# Whose Responsibility Is It? A Community-Level Situational Analysis of Oral Health Care in Amsterdam

## TL;DR

This study explores how different groups in Amsterdam work together to improve community-level oral health care and identifies gaps in responsibility and access.

## Contribution

The study provides a situational analysis of oral health care in Amsterdam, highlighting stakeholder priorities and the need for clearer governance.

## Key findings

- Stakeholders prioritize accessible basic oral health care and social support for all citizens.
- There is a lack of clarity about which organizations or individuals are responsible for improving oral health care quality.
- Social/welfare organizations often take informal responsibility due to unclear governance.

## Abstract

DELIVER (DELiberative ImproVEment of oRal care quality) is a multinational project funded under the EU’s Horizon Europe program that aims to improve the quality of oral health care at the practice, community, national, and international levels. It is important to understand the current situation of oral health care quality to make improvements possible. This study aimed to map oral health care priorities among stakeholders in Amsterdam, the Netherlands, and to describe how these stakeholders interacted to improve the quality of oral health care at the community level.

A situational analysis approach was used to collate data from desk research and semi-structured interviews with key informants. Interview transcripts were analyzed and grouped into main themes and subthemes using inductive coding. A situational map, a social worlds/arenas map, and a positional map were constructed to represent the community-level situation of quality improvement of oral health care.

Interviews were conducted with 10 professional stakeholders (5 social/welfare workers, 3 health care professionals, 1 public health professional, and 1 municipality policy maker). Stakeholders described prioritizing at least basic oral health care and stated that it should be accessible for everyone. Other priorities included a need for simplified access to oral health care and strengthened social support. While stakeholders agreed that people should not rely on emergency funds and volunteers, they felt that it was unclear which organizations or individuals were responsible for determining access to oral health care. This led social/welfare organizations to feel a sense of responsibility and offer informal care solutions.

There was consensus among stakeholders about the need for social support and simplified access to oral health care for citizens. Stakeholders also emphasized the lack of clarity about who was responsible for oral health care and quality improvement at the community level, which highlighted the urgent need for improved governance, allocating responsibilities for oral health care quality improvement to all parties operating at the community level.

This study mapped the current practice of oral health care quality in Amsterdam, the Netherlands, through a situational analysis as a crucial starting point for enhancing quality improvement of oral health care at the community level. It underscored the need for clarity about responsibilities and provided insights for oral health care providers, social and welfare workers, policy makers, and researchers that could support research and policy formulation targeted at underserved populations, involving multiple stakeholders.