Analyzing The Water Fluoridation Code For Practice Policy In Australia

The Multiple streams policy-setting framework

Discuss about the Research Design and Narrative Policy.

Oral health is essential for the overall health and well-being of an individual. The Government of Australia addresses the need of having a healthy mouth to people for their overall health as a healthy mouth enables them to speak eat and socialize without any discomfort (Mehta and Kaur 2012). Water fluoridation is one of the most efficient ways of battling tooth decay for those regions, which has the significant level of dental caries. Providing those regions of the country with extensive level of caries with the optimal level of water fluoridation is one of the most cost effective preventive measures the government can give (Gil-Montoya et al. 2015). There are many surveys which showed that the children who lives on those region that received fluoridated water has less percentage of tooth decay than those children who do not get fluoridated water (Iheozor-Ejiofor et al. 2013).

For the prevention of dental caries, the level of fluoride in public water supply has to be well adjusted. The department of health of the Australian Government has recognized the issue and has passed a policy named Water fluoridation code for practice, which meets the requirement of Water Fluoridation Act 2008 and environment legislation. Government of Australia as used this policy to select the dose of fluoride content in the water(National Health and Medical Research Council, 2017).

This essay is written with the purpose of analyzing the stated policy statement. Analyzing a policy is often a hard task as its scope is broad. To analyze this policy, the multiple streams framework is used. By the multiple stream framework, Kingdon has invented a way to understand the public policy agenda within the political system.

Kingdon has proposed a strategy, which states about the three different categories of interdependent variables. These variables interact with each other and give rise to perfect setting for making an agenda (Howlett, McConnell and Perl 2015). Kingdon states that these three variables remain different and more or less independent of each other until a specific time being, when a policy window opens.

These three streams are known as the problem, policy and political stream.

• The problem stream is the perception of the problem, whichis seen in public when the government takes action in order to solve it. The policy makers analyze the problems and try to resolve them by taking action (Maltby 2013).
• The policy stream is the output and analysis of the problem, which proposes the solution to the problem. This part analyses the possibilities of problem actions and inactions, and narrows these down to the feasible action (Zahariadis 2014).
• The political steam includes those factors, which influences the body politics such as the executive and legislative turnover, interest groups and the advocacy campaigns (Ackrill, Kay and Zahariadis 2013).

Dental disease such as caries comes with many difficult outcomes such as substantial pain, inability to eat some particular food, lower self-esteem, reduced capacity to sleep and social embarrassment. Individual treatment for caries is somehow effective but it could delay the process of healing depending on the degree of the decay and financial issues (Pierce, Smith-Walter and Peterson 2014). Dental Caries is one of the most common diseases, which can be seen in the modern societies and treating it individually might cost a considerable financial burden. There are many people who comes from the rural area in Australia who suffers from dental caries. In addition, the Aboriginals and the Torres Strait islanders have teeth problem more than the non-aboriginals do(COAG Health Council, 2017). They are more likely to have missing teeth than the other Australians are. They also have the higher chance of having gum disease and they are less likely to ever receive any dental care from a dental care facility. The same problem is with the people in the rural Australia, in spite of their ethnicity. They are very less likely to go to the dental facility.

Usage of Kingdon’s framework to describe the policy

The most common intervention for the dental caries prevention is water fluoridation, a practice in which a liberal amount of fluoride is added in the water supply. It improves dental health by incorporating into the crystalline structure into the teeth. The centers for disease control prevention have proclaimed water fluoridation as one of the major achievement of 20^th century (Bache 2013). In Australia, there are many anecdotal evidence, in which showed that the oral health of the children some areas which does not provide fluoridated water as prevention, is worse (Rugg?Gunn and Do 2012). There was a report released by the Australian Institute of Health and Welfare in 2007, which documented that oral health, is better for those children who live in those areas, which serves fluoridated water. 

Water fluoridation provides the people with most cost effective way to treat tooth decay and caries as it reaches everyone in the community regardless of the age, cast and creed. Fluoride can naturally occur in various concentrations in all public water supplies. Those people who receives water supplies with optimum fluoride level has shown less prevalence of tooth decay. A survey in Victoria showed that six-year-old children who live in the area that has supply of fluoridated water, showed 45% less tooth decay (Cobiac and Vos 2012).

The policy was made to ensure that all the water supplies in Australia has a certain amount of fluoride, which is not harmful for health, but is enough for fighting the tooth decay. The policy also ensures the installation of fluoride dosing machine, which fluoridates water in a benchmarked way according to the national and international standards. The policy has also adopted the requirements of NSW health code of practice (Edmunds and Smedley 2013).

The act is for promoting good health for the population of Australia. The policy requires the local government to take the decision about which water supply might get the fluoridation to provide it to the community. Before providing fluoridation, the local government must consult with the public portable water supply about the cost implication. The public portable water supplier who would add the fluoride to the water must have to add the fluoride, which is prescribed under a regulation (Cairney and Jones 2016).

The local government must have to take action for this initiative. To provide the community with proper fluoridation, the local government must have to take a survey to know the vulnerability of tooth decay in that community.  The local government must have to take action to reduce the prevalence of caries and tooth decay. The government must have to ensure that the operational control level is incorporated in the whole design of the fluoride system. The water supplier, as appointed by the government should assess the risk properly before providing the fluoride dose properly (Armfield et al. 2013).

The political stream

The water supplier must have to maintain a minimum standard. To maintain the standard, the government along with the supplier must have to install a backflow prevention device to maintain the fluoridation level in a nontoxic way.

The south east Queensland water and other Legislation Amendment Act 2012, has passed the law which decides the addition of fluoride to the portable water supply to those places which has the most prevalence of tooth decay and  caries. This act states that the public water supplier, appointed by the government should have to continue adding fluoride to the water supply as long as the local government makes a different decision (section 7).

