Development and Trend of oral health service system in District level.

Abstract

The purpose of this study was to review the development and situation of the District oral health system' (DOHS) in term of policy, plan and supporting system as well as their effects to the system. Literature review of related documents and key informants interview gave the following over view. DOHS was initiated by the ministry of public health's policy of founding a dental nurse school in 1970 and the graduated dental nurse were under compulsion to work in the district hospital, designed to provide basic oral health care for the children in the district level. The system was strengthen by the dissemination of new graduated dentists to rural area, mainly in the community hospitals at the district level, according to the dentist compulsory project since 1989. Later the decade of health center development project (1991-2001) had extended the DOHS to health center at sub-district level. So the coverage of oral health provision in rural area in Thailand was nearly 90% by means of provision in community hospitals and health centers.

The deficiency of oral health personnels and equipments were still problems in DOHS, though the centralized supporting system had increased the number of both resources annually. This situation was worsen by government zero growth manpower policy, starting by closure of MOPH dental assistance school in 1998, then the cessation of MOPH compulsory system for all health personel students in 2000, leading to uncertainty of human resource suppoert. At the same time, supporting of dental equipments had not met the need for it due to budget decrease resulted from economic crisis since 1997.

As a whole, the DOHS had developped quite well in the past 3 decades. Though the number of people received oral health care increased annually, however the oral health status showed trend of deteriorate, especially in children. So it's time to revise the roles of oral health personnels to make them more effective in prevention, promotion and empowerment of people participation. The future trend of DOHS shaping should stress on decentralization and transfer more roles of provision to private sectors.