature review was completed to find official documents of national organizations. RESULTS: The responsibility of policy development of oral health care at the national level mostly falls on the Oral Health Bureau. This office has formulated a strategic plan for its policy-making and has considered the required capacity to implement them. However, the Bureau has some problems in enforcing its regulatory framework, especially in the private sector. There are rigorous problems in managing information and using them for evidence-based decision making. Setting and allocation of operational budgets for implementing the policies is only partially attained, as is monitoring and evaluating the performance. CONCLUSIONS: While the Ministry of Health and Medical Education has achieved some stewardship measures, it still needs further improvements in the oral health system. It needs to strengthen its information system and its executive capacity to implement the proposed regulations. The Ministry must improve accountability in the oral health system, especially the provider accountability.
AIMS: In this study, we assess the strengths, challenges and opportunities regarding the oral health system stewardship in Iran. METHODS: A mixed methodology was used, comprised of a quantitative questionnaire using the functional standards, semi structured interviews with key stakeholders and document review. The level of current attainments of each standard was determined based on a Likert-type scale. Literature review was completed to find official documents of national organizations. RESULTS: The responsibility of policy development of oral health care at the national level mostly falls on the Oral Health Bureau. This office has formulated a strategic plan for its policy-making and has considered the required capacity to implement them. However, the Bureau has some problems in enforcing its regulatory framework, especially in the private sector. There are rigorous problems in managing information and using them for evidence-based decision making. Setting and allocation of operational budgets for implementing the policies is only partially attained, as is monitoring and evaluating the performance. CONCLUSIONS: While the Ministry of Health and Medical Education has achieved some stewardship measures, it still needs further improvements in the oral health system. It needs to strengthen its information system and its executive capacity to implement the proposed regulations. The Ministry must improve accountability in the oral health system, especially the provider accountability.