{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,8]],"date-time":"2026-03-08T21:38:51Z","timestamp":1773005931020,"version":"3.50.1"},"reference-count":22,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2025,9,23]],"date-time":"2025-09-23T00:00:00Z","timestamp":1758585600000},"content-version":"vor","delay-in-days":265,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,1,1]],"date-time":"2025-01-01T00:00:00Z","timestamp":1735689600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["International Journal of Dentistry"],"published-print":{"date-parts":[[2025,1]]},"abstract":"<jats:p>\n                    <jats:bold>Background:<\/jats:bold>\n                    In 2022, the Tanzanian government launched a comprehensive multicomponent reform aimed at revolutionizing the national oral health care system. This initiative is part of a broader commitment to align with global health standards and address the significant oral health challenges faced by the population. Prior to the reforms, Tanzania\u2019s oral health infrastructure was marked by outdated practices and high prevalence rates of oral diseases, including dental caries and periodontal disease.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Methods:<\/jats:bold>\n                    We employed a qualitative case study design, guided by Walt and Gilson\u2019s Policy Triangle and Kingdon\u2019s Multiple Streams Framework, to analyze the planning, implementation, and early outcomes of the reform. Data were sourced from national surveys, District Health Information System\u20102 (DHIS2), official policy documents, procurement and training reports, and triangulated across multiple systems. Analysis focused on reform milestones, service utilization trends, and contextual drivers.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Results:<\/jats:bold>\n                    The reform resulted in significant system\u2010wide changes, including the procurement of 340 modern dental chairs, installation of 306 digital radiography units, and national phase\u2010out of dental amalgam. An Oral Health Scorecard was deployed to monitor restorative treatment trends, contributing to a reduction in the extraction\u2010to\u2010restoration ratio from 2.8:1 in 2022 to 1.3:1 in 2025. The introduction of a pregnancy\u2010focused oral health program and expanded training for dental therapists further enhanced service equity and quality. Reform implementation was enabled by strong political will, professional consolidation, and integration within existing national health strategies.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Conclusion:<\/jats:bold>\n                    Tanzania\u2019s rapid and multicomponent oral health reform represents a pioneering model for low\u2010 and middle\u2010income countries. By aligning with the WHO Global Oral Health Action Plan and embedding oral health into primary and maternal healthcare, the country has laid the foundation for sustainable and equitable dental care. Continued investments in digital innovation, public\u2013private partnerships, and health education will be critical for scaling impact.\n                  <\/jats:p>","DOI":"10.1155\/ijod\/7004986","type":"journal-article","created":{"date-parts":[[2025,9,24]],"date-time":"2025-09-24T06:59:46Z","timestamp":1758697186000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Two Years of Revolutionizing Oral Health in Tanzania: Evaluation of a Multicomponent Government\u2010Led Model"],"prefix":"10.1155","volume":"2025","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9726-1244","authenticated-orcid":false,"given":"Baraka J.","family":"Nzobo","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sima","family":"Rugarabamu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"James Tumaini","family":"Kengia","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mavere","family":"Tukai","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hamad","family":"Nyembea","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,9,23]]},"reference":[{"key":"e_1_2_9_1_2","unstructured":"World Health Organization Oral Health | WHO | Regional Office for Africa [Internet] 2019 https:\/\/www.afro.who.int\/health-topics\/oral-health. [cited 2024 Dec 11]."},{"key":"e_1_2_9_2_2","unstructured":"World Health Organization Oral Health. Global Strategy on Oral Health 2023."