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Abstract: This article reports an analysis of oral health promotion in South African health policy. The central aim of this research was to determine the form and coherence of oral health promotion elements within health policies of post-apartheid South Africa. The study set out to test the hypothesis that oral health promotion elements are fully integrated into health policy and programmatic efforts. A conceptual framework was developed to systematically analyse oral health promotion policy and subsequent decision-making across the country at national and provincial levels. The information was drawn from policy documents, protocols and programme plans, complemented by interviews. The results indicate distinct contradictions between the policy formulation process and its impact on health system decision-making. South African health policy was found to be strong on the rhetoric of equity, health promotion, integration and several other features of the Primary Health Care Approach, but showed little evidence of translating this into action. The development and implementation of oral health promotion appears to be dominated by the influence of dental professionals that perpetuate a curative focus on service delivery. There is an urgent need to re-examine the process and content of oral health policy-making in South Africa. The conceptual framework developed for this study could facilitate further research in this area. (Global Health Promotion, 2010; 17(1): pp. 16-24)
Key words: health policy, health promotion, oral health, policy analysis
Introduction
Despite technological advancements in oral health care, oral diseases continue to be a major public health concern in South Africa. Data from the National Children's Oral Health Survey 1999-2002 form the only recent and reliable source of epidemiological information on oral disease rates in South Africa (1). The prevalence, distribution and impact of oral diseases, coupledwith the historical imbalances in oral health care, justify the need for coherent oral health policy statements (2,3).
Although a national strategy on oral health (4) has been developed, oral health policy in South Africa has not been previously subjected to rigorous analysis, one that examines the content of the policy, the processes that influence its formulation and its consequent implementation (5-8). Several clearly articulated commitments to integrating health policy across the disciplines and sectors do exist. However, the evidence that this has been realized in health service delivery, appear...