Saudi Cultural Missions Theses & Dissertations
Permanent URI for this communityhttps://drepo.sdl.edu.sa/handle/20.500.14154/10
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Item Restricted A critique of the World Health Organisation's and World Dental Federation's Policy Recommendations for Oral Health Interventions Through the Lens of Intervention-Generated Inequalities(Saudi Digital Library, 2023-09-28) Alsaleh, Ahmed; Watt, RichardBACKGROUND Oral health inequalities remain a global health issue that has been neglected and overlooked. Its impact affect everyone in a socially graded manner where the greatest impacts are experienced by the most the marginalised, vulnerable, and disadvantaged people, making them suffer the most from oral diseases. Some preventive interventions can increase oral health inequalities rather than reducing them by favourably benefiting the most advantaged groups. This is what is known as interventiongenerated inequalities (IGIs). Considering the momentum of oral health globally and the golden opportunity for transformative policy change towards a more upstream intervention approach, it is crucial not only to focus on addressing and documenting the causes of existing oral health inequalities but also to focus on evidence-based policy interventions, to not generate more oral health inequalities and widened the gap unintentionally. AIM The aim of this project was to critically review of the World Health Organisation (WHO) Global Oral Health Action Plan (2023-2030 and World Dental Federation’s (FDI) selected oral health policy recommendations and intervention initiatives through the lens of intervention-generated inequalities METHODS This review provides timely and necessary critiques of such interventions that may increase inequalities. Specifically, it critically reviews the World Health Organisation and World Dental Federation's policy recommendations for oral health interventions through the lens of intervention-generated inequalities. RESULTS The findings of this review support the notion that support the notion that preventive individualistic downstream interventions targeting health behaviours, such as untargeted oral health education and mass media campaigns at the population level, have the risk of generating oral health inequalities. This review also highlights the potential role of public-private partnerships and the influence of corporate funding in driving and directing the focus of interventions towards downstream approaches that risk generating oral health inequalities. CONCLUSION This review has assessed how recommended, un-targeted individualistic downstream prevention interventions on a population level could adversely widen oral health inequalities. A key policy priority should be reducing oral health inequalities; therefore, a transformative upstream approach is required.43 0Item Restricted An ethnographic study on the oral health and access to dental care of Indigenous people in Montreal(McGill University, 2022-11-06) Danish, Basem; Bedos, ChristopheBackground: Although the population of Indigenous people living in urban centres has significantly increased over the past decades, limited research exists about their oral health and access to dental services. We thus know very little about their perspectives, experiences, and needs concerning oral health. However, this knowledge is needed to guide oral health policies and service delivery for urban Indigenous people. Objectives: Our objectives were to (i) understand how urban Indigenous people perceived and experienced oral health and (ii) describe their dental care pathway, including their experiences with dental professionals. Methodology: We conducted a focused ethnography, a useful and practical approach that is sensitive to cultural and social diversity and enables researchers to understand how people from certain cultures integrate health beliefs and practices into their lives. We organized individual in depth interviews with a purposeful sample of 20 Indigenous people living in Montreal, Québec. The interviews were in English, lasted approximately 90 minutes, and were audio-recorded to be transcribed verbatim and analyzed. In addition, we conducted participant observation of various Indigenous cultural events and health conferences in Montreal. Field notes were taken during these events and analyzed. The data analytic process comprised several stages, including summarizing the text, coding it into categories, and merging these categories to create themes. Findings: The participants had a bicultural perception of oral health, although the Western perspective seemed to dominate the Indigenous culture. Through the Indigenous lens, participants tended to understand oral health around the concepts of holism and balance. According to them, good oral health was important to achieve well-being and equilibrium between the physical, mental, emotional, and spiritual aspects of life. Applied to oral health, participants emphasized eating and drinking in moderation to maintain equilibrium and stressed the role of teeth in eatingtraditional diets. In agreement with Western culture, they mentioned the importance of teeth for function and aesthetics and valued personal oral hygiene as well as regular visits to the dentist. Concerning access to dental care, participants reported experiencing challenges in their lives, such as discrimination, unemployment, or chaotic life experiences, which prevented them from searching for a dentist. Finding a dentist was another issue, with participants indicating a shortage of dentists who accepted Non-Insured Health Benefits (NIHB) program beneficiaries. Because of this limited availability of dentists, some participants would return to their home communities to access dental services. Regarding the dental care episode, participants mentioned preferring dental professionals who knew and respected Indigenous culture and had good interpersonal skills. While the NIHB covered the cost of most dental treatments, some participants were required to pay for ineligible services, and some dentists refused to accept NIHB eligibility documents. Conclusions and recommendations: Urban Indigenous people face challenges and needs that require recognition by oral health professionals and policymakers. We invite these stakeholders to draw on our findings to support policies and services that facilitate access to and improve the oral health of urban Indigenous people24 0