WHO/AFRO and FDI 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.
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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 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
Prof Poul Erik Petersen, WHO Global Oral Health Programme
Prof John Clarkson, International Association for Dental Research
(IADR)
Prof Newell Johnson, FDI Science Commission
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 [+]
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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.
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)
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