Introducing Mid-Level Dental Providers in Iran: Challenges and Opportunities

Area of Science:

• Public Health
• Health Services Research
• Dental Public Health

Background:

• The WHO Global Strategy and Action Plan on Oral Health 2023-2030 promotes task-shifting to Mid-level Dental Providers (MLDPs) to enhance oral health access and equity.
• Iran's context requires examination of stakeholder perspectives on MLDP integration.

Purpose of the Study:

• To explore stakeholder views on the challenges and opportunities of introducing MLDPs in Iran.
• To inform policy and practice for effective MLDP implementation.

Main Methods:

• A qualitative descriptive study using the Consolidated Framework for Implementation Research (CFIR).
• Semi-structured interviews were conducted with 10 key stakeholders.
• Thematic analysis was applied to interview transcripts.

Main Results:

• Stakeholders recognized the need for MLDPs but debated their scope of practice, ranging from preventive to essential clinical services.
• A legal framework exists in Iran, but concerns were raised about the 'career transition' pathway.
• Rural areas and primary care settings showed receptiveness, yet infrastructure limitations persist.
• Implementation success depends on collaboration between governmental and non-governmental entities.

Conclusions:

• Introducing MLDPs in Iran offers potential for improved oral health but is impeded by professional protectinism and power imbalances.
• Infrastructural weaknesses also pose significant barriers to successful implementation.
• Redistributing decision-making power through participatory research and public engagement is crucial for overcoming these challenges and prioritizing public needs.