Assessing Malawi’s recent development of a National Oral Health Policy – learning for the future

Background: Traditionally, oral health has not figured prominently in national healthcare frameworks of low- and middle-income countries (LMICs). This challenge has been addressed head-on by the WHO Oral Health Resolution that was ratified at the 2021 World Health Assembly. In most LMICs, policymakers have not prioritised oral health, underestimating the burden of oral and maxillofacial problems, their connection with systemic health and possible threat to human life.The Malawi Government, with the support of the Scottish Government, developed its first National Oral Health Strategy and Plan. An Oral Health Taskforce was established with multi-stakeholder representatives from the Malawi Government, health sector, academic institutions and development partners. This presented a unique opportunity to examine oral health policy development in an African context. 

Methods:A Qualitative case study of Malawi Oral Health Policy development was conducted. Data was collected from semi-structured interviews (n=8) of purposively selected key informants from the Malawi National Oral Health Taskforce team involved in the policy development process. Collected data was analysed in the thematic areas within the Health Policy Triangle of actors, context, processes, content, and challenges encountered. 

Findings:Malawi’s oral health policy development was funded by the Scottish government and Borrow Foundation. The process for the policy development was guided by the Malawi government, a multisectoral approach for oral health stakeholders was adopted. Five groups of actors conducted investigations and wrote the Oral Health Policy: development partners, academics, policy experts, dental practitioners, and civic society organisations. Challenges identified related to resource availability for implementation of the policy; funding and human resources for health; weak and difficult to access pre-existing supporting evidence of oral health research, information and data; poor and partially used in-country network of oral health professionals; and weak leadership and governance in Malawi’s oral health system. 

Conclusion: 

 Strategic guidance to oral health policy development in the African region are available as documents. Networks are an under-utilised resource in Africa, Malawi developed the policy through its good network of partners. Prior inclusion of Malawi’s oral health services into the essential package of basic health services in the Health Services Strategic PlanII proved beneficial for the oral health policy development.