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Perceptions of provincial and district level managers' on the policy implementation of school oral health in South Africa.

省和区级管理者对南非学校口腔健康政策实施的看法。

  • 影响因子:2.26
  • DOI:10.1186/s12913-020-06004-9
  • 作者列表:"Molete M","Stewart A","Moolla A","Igumbor JO
  • 发表时间:2021-01-06
Abstract

BACKGROUND: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. METHODS: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. RESULTS: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. CONCLUSIONS: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.

摘要

背景: 尽管学校口腔健康计划已经持续多年,但几乎没有证据表明其政策要素是如何在地区一级管理或转化为切实的实施活动和人口成果的。由于口腔健康状况的持续负担和南非儿童未满足的口腔治疗需求,对这种研究的需求增加了。因此,本研究试图描述省级和区级管理人员对学校口腔健康政策的看法,并确定成功实施政策所需的差距和条件。 方法: 这是一项探索性的定性研究,对来自豪登省和地区办事处的8名口腔健康管理人员进行抽样调查。使用访谈和政策审查标题收集数据。10 Siddiqi治理原则框架用于指导数据分析。 结果: 管理人员的看法和政策文件审查表明,国家政策涵盖战略愿景、对健康需求的反应、公平和包容性的原则,但这些原则在地方一级的管理人员中没有得到一致的翻译。在利益攸关方参与、问责制、可靠的信息系统和道德准则等领域确定了政策差距。政策翻译方面的大部分差距归因于人力资源不足和国家领导层支持地区一级实施的沟通过程不佳。 结论: 各地区在政策意识和翻译方面存在不一致,因此,在资源和能力有限的情况下,深入审查政策翻译差距对于有效解决政策翻译差距至关重要。此外,优化多部门参与,并确定解决政策翻译障碍的共同、新颖和实际的解决办法是必要的。

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