Health Policy Development
WHO/AFRO and FDI World Dental Federation release report on standardisation of oral health information
With or without an oral health policy, there is a need to evaluate the level of oral health in a country before steps can be taken to improve it or before embarking on a programme of research to identify the specific determinants of oral health in a specific setting in order to establish programmes for the prevention of oral diseases. In most cases these determinants are the same as for other chronic diseases; therefore, an integrated approach is necessary.
Download Report
Standardization of Oral Health Information in the African Region (.pdf, 2MB)
Good quality information is essential for the planning and implementation of health policies in all countries. Surveillance is also necessary to provide ongoing collection, analysis, interpretation and dissemination of population health data. Properly conducted, surveillance ensures that countries have the information that they need to fight an epidemic or plan strategies to prevent disease and adverse health events in the future.
WHO/AFRO organised a workshop with the objective to develop a framework for information for oral health that would help professionals promote and improve oral health in the African Region. The resulting report was financed by the FDI and defines basic standard indicators for oral health that are recommended for use throughout the WHO/AFRO Region.
Global Goals for Oral Health by 2020
The objective of any health strategy is to improve health. Defining, in measurable terms, what aspects of health and by what extent it is hoped to improve specific health indicators, focuses the purpose of any health policy activity. Recently the FDI World Dental Federation (FDI), the World Health Organization (WHO) and the International Association for Dental Research (IADR) embarked on preparing goals for the new millennium to be achieved by the year 2020.
Additional Information
Background
The FDI World Dental Federation and the WHO established the first Global Oral Health Goals jointly in 1981 to be achieved by the year 2000. A review of these goals, carried out just prior to the end of this period, established that they had been useful and, for many populations, had been achieved or exceeded. However, for a significant proportion of the world's population, they remained only a remote aspiration. Nonetheless, the Oral Health Goals had stimulated awareness of the importance of oral health amongst national and local governments and acted as catalyst for securing resources for oral health in general. Therefore, even though not all countries had achieved the goals, they provided a key focus for the efforts
Process
The members of the joint FDI/IADR/WHO working group were:
- Prof Martin Hobdell, Chairman, FDI World Dental Federation
- Prof Poul Erik Petersen, WHO Global Oral Health Programme
- Prof John Clarkson, International Association for Dental Research (IADR)
- Prof Newell Johnson, FDI Science Committee
Prior to the final agreement, drafts of the proposed goals had been circulated to all National Dental Associations (NDA's) which were member associations of the FDI and also placed on the global Dental Public Health list serve for comment. All WHO Collaborating Centres in Oral Health (WHOCC) and the IADR were consulted as well. Responses received from NDAs, IADR, WHOCC as well as those from individuals were subsequently incorporated into the final document. This joint activity was completed in September 2003.
Aims
The Global Oral Health Goals are listed under three headings in increasing order of detail and complexity as: goals, objectives and targets. The aim is to provide a framework for health policy makers at different levels – regional, national and local. They are not intended to be prescriptive. By being focused broadly on the global level, it is hoped that it will encourage local action in the spirit of the United Nations Development Programme's report: ‘Think globally act locally'. Thus, the document provides an instrument for local and national health care planners to specify realistic goals and standards for oral health to be achieved by the year 2020.
The process of formulating a regional, national or local oral health strategy necessitates many stages. This document provides the first step in that process by guiding health planners to evaluate the current situation of oral health and set oral health goals, objectives and targets on the basis of local circumstances such as the adequacy of the information base, local priorities and oral health systems, as well as disease prevalence and severity and socio-environmental conditions.
Each situation will be different not only in so far as the epidemiology of oral diseases, but also with regard to the political, socio-economic, cultural and legislative context. It will require detailed knowledge of the prevailing circumstances and the significant determinants of oral health. This knowledge is crucial to the development of policies, which address not only the immediate known risk factors but also help create a social, legislative and economic environment that is conducive to good oral health.
The following are the Global Goals and Objectives, the targets, which cover a number of important oral conditions and other matters are not given in detail because the need to consider the local context will determine exactly what they should be and how they should be specified.
Goals
- To minimize the impact of diseases of oral and craniofacial origin on health and psychosocial development, giving emphasis to promoting oral health and reducing oral disease amongst populations with the greatest burden of such conditions and diseases;
- To minimize the impact of oral and craniofacial manifestations of systemic diseases on individuals and society, and to use these manifestations for early diagnosis, prevention and effective management of systemic diseases.
