Hum Resour Health. 2012 Nov 26;10:46. doi: 10.1186/1478-4491-10-46.

Cameroon mid-level providers offer a promising public health dentistry model.

Human resources for health

Leo Ndiangang Achembong, Agbor Michael Ashu, Amy Hagopian, Ann Downer, Scott Barnhart

PMID: 23181636 PMCID: PMC3529690 DOI: 10.1186/1478-4491-10-46

Abstract

BACKGROUND: Oral health services are inadequate and unevenly distributed in many developing countries, particularly those in sub-Saharan Africa. Rural areas in these countries and poorer sections of the population in urban areas often do not have access to oral health services mainly because of a significant shortage of dentists and the high costs of care. We reviewed Cameroon's experience with deploying a mid-level cadre of oral health professionals and the feasibility of establishing a more formal and predictable role for these health workers. We anticipate that a task-shifting approach in the provision of dental care will significantly improve the uneven distribution of oral health services particularly in the rural areas of Cameroon, which is currently served by only 3% of the total number of dentists.

METHODS: The setting of this study was the Cameroon Baptist Convention Health Board (BCHB), which has four dentists and 42 mid-level providers. De-identified data were collected manually from the registries of 10 Baptist Convention clinics located in six of Cameroon's 10 regions and then entered into an Excel format before importing into STATA. A retrospective abstraction of all entries for patient visits starting October 2010, and going back in time until 1500 visits were extracted from each clinic.

RESULTS: This study showed that mid-level providers in BCHB clinics are offering a full scope of dental work across the 10 clinics, with the exception of treatment for major facial injuries. Mid-level providers alone performed 93.5% of all extractions, 87.5% of all fillings, 96.5% of all root canals, 97.5% of all cleanings, and 98.1% of all dentures. The dentists also typically played a teaching role in training the mid-level providers.

CONCLUSIONS: The Ministry of Health in Cameroon has an opportunity to learn from the BCHB model to expand access to oral health care across the country. This study shows the benefits of using a simple, workable, low-cost way to provide needed dental services across Cameroon, particularly in rural areas.

References

1. Int Dent J. 2000 Dec;50(6):371-7 - PubMed
2. Int Dent J. 2002 Feb;52(1):30-4 - PubMed
3. Ann Acad Med Singap. 1986 Jul;15(3):284-98 - PubMed
4. Community Dent Oral Epidemiol. 2003 Dec;31 Suppl 1:3-23 - PubMed
5. Int J Dent Hyg. 2010 Nov;8(4):301-7 - PubMed
6. Int Endod J. 2010 Mar;43(3):171-89 - PubMed
7. Int Dent J. 2008 Apr;58(2):61-70 - PubMed
8. Community Dent Oral Epidemiol. 2000 Dec;28(6):399-406 - PubMed
9. Hum Resour Health. 2009 Feb 19;7:14 - PubMed
10. J Public Health Dent. 2011 Spring;71 Suppl 2:S3-8 - PubMed
11. PLoS Med. 2010 Mar 09;7(3):e1000242 - PubMed
12. Health Aff (Millwood). 2009 Sep-Oct;28(5):w849-62 - PubMed
13. Int Dent J. 1985 Mar;35(1):78-82 - PubMed
14. Lancet. 2007 Dec 22;370(9605):2158-63 - PubMed
15. Community Dent Oral Epidemiol. 2004 Oct;32(5):319-21 - PubMed
16. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2008 Jul;106(1):66-73 - PubMed

Publication Types

• Journal Article