Oral Health Care System in Libya: Case Study of Benghazi

Abstract

The World Health Organization (WHO) defines a health care system as all organizations, people and actions whose primary intent is to promote, restore or maintain health. This includes efforts to influence determinants of health as well as more direct health-improving activities (WHO, 2007). Dentistry is only one component of the broader healthcare system and part of the overall social welfare system. Therefore, as health professionals, dentists need to understand the essential elements of the health care system within which they are working and how the changes in the system impact them (Gift et al., 2007). All Health care systems are complex organizations in a constant process of change and evolution to meet the health needs of their citizens. However, there are no universally acknowledged definitions of a health system since they have been defined differently for different purposes by different scholars (Hsiao, 2003). For example, Policy makers are interested in understanding what interventions are likely to improve the performance of a health system. On the other hand, researchers want to investigate what structural components cause the varied outcomes. The need to make the health care system available to all citizens has historically increased in numerous nations as their civilizations developed. Health systems not only benefit people by preventing and treating illnesses, but they improve people's lives by generating security within society and including them in the developmental process with political support (Gilson et al., 2007). Other important factors that influence the nature, extent, and shape of a healthcare system include the demographics of society, advances in technology, expectations and a country's economic wealth (Arah et al, 2003). Therefore, some scholars suggested that an ideal oral health care system would be integrated with the rest of the health care system to respond to the ongoing changes in society. Many of the current challenges to oral health care systems are based on incongruities that have evolved among policy, organizational structures, reallocation of resources, actual population oral health care needs, altered disease patterns and changing socio-political systems. The oral health care system, therefore, would include surveillance of population oral health status and needs, and be evidence-based, effective, cost-effective, sustainable, equitable, comprehensive, ethical, and culturally competent, with an emphasis on health promotion and disease prevention. Moreover, it should include universal coverage, and continuous quality assessment and assurance. Finally, the ideal system would empower communities and individuals to create conditions conducive to health (Tomar & Cohen, 2010). It is crucial for each country to regularly examine its healthcare system to ensure that it is taking account of population changes, health needs, workforce numbers, skills and expectations (Gallagher et al., 2009). There are disparities in human and financial resources, dental workforce and types of trained personnel between developed and developing countries. Unfortunately, in many countries, the human, financial and material resources are still insufficient to meet the need for oral health care services and to provide universal access, especially in disadvantaged communities in developing and developed countries (Kandelman et al.,2012). In recent years many countries have been affected by the state of fragility is associated with a range of challenging, complex and inter-related political, security, economic, and social challenges, with people's health being at the centre of these challenges since it has significant adverse impacts on how health care is delivered and utilized (Guha-Sapir & van Panhuis, 2002 & Woodward et al., 2016). A fragile state is defined as one that failed or is vulnerable to failure regarding its authority, legitimacy and comprehensive service entitlements that it should provide to its population (Stewart-Brown, 2009). Recently, the number of people living in fragile and conflict-affected states has increased, particularly in the Middle East and North Africa region. Many of these states were part of the so-called Arab Spring revolution to oust dictatorships in these countries, but the aftermath of these revolutions turned sour. As a result, most of these countries have experienced a chronic state of instability ranging from economic and political turmoil, such as Egypt and Tunisia, to armed conflicts and completely failed states, such as Libya and Syria. The Libyan healthcare system has once been described as one of the most successful. However, as with other aspects of life in Libya, the healthcare system has been affected by turmoil and political crises in the last ten years. Health systems are affected by various contextual factors, for example, personal, organizational and social factors, which affect staff, their motivation, and the beneficiaries' response to health services (Gilson et al., 2011). Several attempts to assess the performance of the health care system in Libya were made by several organizations and groups. Yet, the oral health sector was neglected, and attention was given to the medical field. Therefore, this research aims to describe the Libyan oral healthcare system in terms of its structure, function, personnel, funding, reimbursement and target group. This will inform health care planners and policy makers as well as educational institutions about the current status of Libyan oral health care system and how it can be improved.