Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran.
Health Human Recourses Research Center, School of Health Management and Medical Informatics, Shiraz University of Medical Sciences, Shiraz, Iran.
BMC Oral Health. 2020 Jun 1;20(1):158. doi: 10.1186/s12903-020-01148-w.
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.
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.
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.
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.
由于发达国家提出的改善口腔健康的策略并不适用于发展中国家，因此本研究旨在确定伊朗作为一个低收入发展中国家实施口腔卫生政策所面临的挑战。
本定性研究于 2019 年在伊朗进行，伊朗是一个中东发展中国家。研究人群包括在口腔健康方面有经验且愿意参与研究的专家。采用雪球抽样法选择了 12 名参与者进行半结构式访谈，在进行了 16 次访谈后达到了饱和状态。采用 Guba 和 Lincoln 的标准（包括可信度、可转移性、可证实性和可靠性）来确定可靠性和透明度，最后采用五步框架分析法对数据进行分析。
对访谈的分析结果确定了 7 个主要主题，这些主题被归类为 Matus 框架提出的 5 个政策实施问题。执行和预防口腔卫生政策的挑战的主要主题被归类为组织问题，教育和资源挑战的主要主题被归类为物质问题，保险、政策制定和信托挑战的主要主题被认为是法律、政策制定和观点问题。
口腔卫生政策的实施面临一些挑战。似乎扩大口腔卫生的国家覆盖范围，将这些服务纳入预防工作并严重关注私营部门，可以被视为伊朗改善口腔健康的最重要战略。
