Perceptions of Oral Health Interventions among Providers in South Africa

Objectives: The World Health Organization recognizes the need to address the growing epidemic of poor oral health, acknowledging poverty, inequity, and systemic disease as contributors. Most oral diseases remain common and are easily preventable early in the disease process; however, current healthcare delivery models often prevent early diagnosis and treatment due to limited available providers and treatment options and/or a lack of understanding of available services. Patients with oral health complaints thus often present late in disease progression to the medical health centers, even though they lack oral health services. Here, we examine medical provider perceptions of interventions to improve access to oral health services.
Methods: This qualitative study was conducted at Gugulethu Community Health Center (GCHC)— a community hospital located outside of Cape Town, South Africa, where no dental services are available. Local public-sector health services provided free of charge are the main source of all primary healthcare for local residents. In depth qualitative interviews were conducted with physicians, nurses, and health promoters caring for patients at GCHC. Data were analyzed using an inductive content analytical approach.
Results: Participants stressed the difficulties their patients face accessing dental services due to the separation of medical and dental services, lack available dental services overall, and their own lack of knowledge oral disease. All participants stated that colocation of dental services would improve both access to dental care and efficiency in care delivery. Participants suggested that increasing their own knowledge of oral health would improve the care they provide for patients.
Conclusions: Our findings suggest medical providers are interested in integration of oral healthcare into medical care and feel these changes may increase patient knowledge about oral health and improve access to care. This exploratory data supports investment in interventions to improve healthcare delivery and efficiency.