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Cited by 39Dental Health and Care UtilizationGlobal Public Health Policies and EpidemiologyHealthcare Systems and Reforms

Development of oral health policy in Nigeria: an analysis of the role of context, actors and policy process

Open access
Etiaba, Enyi, Uguru, Nkoli, Ebenso, Bassey, Russo, Giuliano, Ezumah, Nkoli, Uzochukwu, Benjamin, Onwujekwe, Obinna·2015·BMC Oral Health
DOI 10.1186/s12903-015-0040-8PMC PMC4424590
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Abstract

BACKGROUND: 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. METHODS: 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. RESULTS: 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. CONCLUSIONS: 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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  • Historically, oral health has not been prioritised in health policy agendas in Africa, largely due to the continent's overwhelming disease burden from communicable diseases like HIV/AIDS, tuberculosis and malaria.

    “Historically, oral health has not been prioritised in health policy agendas, largely due to the continent's overwhelming disease burden from communicable diseases like HIV/AIDS, tuberculosis and malaria (12, 13).”

    From Oral health in Africa: a neglected public health priority (2026) · cites this paper as [13]

    The Background says oral health received poor expenditure in Nigeria, as in most African countries, because limited resources were directed toward life-threatening conditions such as HIV/AIDS. It also describes historically inadequate oral-health services and policies across the region. The paper does not name tuberculosis or malaria as competing priorities, or establish that the continent’s overall communicable-disease burden was the main reason oral health was absent from policy agendas. (LLM, conf=0.85)

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Research works printed but not linked: 4

  1. [11]Ministry of Health K, Rwanda,, FDI World Dental Federation F-V, France,. ORAL HEALTH POLICY IN RWANDA-Report of the 1st National Stakeholder Workshop 17-18 February, Kigali, Rwanda, Brazzaville, Cogo: 2005.
  2. [16]Olomola A An analysis of the research-policy nexus in Nigeria.g links between economic research and policymaking 2007 Canada African World Press, New Jersey & IDRC
  3. [19]Olomola A An analysis of the research-policy nexus in Nigeria. The Policy paradox in Africa – Strengthening links between economic research and policymaking (Chapter 8) 2007 A. (ed.): An analysis of the research-policy nexus in Nigeria. The Policy paradox in Africa – Strengthening links between economic research and policymaking (Chapter 8) Trenton New Jersey & Ottawa, Canada African World Press & International Development Research Centre
  4. [40]Green A Gerein N Mirzoev T Bird P Pearson S Anh LV Health policy processes in maternal health: a comparison of Vietnam, India and China Health Policy. Health Policy. 2011 100 167 73 10.1016/j.healthpol.2010.11.016 21194780 · DOI

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Authors
Etiaba, E., Uguru, N., Ebenso, B., Russo, G., Ezumah, N., Uzochukwu, B., & Onwujekwe, O.
Affiliations
  • University of Nigeria (NG)
  • University of Leeds (GB)
  • University of Lisbon (PT)
Corresponding author
Etiaba, Enyi
ORCID
Venue
BMC Oral Health
Publisher
Springer Science and Business Media LLC
Published
2015-05-06
Volume
15
Issue
1
Pages
56-56
ISSN
1472-6831 (ISSN-L)
DOI
10.1186/s12903-015-0040-8
PMC
PMC4424590
OpenAlex
W1956858488
Cited by
39
References
29
Citations by year
2026: 2 · 2025: 3 · 2024: 3 · 2023: 2 · 2022: 4 · 2021: 4 · 2020: 5 · 2019: 2 · 2018: 3 · 2017: 4 · 2016: 6 · 2015: 1
FWCI
6.31
Type
journal article
Language
en
Open access
Licence
Locations
  • BMC Oral Health (publishedVersion, cc-by)
  • Europe PMC (PubMed Central) (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • White Rose Research Online (University of Leeds, The University of Sheffield, University of York) (acceptedVersion)
  • Portuguese National Funding Agency for Science, Research and Technology (RCAAP Project by FCT) (submittedVersion, other-oa)
  • Greater South Information System
Funders
European Commission (2007-13, 261389, FP7/2007)
Topics
  • Health Sciences › Dentistry › Periodontics › Dental Health and Care Utilization
  • Social Sciences › Business, Management and Accounting › Organizational Behavior and Human Resource Management › Global Public Health Policies and Epidemiology
  • Social Sciences › Economics, Econometrics and Finance › Finance › Healthcare Systems and Reforms
Keywords
oral health policy, policy development, policy triangle, policy actors, health care reform, evidence-based policy, health system strengthening, oral disease burden, Nigeria, low- and middle-income countries, Federal Ministry of Health
MeSH terms
Administrative Personnel, Decision Making, Developing Countries, Faculty, Dental, Financial Support, Government, Health Policy, Humans, Interprofessional Relations, Nigeria, Oral Health, Policy Making, Research Design, Health Care Reform, Biomedical Research, Evidence-Based Dentistry

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