},{"key":"e_1_2_9_3_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12903-024-04148-2"},{"key":"e_1_2_9_4_2","doi-asserted-by":"publisher","DOI":"10.3389\/froh.2021.725460"},{"key":"e_1_2_9_5_2","doi-asserted-by":"publisher","DOI":"10.1002\/puh2.70000"},{"key":"e_1_2_9_6_2","doi-asserted-by":"publisher","DOI":"10.3390\/healthcare12090920"},{"key":"e_1_2_9_7_2","unstructured":"MasaluJ. R. MtayaM. MbawallaH. andNyamuryekung\u2019eK. The Fifth Tanzania National Oral Health Survey Report 2020 Ministry of Health Community Development Gender Elderly and Children https:\/\/hssrc.tamisemi.go.tz\/storage\/app\/uploads\/public\/61e\/962\/c04\/61e962c047b75470406472.pdf."},{"key":"e_1_2_9_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.identj.2023.03.008"},{"key":"e_1_2_9_9_2","first-page":"227","article-title":"Dental Amalgam and the Minamata Convention on Mercury Treaty: Make Mercury History for All","volume":"7","author":"Tibau A. V.","year":"2023","journal-title":"Journal of Oral & Dental Health"},{"key":"e_1_2_9_10_2","unstructured":"United Nations Environment Programme Minamata Convention on Mercury 2013 https:\/\/www.unep.org."},{"key":"e_1_2_9_11_2","unstructured":"Ministry of Health Phasing Out the Use of Dental Amalgam in Dental Practice. The United Republic of Tanzania 2022 https:\/\/environmentalmedicine.eu\/wp-content\/uploads\/PHASING-OUT-ON-DENTAL-AMALGAM-USE-Tanzania.pdf."},{"key":"e_1_2_9_12_2","unstructured":"Ministry of Health Tanzania Health Management Information System: Implementation Guidelines 2022 https:\/\/www.tanzaniahealth.go.tz."},{"key":"e_1_2_9_13_2","volume-title":"Oral Health Scorecard Development Framework","author":"District Health Information System-2 (DHIS2)","year":"2022"},{"key":"e_1_2_9_14_2","unstructured":"MCW Global MC-Tanzania\u2019s Dental Therapist Outreach Training Program: Enhancing Community-Based Dentistry in Tanzania 2024 https:\/\/mcwglobal.org\/mc-tanzanias-dental-therapist-outreach-training-program-enhancing-community-based-dentistry-in-tanzania\/."},{"key":"e_1_2_9_15_2","unstructured":"Ministry of Health Tanzania Dental Therapist Training Guide and Practical Guide: Training Pack 2016 Bridge2Aid https:\/\/bridge2aid.org\/wp-content\/uploads\/2016\/08\/DTP-Section-5-Ministry-of-Health-Training-Guide-and-Practical-GuideTraining-Pack-Read-only.pdf."},{"key":"e_1_2_9_16_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0258268"},{"key":"e_1_2_9_17_2","first-page":"10","article-title":"Teledentistry for Underserved Populations: An Evidence-Based Exploration of Access, Outcomes, and Implications","volume":"11","author":"Mutashar M. T.","year":"2023","journal-title":"Journal of Research in Medical and Dental Science"},{"key":"e_1_2_9_18_2","doi-asserted-by":"publisher","DOI":"10.7759\/cureus.62286"},{"key":"e_1_2_9_19_2","doi-asserted-by":"publisher","DOI":"10.1111\/cdoe.12538"},{"key":"e_1_2_9_20_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.hpopen.2021.100042"},{"key":"e_1_2_9_21_2","doi-asserted-by":"publisher","DOI":"10.2147\/RMHP.S460703"},{"key":"e_1_2_9_22_2","doi-asserted-by":"publisher","DOI":"10.2471\/BLT.17.203141"}],"container-title":["International Journal of Dentistry"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1155\/ijod\/7004986","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1155\/ijod\/7004986","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1155\/ijod\/7004986","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,8]],"date-time":"2026-03-08T19:21:32Z","timestamp":1772997692000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1155\/ijod\/7004986"}},"subtitle":[],"editor":[{"given":"Andrea","family":"Scribante","sequence":"additional","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]}],"short-title":[],"issued":{"date-parts":[[2025,1]]},"references-count":22,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2025,1]]}},"alternative-id":["10.1155\/ijod\/7004986"],"URL":"https:\/\/doi.org\/10.1155\/ijod\/7004986","archive":["Portico"],"relation":{},"ISSN":["1687-8728","1687-8736"],"issn-type":[{"value":"1687-8728","type":"print"},{"value":"1687-8736","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,1]]},"assertion":[{"value":"2025-04-28","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-08-30","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-09-23","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"7004986"}}