Oral health policy development
Ministry of Health leadership	The Ministry of Health had to be the lead agency for the policy development process.
Staffing resource for policy development	Malawian dentists, dental therapists and other members of the task force had to be taken away from frontline duties, including delivery of clinical service, in order to participate.
	The task force had 15/16 members but at most of the meetings approximately seven were present and some never attended meetings.
	Funding required to backfill staff involved and supporting policy development.
	No dedicated time awarded to task force members for policy development – activities additional to normal work duties.
	Significant amounts of feedback were collected from task force members between meetings.
	Credibility of policy development process was strengthened by multi-stakeholder group representation.
Financial support for the policy development process	Funding for workshops, Technical Working Group meetings, publication, print costs, launch and publicity were made available by the Scottish Government through its funding of the MalDent Project.
Centrality of prevention of oral disease as a key pillar of the policy	The disease prevention message must be central to the Oral Health Policy and a priority for implementation.
Integration of oral health into broader NCD / UHC agendas	Need to integrate basic oral health services package into the primary care level, as recommended by the World Health Organisation.
Oral health workforce	Scope of practice of dentists and dental therapists is not clearly identified by Medical Council of Malawi.
	Dentists and dental therapists have no chairside assistants and work single-handed.
	Training and task shifting to Medical Assistants of some emergency dental procedures may be helpful in rural environments.
Availability of dental and pharmaceutical consumables	Government needs to improve availability of dental consumables, materials, and drug availability, together with fluoride toothpaste and water fluoridation.
Data collection and research	More funding required for data collection to establish effectiveness of any future oral health interventions.
	Research hindered by frequent power cuts, Wi-Fi outages, and communication difficulties.
Geographic variation in levels of fluoride in drinking water	The wide variation in the levels of fluoride in drinking water in different areas of Malawi has great relevance to the epidemiology of dental fluorosis and dental caries.
Resource Strategy for policy development	Incorporate more Non-Governmental Organizations to support oral health work in Malawi. The World Health Organization can support the written proposals to apply for financial aid.