The health department of the Government of Australia has thinking about water fluoridation until 1960 has and has contributed about improving the status of oral health of the Australians. The government knows about the importance of having a good oral hygiene and healthy diet as it call prevent tooth decay (Herweg, Huß andZohlnhöfer 2015).

For the latest water fluoridation status, the government has initiated a campaign named Healthy mouths Healthy Lives: Australia’s National Oral health plan 2015-2024. The campaign has initiated a Fluoride Reference Group established by NHMRC, which guides the evaluation of the potential health effect of water fluoridation.

For providing the community with competent amount of fluoridated water, the Health Council of Government of Australia, has conducted many surveys, such as Aboriginal and Torres Strait islander Health Workforce Working Group annual report in 2015, where the problem of the tooth decay and their bad oral health has been reported there.

The Government of Australia has conducted Australia’s National Oral Health Plan 2015-2024, where they have organized two subcommittees about the Community care and population Health Principal. These committees reports through the advisory council of the Australian Health Ministry to the health council of COAG.

The healthy mouth, healthy lives: Australia’s Oral health Plan 2015-2024, has a goal to improve the health and well-being of the population of Australia. This reduces the burden of the poor oral health of the population.

The Healthy mouth, Healthy lives: Australia’s Oral health Plan 2015-2024, has addressed the poor oral health status of the priority population. To reduce the number of people of the priority population, the government of Australia has addressed the cost effective way of providing water fluoridation to the community. Because of the status of providing fluoridated drinking water to the community, the status of improvement has been substantial.

To implement the health policy, the local government has to take charge along with the Australian government. The local government themselves has to conduct many surveys to know the oral health status of the children and the priority population recognized by the Australian Government (Cobiac and Vos 2012). This would give them an idea to provide them with fluoridated water according to the need. They should also have to do time to time surveys to know the oral health status of the priority population and the children. The government should also time check the fluoridation level in water in order to reduce the environmental risk. The government should have to maintain the risk identification strategy in order to implement the policy fully to the communities.

The policy does not properly address the environmental hazard level fluoride gives to the environment. Nevertheless, the section 10 of the policy addresses the environmental hazards part and directs the suppliers to comply with the Environmental protection Act 1994 (EP act). The section 10 also addresses the waste management about the empty chemical container and the fluoride chemicals which have been contaminated. The policy has a specific part about the risk management, which the local government, policy makers and the water supplier should follow. The policy addresses the need of operational control over the fluoride dosing system. The policy also has a section (section 3) about the water supply system and the dosing facility. Another good part of the policy mentions the chemicals and measures to limit the fluoridation dosing in limitation. The policy also addresses how to provide the quality assurance and how to take the quality control samples to examine the right dose of fluoride.

The current policy regarding Water fluoridation does not address the issue of environmental hazards. There are many countries, which still have not implemented this health practice. The state of Queensland, in Australia, itself had not accepted the fluoridation policy until recently. The reason of not implementing the status of water fluoridation is the bad status of fluoride being an environmental hazard(Ackrill, Kay and Zahariadis 2013). If the fluoridation level increases in any system unknowingly, this will gradually increase the level of water toxicity. The public health practice that has been generated controversy from the environmentalist because of the fact that fluoride is an environmental hazard.

The health department of the Australian Government should implement some alternative strategy to prevent the problem of tooth decay and all over oral health. The presence of the problem means that the policy still needs some improvement and there has been still some space for improvement. The health department of Australia has to provide the priority population and the children with free dental camps and check-ups (Iheozor-Ejiofor et al. 2013). The Health ministry should also have to provide the rural areas of the country with competent dental practitioners who would provide the rural people with free dental practice. The health department should have to employ the practitioners to increase their awareness about using and drinking fluoridated water.

Conclusion

Water fluoridation is one of the major ways to tackle the decay of tooth, especially in the areas where the dental carries occurs on the major basis. Fluoridation of the water is one of the effective program that has been carried out in the communities to let them support while suffering from dental cavities and disorders. This intervention helps people regardless of their cast, creed, socio-economic status, race, and gender and education level. Generally, fluoride occurs in every drinking water coming through public water supplies. Further, this is the [rime reason of the decay of tooth in population despite of the presence of fluoride. Kingdon proposed a strategy that deals with the three different aspects of interdependent values. He proposed three streams namely, problem stream, policy stream and the political stream. The problem stream talks about the different problems associated with the dental carries that affects the person socially, mentally and physically. On the other hand, the policy stream talks about the policies that need to modified for the fluoridation of the water taken by a community. Finally, the political stream talks about the legislatives and action that has been taken about the issue in the community.

Kingdon’s model was very useful in the analysis of the water fluoridation policy and related program. The agenda setting process for this intervention was not easy and every associated factor had to work effectively. Especially the political stream had to work very hard as they are the only one who can gather the data about the communal issue regarding oral decay and dental caries. According to Pierce, Smith-Walter and Peterson (2014), the problem stream that has been discussed in this article shows the data about the dental caries. Aboriginal and the Torres Strait islanders face tooth decay, and these data can be generated and used for the development by the political parties in power in that local or state government. According to Iheozor-Ejioforet al. (2013), the fluoridation of water is termed as one of the cost effective and easy way to treat the dental caries in these local communities suffering from such disorders. The prime of the policy and the described framework was to ensure the addition of fluoride in the drinking water supply chain. The amount of the fluoride is also been screened as elevated amount of fluoride can lead to health problems. The policy focuses on the installment of the fluoride-dosing machine in the water supply chains and the benefit of this step is addition of fluoride can be detected as per the international standards.

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