Tahani B¹ (DDS, PhD), Yazdani Sh² (MD, MSc.), Khoshnevisan MH³ * ( PhD, DMD, DPHDent, DrPH )

  ¹ Torabinejad Dental Research Center, Department of Oral Public Health, School of Dentistry,

  Isfahan University of Medical Sciences, Isfahan, Iran

  ² School of Medical Sciences Education, Shahid Beheshti University of Medical Sciences, Tehran, Iran

  ³ Preventive Dentistry Research Centre. Dental Research Institute Community Oral Health Department,

  School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

  Received: 5 Jan 2014, Accepted: 14 Apr 2014

  Abstract

  Introduction: The aim of this two-phase study was to develop standards for stewardship of oral health system of Iran and to evaluate the current attainments regarding them.

  Methods: Based on the modified RAND-UCLA method, a comprehensive review of related electronic databases and the official web-site of international organizations, effective policy statements related to stewardship components were selected. Standards were categorized according to the six sub-functions of stewardship including generating and disseminating intelligence defining strategic policy direction ensuring alignment of policy objectives and organizational structure, regulation exerting influence over all related sectors via inter-sectoral leadership and ensuring accountability. Then the level of relevancy and importance of standards were assessed using the experts’ opinions. In phase two, using the finalized list of standards, semi-structured interviews with key stakeholders in oral health system at different levels of policymaking were conducted and the stewardship of oral health system was critically evaluated. The results of regulation sub-function are presented in this study.

  Results: From 38 finalized standards appropriate for evaluating the stewardship of oral health system according to the opinion of experts, 18 were related to regulation. Most of the standards rejected were included in dental health insurance regulation. Evaluation of this sub-function determined that currently there are deficiencies in meeting regulations concerned with evaluating the safety and cost effectiveness of dental materials, and quality of provided dental care to patients. Also it was shown that implementation of penalties and sanctions commensurate with instances of malpractice at individual and institutions were not completed attained. Regulations such as water fluoridation, property rights and regulations to ensure the basic conditions of market exchanges were either absent or only partially implemented. There were also some weaknesses in regulations concerning the supply of dentists, especially their distribution. The fields that currently had some regulations, were those in relating to labeling on products used in dentistry and covering the needs of disadvantaged populations .

  Conclusion: While the Ministry of Health and Medical Education has achieved some stewardship measures in the field of regulation, there are some problems in enforcing the regulatory framework especially in the private sector.

  Key words: oral health system, evaluation, stewardship, legislation

  Please cite this article as follows:

  Tahani B, Yazdani Sh, Khoshnevisan MH. Proposed Standards for Evaluating the Stewardship of National Oral Health System Part 1: Evaluation of Regulation. Hakim Health Sys Res 2014 17(2): 108- 117.

  ^* Corresponding Author: Daneshjoo B l vd., Evin, Tehran, 19834 IR-Iran. F ax:+98-21-22421813 E-mail: khoshmh@gmail.com