Attrition of dental therapists in South Africa—A 42‐year review

Abstract

Professionals leave their positions for varied reasons. Attrition is defined as a gradual reduction of the workforce, which may be due to either voluntary or involuntary factors. 1 Involuntary factors are factors that either the employer or employee has no control over, such as retirement, ill health or death, while voluntary factors are those that lead to resignation but can be prevented or addressed by the employer. 1 Voluntary factors that influence attrition may include people seeking improved remuneration, better benefits, an improved work/life balance, more opportunities to progress in their careers, time to address personal issues like health problems or relocations, increased flexibility or to escape a toxic environment. [1][2][3] Attrition rates in healthcare professions vary from country to country although the highest attrition rates are reported among lowand middle-income countries (LMICs) as compared to high-income

Exploring reasons why South African dental therapists are leaving their profession: A theory-informed qualitative study

“…With only two universities training dental therapists in South Africa [ 4 ], the finding that many dental therapists did not intend to enroll for the degree is concerning, particularly for other universities that may consider offering dental therapy training. Training institutions need to consider how to make this profession more attractive to prospective students to address the issue of underproduction, which was flagged in the recent 42-year review of the dental therapy profession in South Africa [ 14 ]. There is also a need to expand training to dental schools in other provinces to both increase the annual production and geographic coverage.…”

“…The Western Cape is among the provinces with the highest prevalence of dental caries [ 6 ]. However, there was only one dental therapist employed in the public sector in the Western Cape out of the 714 who were registered in SA in 2019 [ 14 ]. Only two out of six dental schools in South Africa train dental therapists [ 14 ], which raises concerns about production of this cadre of mid-level oral health professionals.…”

“…Dental therapist attrition has been reported globally; a study conducted among Australian dental therapists who were registered over a five-year period (1999)(2000)(2001)(2002)(2003), reported that 28% of participants left the profession for reasons such as family, career change, poor salaries, relocation, illness and injury, and stress [15]. Similarly, Sodo and colleagues have reported attrition and underproduction in South Africa [14]. The numbers of registered dental therapists remain low because some choose to leave the profession due to dissatisfaction or to start new careers [3,16].…”

Dental therapist job satisfaction and intention to leave: A cross-sectional study

“…A recent review of HCPSA records also reported an unequal distribution of dental therapists across South African provinces, with most located in KZN (44%) and Gauteng (27%). 11 To ensure equitable distribution of dental therapists throughout the country, training offerings should either be expanded to other provinces or existing programmes should consider more targeted recruitment of future students to be more reflective of underserved provinces.…”

“…A more recent South African nationwide study of dental therapist attrition reported 40% attrition over a 42-year period and attrition of 9% over the 10-year period of 2009-2019. 11 Voluntary workforce attrition is a major public health problem globally, which may lead to staff shortages. Some of the downstream effects of voluntary attrition are increased workload, unavailability of healthcare workers and limited access to healthcare, leading to a higher burden of untreated diseases.…”