Oral health information systems
Oral health information systems, evidence for oral health policy and formulation of goals
The burden of oral disease and needs of populations are in transition and oral health systems and scientific knowledge are changing rapidly. In order to meet these challenges effectively public health care administrators and decision-makers need the tools, capacity and information to assess and monitor health needs, choose intervention strategies, design policy options appropriate to their own circumstances, and to improve the performance of the oral health system.
The WHO/FDI goals for oral health by the year 2000 urged Member States to establish oral health information systems and this remains a challenge for most countries of the world. The WHO Oral Health Programme is prepared to assist countries in their efforts to develop oral health information systems which include data additional to epidemiological indicators.
The information obtainable through a health information system may be usefully categorized into the following interrelated subsystems:
- Epidemiological surveillance
- Service coverage of the population
- Service records and reporting
- Administration and resource management
- Quality of care provided
- Oral health programme monitoring and outcome evaluation
Systematic evaluations of oral health systems are much needed and the WHO Oral Health Programme advocates a comprehensive model whereby input, processes, output and outcomes are measured (Figure 8).
At WHO, information systems are being established for surveillance of global trends in oral disease and risk factors. The WHO Global Oral Health Data Bank compiles valuable information for monitoring the global epidemiological picture and trends over-time in oral health and the WHO Oral Health Programme has initiated integration of the existing database with other WHO health databases and surveillance systems on risk factors. The main surveillance tool is called STEPS (STEP-wise approach to surveillance), a simple approach which provides countries with core standardized methods but leaves them flexibility to expand tools by adding information relevant to the local situation.
The WHO Oral Health Programme provides modern global health information systems through several activities:
- Revision of the WHO Oral Health Surveys Basic Methods, taking new oral disease patterns into account and allowing recording of risk factors to oral health (e.g. dental erosion and consumption of soft drinks).
- Development of procedures for management and analysis of data based on the use of information technology.
- Linking the Global Oral Health Data Bank with the Country/Area Profile Programme information system.
- Development of methodologies and approaches for evaluation of effectiveness of community oral health programmes with focus on health promotion and disease prevention. Such evaluation also includes process documentation in order to allow sharing of experiences from programmes.
WHO Oral Health Programmes at Headquarters and Regional levels recently assessed the accomplishment of theWHO/FDI goals for oral health by the year 2000, and the formulation of new WHO goals has been initiated. The WHO Regional Office for Europe specified oral health targets (target 8.5) for the year 2020 as part of the Health21 policy. WHO, FDI and IADR are jointly preparing new goals up to the year 2020. The objectives and targets have been broadened in order to cover significant indicators related to oral health and care of population groups. The global goals are not intended to be prescriptive but the framework is primarily designed to encourage health policy makers at regional, national and local levels to set standards for oral health in relation to pain, functional disorders, infectious diseases, oro-pharyngeal cancer, oral manifestations of HIV-infection, noma, trauma, cranio-facial anomalies, dental caries, developmental anomalies of teeth, periodontal disease, oral mucosal diseases, salivary gland disorders, tooth loss, health care services and health information systems.
The WHO Oral Health Programme will support countries directly as well as through regional and country offices in their formulation of goals, targets and standards of oral health.