Development of oral health policy in Nigeria: an analysis of the role of context, actors and policy process.
Development of oral health policy in Nigeria: an analysis of the role of context, actors and policy process.
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DOI：
10.1186/s12903-015-0040-8
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发表时间：
2015-05-06
期刊：
影响因子：
2.9
通讯作者：
Onwujekwe O
中科院分区：
文献类型：
--
作者：
Etiaba E;Uguru N;Ebenso B;Russo G;Ezumah N;Uzochukwu B;Onwujekwe O
在尼日利亚，口腔健康疾病的负担很重，保健服务和提供口腔保健服务的人力资源协调不力。以前试图制定口腔健康政策（OHP），以减少口腔疾病负担失败。然而，最终在2012年11月制定了一项政策。本文探讨了环境因素、行动者和政策过程在OHP发展中的作用，以及当前批准的OHP成功的可能原因。这项研究是在尼日利亚各地进行的;通过文件审查和对五组有目的地选择的答复者进行深入访谈收集的信息。对政策制定过程的分析以政策三角框架为指导，审查了政策制定的背景、政策过程和参与者。最重要的有利因素是政策行为者对一项政策的渴望，他们曾四次尝试失败。其他因素包括民选政府的存在，以及联邦卫生部制定的卫生部门改革框架。与以前的尝试不同，已核准的职业健康计划经历了政策制定所需的所有阶段。在这一进程中，学术界/研究人员、发展伙伴和决策者这三类行为者发挥了关键作用。他们要么有决策权，要么通过资金或技术能力来影响政策，以产生可信的研究证据，所有这些都对开发OHP有共同的兴趣。虽然证据被用来为政策的制定提供信息，但背景和行为者之间的复杂互动促进了政策的批准。OHP的发展是通过背景、过程和行为者之间复杂的相互关系取得成功的，这清楚地表明，这些因素中没有一个可以孤立地促进政策的发展。有证据是必要的，但不足以制定这方面的政策。行为者制定政策所处的更广泛的社会政治环境可以促进和/或限制行为者的作用和利益以及政策进程。在政策制定阶段必须考虑到这些因素，以便制定加强卫生系统的政策，特别是在政策过程和影响往往不透明的低收入和中等收入国家。
In Nigeria, there is a high burden of oral health diseases, poor coordination of health services and human resources for delivery of oral health services. Previous attempts to develop an Oral Health Policy (OHP) to decrease the oral disease burden failed. However, a policy was eventually developed in November 2012. This paper explores the role of contextual factors, actors and the policy process in the development of the OHP and possible reasons why the current approved OHP succeeded. The study was undertaken across Nigeria; information gathered through document reviews and in-depth interviews with five groups of purposively selected respondents. Analysis of the policy development process was guided by the policy triangle framework, examining context, policy process and actors involved in the policy development. The foremost enabling factor was the yearning among policy actors for a policy, having had four failed attempts. Other factors were the presence of a democratically elected government, a framework for health sector reform instituted by the Federal Ministry of Health (FMOH). The approved OHP went through all stages required for policy development unlike the previous attempts. Three groups of actors played crucial roles in the process, namely academics/researchers, development partners and policy makers. They either had decision making powers or influenced policy through funding or technical ability to generate credible research evidence, all sharing a common interest in developing the OHP. Although evidence was used to inform the development of the policy, the complex interactions between the context and actors facilitated its approval. The OHP development succeeded through a complex inter-relationship of context, process and actors, clearly illustrating that none of these factors could have, in isolation, catalyzed the policy development. Availability of evidence is necessary but not sufficient for developing policies in this area. Wider socio-political contexts in which actors develop policy can facilitate and/or constrain actors’ roles and interests as well as policy process. These must be taken into consideration at stages of policy development in order to produce policies that will strengthen the health system, especially in low and middle-income countries, where policy processes and influences can be often less than transparent.
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影响因子：
5.4
作者：
Dobrow, MJ;Goel, V;Upshur, REG
通讯作者：
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影响因子：
5.4
作者：
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影响因子：
3.3
作者：
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影响因子：
3.3
作者：
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通讯作者：
Soors, Werner
DOI：
10.1590/s1519-38292001000300002
发表时间：
2001-01-01
影响因子：
--
作者：
Araujo Junior, J. L. C. de;Maciel Filho, R.;de Araujo Junior, J. L. C.
通讯作者：
de Araujo Junior, J. L. C.