A comparative analysis of oral healthcare policy development between a developed country (Australia) and a developing country (South Africa)

Ph. D. University of KwaZulu-Natal, Durban 2014.Introduction: Health policy analysis aims to explain the interaction between institutions, interests and ideas in the policy process in order to ensure the best possible health outcomes. Cross-national policy analysis of oral health policies can be undertaken using a conceptual framework, and the results of this analysis could allow for cross-national lessons to be learnt that could be used to improve policy processes. This could result in improved population oral health service delivery and health outcomes. Aim: To undertake a cross-national policy analysis of a developed country (Australia) and a developing country (South Africa) in order to highlight lessons that could be learnt to improve policy development, implementation, reform and service delivery, that could lead to improved oral healthcare policy-making and provision. Objectives: This study sought to develop, and apply, a conceptual framework to undertake a cross-national comparative policy analysis study of a developed country (Australia) and a developing country (South Africa). This developed conceptual framework would need to allow policy analysts to undertake a comprehensive comparative policy analysis that could lead to an understanding and contextualisation of the complex policy environments found in developed and developing countries. Methods: A cross-national policy analysis of oral health policies for the period 2001-2011 was undertaken. A policy analysis conceptual framework was developed and used to comparatively analyse the various constructs, policy influences and policy actors that were involved in oral health policy-making. Data from a desktop literature search, and key stakeholder interviews were comparatively analysed using thematic content analysis, and a Strengths, Weakness, Opportunities and Threats (SWOT) analysis was used to identify lessons in policy development, implementation and reform that could be applied cross-nationally. Thereafter a Systems Dynamic (SD) computer simulation model was constructed and applied cross-nationally to human resources for health forecasting in order to expound the use of SD modelling in policy development and reform. Results: The results revealed that both countries have policy development and implementation structures that are historically embedded within the countries unique social contexts, and offer lessons regarding their strengths and weaknesses that could be applied cross-nationally to improve healthcare policy-making and provision. The results of the document analysis, together with the interviews and literature review, were triangulated and comparatively analysed using the themes outlined in the conceptual framework. These results revealed that a general policy development theory could be formulated and modified to suit local conditions. The need for high-quality valid and reliable data was also highlighted. Another result is the need for the appropriate needs-based and equitable reallocation of resources in order to ensure a feasible and practical oral healthcare system. Conclusions: The lessons offered from the cross-national oral health policy analysis could be adjusted and implemented to both developed and developing countries in order to improve their oral health policy development, implementation and reform structures and processes

Knowledge, attitudes and practices of emergency care practitioners in the management of common dental emergencies in the eThekwini District, KwaZulu-Natal.

It is essential to provide timeous and appropriate treatment in cases of dental emergencies. First responders such as Emergency Care Practitioners (ECPs) usually provide this prehospital care. The successful management of casualties experiencing common dental emergencies is dependent on two fundamental factors; the first responder's knowledge and ability to render the appropriate level and standard of medical care, and secondly, the time that expires between the onset of the incident and the initiation of definitive emergency medical treatment. Delayed or inappropriate management can have long term physiological and psychological effects.This was an exploratory and descriptive study, using quantitative and qualitative methods to determine the knowledge and attitudes of Emergency Care Practitioners of the eThekwini District of KwaZulu-Natal, South Africa, in the management of dental emergencies.The results revealed that Emergency Care Practitioners had inadequate knowledge, training, and understanding of the management of common dental emeregncies by ECPs. There was limited initial training, with a significant portion of the participants (44.9%, p 0.233) having not received any training at all in the management of orofacial traumas, and with a significant majority (78.3%, < 0.001) having no further education and training. Most ECPs indicated a desire to receive such training. This study indicated that ECPs lacked confidence in managing dental emergencies, which highlighted a need for specific dental awareness and training programs to further empower ECPs in the management of such emergencies

An analysis of methods used by African Traditional Health practitioners to treat oral health conditions in Johannesburg, Gauteng.

Masters Degree. University of KwaZulu-Natal, Durban.Background African traditional medicine is widely used in South Africa. African traditional health practitioners treat patients who present with a variety of medical conditions, including oral health conditions. The aim of this study was to determine the knowledge, and practices of African traditional health practitioners regarding oral health conditions. Materials and Methods A cross-sectional survey of 11 African traditional health practitioners who consented to be interviewed in the Johannesburg area was recruited to participate in a structured questionnaire survey, followed by focus group interviews with 10 practitioners. Ethical approval was obtained from the Biomedical Research Ethics Committee (BREC ref. no 451/19). Following the collection of data from the questionnaire administration, a focus group interview was conducted. Data on the knowledge, treatment practices, and post-treatment management of four common oral conditions was collected and analysed. Results Eleven participants who consented to be interviewed, their average age was 44.1 (±8.1) years, with a range of 21-67 years, and a slight majority of female (55.5%, n=6). Ten further participants took part in focus group interviews. African traditional health practitioners were asked a series of questions, in non-dental terminology or language, related to their knowledge (causes); practise (what do you use to treat?, What advise do you give to the patient?); of four common oral health conditions. These are: sores on the lips, sores on the tongue, swollen gums and toothache. Participants reported using a variety of practices such as throwing bones, burning incense, using plants and animal product, as well as commercially manufactured products to treat and manage patients. Conclusion The results of the study reveal that there are vast differences in knowledge, management practices and treatment modalities of African traditional healthcare practitioners. Further research in the knowledge, practises and treatment of oral healthcare practitioners needs to be conducted. Mutual cooperation, collaboration and integrating African traditional health practitioners into primary oral healthcare services need to be urgently prioritised

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

Dental therapy is a mid-level oral health profession that was introduced to the South African health system more than four decades ago, during the apartheid era. The purpose for the introduction of this profession was to meet the oral health needs of the underserved majority population1,2,3. However, even with the dismantling of apartheid and the creation of a democratic state, disparities in access to basic oral healthcare persist.1 Local studies have reported limited access to oral health services, especially among the disadvantaged and vulnerable population groups where the highest burden of oral diseases has been reported.4,5,