School of Oral Health Sciences, Department of Community Dentistry, University of the Witwatersrand, Johannesburg, South Africa.
School of Therapeutic Sciences, University of the Witwatersrand, Johannesburg, South Africa.
BMC Health Serv Res. 2021 Jan 6;21(1):18. doi: 10.1186/s12913-020-06004-9.
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.
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.
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.
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.
尽管学校口腔健康计划已经开展多年，但几乎没有证据表明其政策要素是如何在地区层面上进行管理或转化为有形的实施活动和人群结果的。南非儿童的口腔健康状况负担持续存在，口腔治疗需求未得到满足，这使得此类研究的需求更加迫切。因此，本研究旨在描述省级和地区级管理人员对学校口腔卫生政策的看法，并确定成功实施政策所需的差距和条件。
这是一项探索性的定性研究，从豪登省的省级和地区办事处中有意选取了 8 名口腔健康管理人员。采用访谈和政策审查纲要收集数据。使用 10 项 Siddiqi 治理原则框架指导数据分析。
管理人员的看法和政策文件审查表明，国家政策涵盖了明确的战略眼光、对健康需求的反应能力、公平性和包容性等原则；然而，这些原则在地方层面并没有得到管理人员的一致转化。在利益相关者参与、问责制、可靠的信息系统和道德准则等方面，政策存在差距。政策翻译中的许多差距归因于国家领导层缺乏人力资源和支持地区一级实施的沟通不畅。
在地区层面存在政策意识和翻译的不一致性，因此，深入审查政策翻译差距对于在资源和能力有限的情况下有效解决问题至关重要。此外，还需要优化多部门参与，并确定共同的、新颖的和实用的政策翻译障碍解决方案。
