Mpho Molete1, Aimee Stewart2, Aneesa Moolla1, Jude Ofuzinim Igumbor3. 1. School of Oral Health Sciences, Department of Community Dentistry, University of the Witwatersrand, Johannesburg, South Africa. 2. School of Therapeutic Sciences, University of the Witwatersrand, Johannesburg, South Africa. 3. School of Public Health, University of the Witwatersrand, Johannesburg, South Africa. jude.igumbor@wits.ac.za.
Abstract
BACKGROUND: Although school oral health programmes have been ongoing for years, there is little evidence to show how their policy elements are governed or translated into tangible implementation activities and population outcomes at the district level. The need for such a study is heightened by the persistent burden of oral health conditions and unmet oral treatment needs of South Africa's children. This study therefore sought to describe provincial and district level managers' perceptions of school oral health policy, and to identify gaps and conditions needed for successful policy implementation. METHODS: This was an exploratory qualitative study where eight oral health managers from the Gauteng provincial and district offices were purposively sampled. Data were collected using interviews and a policy review rubric. The 10 Siddiqi governance principles framework was used to guide the data analysis. RESULTS: The managers' perceptions and the policy document review indicated that national policy covered the principles of strategic vision, responsiveness to health needs, equity and inclusivity with clarity; however these principles were not translated consistently by the managers at a local level. Policy gaps were identified in the areas of stakeholder involvement, accountability, reliable information systems and ethical guidelines. Much of the gaps in policy translation were attributed to inadequate human resources and poor communication processes by the national leadership to support district level implementation. CONCLUSIONS: There were inconsistencies in policy awareness and translation in the districts and hence an in-depth review of the policy translation gaps is paramount to its efficient resolution in the context of resource and capacity limitations. Furthermore, optimizing multi-sectoral participation and identifying shared, novel and practical solutions to policy translation impediments is necessary.
BACKGROUND: Although school oral health programmes have been ongoing for years, there is little evidence to show how their policy elements are governed or translated into tangible implementation activities and population outcomes at the district level. The need for such a study is heightened by the persistent burden of oral health conditions and unmet oral treatment needs of South Africa's children. This study therefore sought to describe provincial and district level managers' perceptions of school oral health policy, and to identify gaps and conditions needed for successful policy implementation. METHODS: This was an exploratory qualitative study where eight oral health managers from the Gauteng provincial and district offices were purposively sampled. Data were collected using interviews and a policy review rubric. The 10 Siddiqi governance principles framework was used to guide the data analysis. RESULTS: The managers' perceptions and the policy document review indicated that national policy covered the principles of strategic vision, responsiveness to health needs, equity and inclusivity with clarity; however these principles were not translated consistently by the managers at a local level. Policy gaps were identified in the areas of stakeholder involvement, accountability, reliable information systems and ethical guidelines. Much of the gaps in policy translation were attributed to inadequate human resources and poor communication processes by the national leadership to support district level implementation. CONCLUSIONS: There were inconsistencies in policy awareness and translation in the districts and hence an in-depth review of the policy translation gaps is paramount to its efficient resolution in the context of resource and capacity limitations. Furthermore, optimizing multi-sectoral participation and identifying shared, novel and practical solutions to policy translation impediments is necessary.
Entities:
Keywords:
Governance; Oral health; Policy implementation; School health
Authors: Sameen Siddiqi; Tayyeb I Masud; Sania Nishtar; David H Peters; Belgacem Sabri; Khalif M Bile; Mohamed A Jama Journal: Health Policy Date: 2008-10-05 Impact factor: 2.980
Authors: Laura J Damschroder; David C Aron; Rosalind E Keith; Susan R Kirsh; Jeffery A Alexander; Julie C Lowery Journal: Implement Sci Date: 2009-08-07 Impact factor: 7.327
Authors: Nawaraj Upadhaya; Mark J D Jordans; Ruja Pokhrel; Dristy Gurung; Ramesh P Adhikari; Inge Petersen; Ivan H Komproe Journal: Int J Ment Health Syst Date: 2017-06-08