Objectives
- To reduce mortality from oral and craniofacial diseases;
- To reduce morbidity from oral and craniofacial diseases and thereby increase the quality of life;
- To promote sustainable, priority-driven policies and programmes in oral health systems that have been derived from systematic reviews of best practices (i.e. the policies are evidence-based);
- To develop accessible cost-effective oral health systems for the prevention and control of oral and craniofacial diseases;
- To integrate oral health promotion and care with other sectors that influence health, using the common risk factor approach;
- To develop oral health programmes that will empower people to control determinants of health;
- To strengthen systems and methods for oral health surveillance, both processes and outcomes;
- To promote social responsibility and ethical practices of care givers;
- To reduce disparities in oral health between different socio-economic groups within country and inequalities in oral health across countries;
- To increase the number of health care providers who are trained in accurate epidemiological surveillance of oral diseases and disorders.
Targets by the year 2020
The following areas should be considered when establishing Oral Health related targets:
- Pain
- Functional disorders
- Infectious diseases
- Oro-pharyngeal cancer
- Oral Manifestations of HIV infection
- Noma
- Trauma
- Craniofacial anomalies
- Dental caries
- Developmental anomalies of teeth
- Periodontal diseases
- Oral mucosal diseases
- Salivary gland disorders
- Tooth loss
- Health care services
- Health care information system
Further information
Download the joint FDI/IADR/WHO statement that was endorsed by the FDI's General Assembly in Sydney 2003.
Download the related publication in the International Dental Journal (.pdf, 488KB)
Rwanda Oral Health Policy
Development of a National Oral Health Policy - The engagement of the FDI in the process of health policy formulation is an example of advocacy for better oral health. The activities are direct result of previous project of the World Dental Development Fund that resulted in important baseline data on oral health in the country.
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Background: Oral health in Rwanda
In most African countries one of the major barriers to the improvement of oral health is the absence of a clear policy strategy on oral health that guides oral health activities. Previous approaches in the majority of countries have consisted in the provision of unplanned, ad hoc and spasmodic curative dental services. There is a compelling need for technical assistance in formulating policies capable of ensuring proper planning, management and evaluation of oral health care programmes.
In 1999 the Association des Chirurgiens Dentistes du Rwanda (ARCD) approached the FDI World Dental Development Fund for assistance in a conducting a basic survey of oral health needs of children. The survey was carried out by the end of 2003 and demonstrated that over 60% of children suffered from dental pain. For adults, the situation is exacerbated by other conditions such as trauma, oral manifestations of HIV/AIDS and oral cancer.
Resulting from the survey and the regular advocacy activities undertaken by WHO/AFRO and the FDI World Dental Federation, as well as the National Dental Association (ACDR), a special meeting on oral health in Rwanda was organised during the Nairobi Planning Conference for Oral Health, in April 2004. It was decided to embark on the process of developing a comprehensive National Oral Health Plan. Such a plan would be the basis for any future activity with regards to oral health in the country. The Minister of Health and his administration were in full support of this process.
Indeed, Rwanda has never had a statement on oral health policy. Taking into account the challnging context of the country, there is the clear mandate to help oral health managers in Rwanda to select the most appropriate policy, programmes and specific oral health interventions. Rwanda has a population of 8 million - but only 11 dentists.
A first ever national workshop on oral health, jointly organised by the Ministry of Health in Rwanda, the WHO Regional Office in Congo and the FDI was held in February in Kigali, capital of Rwanda. Prof Martin Hobdell, member of the World Dental Development and Health Promotion Committee, facilitated the event.
The purpose of the workshop was to develop a draft framework for a National Oral Health Policy and to get participation and ownership of the policy from all national stakeholders. The event was a great success with the Minister of Health, Dr Ntawukuliryayo, participating and an overwhelming level of involvement from all present. Dr Ntawukuliryayo said that the ministry gives high priority to the management of non-communicable diseases, including oral health. He further mentioned that in Rwanda oral health is a public health concern according to oral health needs expressed by the population. All who participated in the workshop were optimistic that a detailed legal and policy framework for oral health and the practice of dentistry in Rwanda would be ready within 2 years.
The workshop participants decided on the oral health priorities being: caries, periodontal diseases, trauma, oral manifestations of HIV infection, tumours, congenital malformations and harmful practices. It was also agreed that the strategic approaches would need to take some basic principles into account: prevention, integration of oral health and general health, training and installation of oral health personnel at all levels of the health system, as well as the development of new and the rehabilitation of existing oral health care facilities. To make affordable, accessible, appropriate and safe oral care available for all communities in Rwanda is the vision of the process that has now been successfully initiated.
Press Releases
Second workshop to address oral health opens in Rwanda (English)
Deuxième colloque sur la santé bucco-dentaire au Rwanda (French)
First forum to address oral health opens in Rwanda (English)
Le premier colloque sur la santé bucco-dentaire s'ouvre au Rwanda (French)
Workshop Report
National Workshop in Kigali / February 2005 (.pdf, 2.6MB)
Rapport de l'atelier national de Kigali / Février 2005 (.pdf, 2.7MB)