Stewardship of National Oral Health system in Iran: Its strengths and weaknesses

Aims: In this study, we assess the strengths, challenges and opportunities regarding the oral health system stewardship in Iran. Methods: A mixed methodology was used, comprised of a quantitative questionnaire using the functional standards, semi structured interviews with key stakeholders and document review. The level of current attainments of each standard was determined based on a Likerttype scale. Literature review was completed to find official documents of national organizations. Results: The responsibility of policy development of oral health care at the national level mostly falls on the Oral Health Bureau. This office has formulated a strategic plan for its policy-making and has considered the required capacity to implement them. However, the Bureau has some problems in enforcing its regulatory framework, especially in the private sector. There are rigorous problems in managing information and using them for evidence-based decision making. Setting and allocation of operational budgets for implementing the policies is only partially attained, as is monitoring and evaluating the performance. Conclusions: While the Ministry of Health and Medical Education has achieved some stewardship measures, it still needs further improvements in the oral health system. It needs to strengthen its information system and its executive capacity to implement the proposed regulations. The Ministry must improve accountability in the oral health system, especially the provider accountability.