Oral health systems, universal health coverage, childhood dental
caries, oral health policy, health system financing, protocol, reform.
Background: Oral diseases have the highest global prevalence rate
among all diseases, with dental caries being one of the most common
conditions in childhood. A low political priority coupled with a failure
to incorporate oral health within broader health systems has
contributed to its neglect in previous decades. In response, calls are
emerging for the inclusion of oral health within the universal
healthcare domain (UHC). This protocol outlines the methodology for
a cross-country comparative analysis of publicly funded oral health
systems for children across six European countries, reporting on oral
health status in line with the indicators for UHC.
Methods: This study will follow Yin’s multiple case study approach and
employ two strands of data collection, analysis, and triangulation: a
systematic documentary analysis and semi-structured interviews with
elite participants local to each country. The countries chosen for
comparison and providing a representative sample of European
dental systems are Denmark, Hungary, the Republic of Ireland,
Germany, Scotland, and Spain. A systematic search of five electronic
databases and four additional electronic resources will be undertaken,
in addition to grey literature and other publicly available sources, with the outcomes verified and further informed by local experts. The WHO
Universal Health Coverage Cube will be used to guide data collection
and analysis.
Conclusions: This research will provide policy makers with an in-depth
analysis and comparison of publicly funded oral health systems for
children in Europe, including consideration of effective preventive
strategies, oral health system reform, and indicators of universal oral
health coverage. It is anticipated that the outcomes may help in
positioning oral health on governmental health agendas and support
its integration into wider health systems’ reform in an accessible and
affordable manner.