Barriers to the adoption of the ART approach as perceived by dental practitioners in governmental dental clinics, in Tanzania

Kikwilu, Emil N.; Frencken, Jo E.; Mulder, J.

doi:10.1590/s1678-77572009000500011

Cited by 8 publications

(12 citation statements)

References 15 publications

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“…Dental materials and equipment availability are necessary for delivery of comprehensive oral care [ 4 ]. In line with previous studies conducted in Eastern Africa (Tanzania, Kenya, Sudan) this study provided further evidence of widespread shortage of dental materials and equipment in public facilities [ 19 , 25 , 29 , 30 ]. The finding that less than half of the facilities had any of the materials consistently throughout the previous year means that restorative services are not available in many facilities, even if demanded by the dental patients.…”

Section: Discussionsupporting

confidence: 89%

“…This study revealed that up to 50 % of Tanzanians would need to invest financial resources equivalent to 9 days-worth of consumption [ 11 ] in order to pay for a filling, illustrating the high cost of dental care. Previous studies in Tanzania, Burkina Faso and Nigeria have indicated cost, and specifically the price of services, as one of the major barriers towards utilization of oral care services [ 12 , 22 – 25 ]. In Benin City, Nigeria, even among respondents with high socioeconomic status, 12 % were unable to afford dental treatment when required [ 26 ].…”

Section: Discussionmentioning

confidence: 99%

“…This variability might selectively preclude consumers with the same socioeconomic status across different geographic locations from accessing oral care. None of the previous studies [ 12 , 22 – 25 ] have determined the price of dental services directly from the facilities, relying instead on reports from the served population. Our findings confirm the conclusions of previous studies, that the costs for dental services are considerably high.…”

Section: Discussionmentioning

confidence: 99%

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The relative patient costs and availability of dental services, materials and equipment in public oral care facilities in Tanzania

2015

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BackgroundPatient charges and availability of dental services influence utilization of dental services. There is little available information on the cost of dental services and availability of materials and equipment in public dental facilities in Africa. This study aimed to determine the relative cost and availability of dental services, materials and equipment in public oral care facilities in Tanzania. The local factors affecting availability were also studied.MethodsA survey of all district and regional dental clinics in selected regions was conducted in 2014. A total of 28/30 facilities participated in the study. A structured interview was undertaken amongst practitioners and clinic managers within the facilities. Daily resources for consumption (DRC) were used for estimation of patients’ relative cost. DRC are the quantified average financial resources required for an adult Tanzanian’s overall consumption per day.ResultsTooth extractions were found to cost four times the DRC whereas restorations were 9–10 times the DRC. Studied facilities provided tooth extractions (100 %), scaling (86 %), fillings (79 %), root canal treatment (46 %) and fabrication of removable partial dentures (32 %). The ratio of tooth fillings to extractions in the facilities was 1:16. Less than 50 % of the facilities had any of the investigated dental materials consistently available throughout the year, and just three facilities had all the investigated equipment functional and in use.ConclusionsDental materials and equipment availability, skills of the practitioners and the cost of services all play major roles in provision and utilization of comprehensive oral care. These factors are likely to be interlinked and should be taken into consideration when studying any of the factors individually.Electronic supplementary materialThe online version of this article (doi:10.1186/s12903-015-0061-3) contains supplementary material, which is available to authorized users.

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Section: Discussionsupporting

confidence: 89%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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The relative patient costs and availability of dental services, materials and equipment in public oral care facilities in Tanzania

2015

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“…Investigations have been carried out in South Africa 44 and in Tanzania 35 asking government dentists what they consider to be the major barriers that exist to using ART. In both these cases the barriers include: work load, lack of provision of materials and perception of clinical skill.…”

Section: Community Public Health and Health Services Researchmentioning

confidence: 99%

Two decades of ART: improving on success through further research

Holmgren

Figueredo

2009

J. Appl. Oral Sci.

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Since the introduction of the Atraumatic Restorative Treatment (ART) approach over twenty years ago, more than 190 research publications have appeared. The last research agenda defining research priorities for ART was published in 1999. The objective of the present work was to review existing research in the context of future research priorities for ART. Material and Methods: An internet survey was conducted amongst those who had published on ART or were known to be working on the ART approach, to solicit their views as to areas of future ART research. Three broad categories were defined, namely: 1. Basic and laboratory research; 2. Clinical research, and, 3. Community, Public Health, Health Services Research. Results: A 31% response rate was achieved. The study identified a number of new areas of research as well as areas where additional research is required. These are expressed as recommendations for future ART research. Conclusions: The ART approach is based on a robust, reliable and ever-growing evidence base concerning its clinical applications which indicates that it is a reliable and quality treatment approach. In common with all other oral health care procedures, targeted applied research is required to improve the oral health care offered.

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“…However, organizational supervision of operative units needs improvement. In Tanzania, the use of atraumatic restorative care (ART) has been introduced in areas with no electricity, especially rural areas (Kikwilu et al 2009). …”

Section: Low-income Countriesmentioning

confidence: 99%

Capacity Building and Financing Oral Health in the African and Middle East Region

et al. 2015

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Many low- and middle-income countries do not yet have policies to implement effective oral health programs. A reason is lack of human and financial resources. Gaps between resource needs and available health funding are widening. By building capacity, countries aim to improve oral health through actions by oral health care personnel and oral health care organizations and their communities. Capacity building involves achieving measurable and sustainable results in training, research, and provision of care. Actions include advancement of knowledge, attitudes and skills, expansion of support, and development of cohesiveness and partnerships. The aim of this critical review is to review existing knowledge and identify gaps and variations between and within different income levels in relation to the capacity building and financing oral health in the African and Middle East region (AMER). A second aim is to formulate research priorities and outline a research agenda for capacity building and financing to improve oral health and reduce oral health inequalities in the AMER. The article focuses on capacity building for oral health and oral health financing in the AMER of the IADR. In many communities in the AMER, there are clear and widening gaps between the dental needs and the existing capacity to meet these needs in terms of financial and human resources. Concerted efforts are required to improve access to oral health care through appropriate financing mechanisms, innovative health insurance schemes, and donor support and move toward universal oral health care coverage to reduce social inequality in the region. It is necessary to build capacity and incentivize the workforce to render evidence-based services as well as accessing funds to conduct research on equity and social determinants of oral health while promoting community engagement and a multidisciplinary approach.

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Barriers to the adoption of the ART approach as perceived by dental practitioners in governmental dental clinics, in Tanzania

Cited by 8 publications

References 15 publications

The relative patient costs and availability of dental services, materials and equipment in public oral care facilities in Tanzania

The relative patient costs and availability of dental services, materials and equipment in public oral care facilities in Tanzania

Two decades of ART: improving on success through further research

Capacity Building and Financing Oral Health in the African and Middle East Region

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