Strengthening policy interventions at the primary health care level to achieve Universal Oral Health Coverage in Karnataka, India
Principal Investigator: Rajeev B R
Mentor: Manu Raj Mathur
Oral diseases are chronic, non-communicable diseases, affecting a large population with a significant effect on overall health and carrying a large socio-economic burden. Yet, oral health is a neglected public health issue and the political priority accorded to oral health is very low in India (2) and globally (3). The policy window to highlight oral health’s status of neglect in the broader health and social arena is minimal. The opportunities to advocate for the inclusion of oral health in UHC benefit packages within the political context of power for policymakers are rare. Yet, recent global developments give hope for championing oral health causes. A resolution on oral health was adopted at the 74th WHA, which urged member states to address oral health issues within the national policy frameworks guided by the principles of UHC (1). Indian government has also released operational guidelines for state and district program officers and service providers to strengthen and expand oral healthcare services under the Ayushman Bharath scheme (4). The International Dental Federation has released a Vision 2030 document proposing three-pillared strategies to achieve optimum oral health within the context of SDG and UHC (5). As a follow up to the WHA’s resolution, WHO will be releasing an action plan in 2022 to realize the pipe dream of making high-quality oral health care services affordable, available and accessible by all (6). All of the above developments have a joint call for strengthening governance, particularly policy intervention mechanisms such as tailor-made oral health policies and subsequently designing appropriate oral health programs to achieve UOHC.
Karnataka state in South India has a relatively better health system (7), yet oral health in the state has received little attention. Effective leadership and strong governance in health reflect the state’s commitment to achieving health equity. Lack of such strong commitment is a prime concern for achieving oral health equity. Reiterating WHOs oral health resolution to frame oral health policies and plan programs for the management of oral health care and aligning with the political agenda of vision 2030, there is a need for developing policies where oral health is integrated into other health programs, thus responding to the needs and demands of appropriate quality of preventive, promotive, rehabilitative and curative services available for people. Very few attempts have been made to analyse the mainstreaming initiatives at policies and programmatic level for inclusion of oral health in the national and state health policies in India. A few reports have briefly elucidated on the subject (8), but a comprehensive analysis is not yet reported. Recognising this gap, this study aims to develop policy recommendations that result in preparing a road map to achieve universal coverage for oral health in PHC settings in India with a particular focus on the Karnataka state. While the Karnataka state has made significant gains in achieving SDGs (7), there is little mention of oral health in the recent report on SDG progress in Karnataka (9). In this study, attention to oral health within the policy sphere in the Karnataka state is made.