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The policy implementation gap of school oral health programmes in Tshwane, South Africa: a qualitative case study
BACKGROUND: School going children across the world continue to experience high levels of untreated dental diseases. The South African Oral Health policy documents present measures to address the oral health needs of children in school settings, yet the burden of oral disease in the country is over 5...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7171775/ https://www.ncbi.nlm.nih.gov/pubmed/32316953 http://dx.doi.org/10.1186/s12913-020-05122-8 |
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author | Molete, Mpho Stewart, Aimee Bosire, Edna Igumbor, Jude |
author_facet | Molete, Mpho Stewart, Aimee Bosire, Edna Igumbor, Jude |
author_sort | Molete, Mpho |
collection | PubMed |
description | BACKGROUND: School going children across the world continue to experience high levels of untreated dental diseases. The South African Oral Health policy documents present measures to address the oral health needs of children in school settings, yet the burden of oral disease in the country is over 50% among primary school children. METHODS: Our study therefore sought to assess the implementation of school oral health programmes in Tshwane in line with policy recommendations using the Walt & Gilson policy analysis triangle. A qualitative explanatory case study was undertaken using a combination of data from direct observations and interviews. The case analysis involved assessing the processes of providing school oral health programmes that were offered at 10 schools in Tshwane. The measuring tools included process maps and an interview guide. RESULTS: The results found that policy implementation was affected by poor prior planning, inadequate resources, poor school infrastructure and lack of support from key stakeholders. Furthermore, inconsistencies in policy interpretation by management, coupled with the fact that the oral hygienists were not conversant with the policy hampered delivery of the policy content. The variations in policy implementation observed were often at the discretion of the oral hygienist in response to contextual challenges. CONCLUSION: There was policy and practice misalignment and variations in the processes of implementing oral health programmes across the 10 schools. Hence regular monitoring, evaluation and root cause analysis is recommended for such programmes in order to make informed decisions on contextually relevant and standardised programme modifications. |
format | Online Article Text |
id | pubmed-7171775 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-71717752020-04-24 The policy implementation gap of school oral health programmes in Tshwane, South Africa: a qualitative case study Molete, Mpho Stewart, Aimee Bosire, Edna Igumbor, Jude BMC Health Serv Res Research Article BACKGROUND: School going children across the world continue to experience high levels of untreated dental diseases. The South African Oral Health policy documents present measures to address the oral health needs of children in school settings, yet the burden of oral disease in the country is over 50% among primary school children. METHODS: Our study therefore sought to assess the implementation of school oral health programmes in Tshwane in line with policy recommendations using the Walt & Gilson policy analysis triangle. A qualitative explanatory case study was undertaken using a combination of data from direct observations and interviews. The case analysis involved assessing the processes of providing school oral health programmes that were offered at 10 schools in Tshwane. The measuring tools included process maps and an interview guide. RESULTS: The results found that policy implementation was affected by poor prior planning, inadequate resources, poor school infrastructure and lack of support from key stakeholders. Furthermore, inconsistencies in policy interpretation by management, coupled with the fact that the oral hygienists were not conversant with the policy hampered delivery of the policy content. The variations in policy implementation observed were often at the discretion of the oral hygienist in response to contextual challenges. CONCLUSION: There was policy and practice misalignment and variations in the processes of implementing oral health programmes across the 10 schools. Hence regular monitoring, evaluation and root cause analysis is recommended for such programmes in order to make informed decisions on contextually relevant and standardised programme modifications. BioMed Central 2020-04-21 /pmc/articles/PMC7171775/ /pubmed/32316953 http://dx.doi.org/10.1186/s12913-020-05122-8 Text en © The Author(s) 2020 Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data. |
spellingShingle | Research Article Molete, Mpho Stewart, Aimee Bosire, Edna Igumbor, Jude The policy implementation gap of school oral health programmes in Tshwane, South Africa: a qualitative case study |
title | The policy implementation gap of school oral health programmes in Tshwane, South Africa: a qualitative case study |
title_full | The policy implementation gap of school oral health programmes in Tshwane, South Africa: a qualitative case study |
title_fullStr | The policy implementation gap of school oral health programmes in Tshwane, South Africa: a qualitative case study |
title_full_unstemmed | The policy implementation gap of school oral health programmes in Tshwane, South Africa: a qualitative case study |
title_short | The policy implementation gap of school oral health programmes in Tshwane, South Africa: a qualitative case study |
title_sort | policy implementation gap of school oral health programmes in tshwane, south africa: a qualitative case study |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7171775/ https://www.ncbi.nlm.nih.gov/pubmed/32316953 http://dx.doi.org/10.1186/s12913-020-05122-8 |
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