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Published in: BMC Oral Health 1/2015

Open Access 01-12-2015 | Research article

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

Authors: Kasusu K. Nyamuryekung’e, Satu M. Lahti, Risto J. Tuominen

Published in: BMC Oral Health | Issue 1/2015

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Abstract

Background

Patient 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.

Methods

A 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.

Results

Tooth 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.

Conclusions

Dental 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.
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Literature
1.
go back to reference Gottret PE, Schieber G. Health financing revisited: a practitioner’s guide: World Bank Publications, Washington DC; 2006 Gottret PE, Schieber G. Health financing revisited: a practitioner’s guide: World Bank Publications, Washington DC; 2006
2.
go back to reference Boutayeb A. The double burden of communicable and non-communicable diseases in developing countries. Trans R Soc Trop Med Hyg. 2006;100:191–9.CrossRefPubMed Boutayeb A. The double burden of communicable and non-communicable diseases in developing countries. Trans R Soc Trop Med Hyg. 2006;100:191–9.CrossRefPubMed
3.
go back to reference World Health Organization. Everybody’s business--strengthening health systems to improve health outcomes: WHO’s framework for action. Geneva: World Health Organization; 2007. World Health Organization. Everybody’s business--strengthening health systems to improve health outcomes: WHO’s framework for action. Geneva: World Health Organization; 2007.
4.
go back to reference Kandelman D, Arpin S, Baez RJ, Baehni PC, Petersen PE. Oral health care systems in developing and developed countries. Periodontol 2000. 2012;60:98–109.CrossRefPubMed Kandelman D, Arpin S, Baez RJ, Baehni PC, Petersen PE. Oral health care systems in developing and developed countries. Periodontol 2000. 2012;60:98–109.CrossRefPubMed
5.
6.
go back to reference Musgrove P, Zeramdini R, Carrin G. Basic patterns in national health expenditure. Bull World Health Organ. 2002;80:134–46.PubMedPubMedCentral Musgrove P, Zeramdini R, Carrin G. Basic patterns in national health expenditure. Bull World Health Organ. 2002;80:134–46.PubMedPubMedCentral
7.
go back to reference Petersen PE. Global policy for improvement of oral health in the 21st century–implications to oral health research of World Health Assembly 2007, World Health Organization. Community Dent Oral Epidemiol. 2009;37:1–8.CrossRefPubMed Petersen PE. Global policy for improvement of oral health in the 21st century–implications to oral health research of World Health Assembly 2007, World Health Organization. Community Dent Oral Epidemiol. 2009;37:1–8.CrossRefPubMed
8.
go back to reference Petersen PE, Bourgeois D, Ogawa H, Estupinan-Day S, Ndiaye C. The global burden of oral diseases and risks to oral health. Bull World Health Organ. 2005;83:661–9.PubMedPubMedCentral Petersen PE, Bourgeois D, Ogawa H, Estupinan-Day S, Ndiaye C. The global burden of oral diseases and risks to oral health. Bull World Health Organ. 2005;83:661–9.PubMedPubMedCentral
12.
go back to reference Matee M, Simon E. Utilisation of dental services in Tanzania before and after the introduction of cost-sharing. Int Dent J. 2000;50:69–72.CrossRefPubMed Matee M, Simon E. Utilisation of dental services in Tanzania before and after the introduction of cost-sharing. Int Dent J. 2000;50:69–72.CrossRefPubMed
13.
go back to reference Brinda EM, Andrés AR, Enemark U. Correction: Correlates of out-of-pocket and catastrophic health expenditures in Tanzania: results from a national household survey. BMC International Health and Human Rights. 2014;14:18.CrossRefPubMedCentral Brinda EM, Andrés AR, Enemark U. Correction: Correlates of out-of-pocket and catastrophic health expenditures in Tanzania: results from a national household survey. BMC International Health and Human Rights. 2014;14:18.CrossRefPubMedCentral
15.
go back to reference McIntyre D, editor. Proceedings of the Learning from Experience: Health Care Financing in Low-and Middle-Income Countries. Geneva: Global forum for health research; 2007. McIntyre D, editor. Proceedings of the Learning from Experience: Health Care Financing in Low-and Middle-Income Countries. Geneva: Global forum for health research; 2007.
16.
go back to reference Kikwilu EN, Masalu JR, Kahabuka FK, Senkoro AR. Prevalence of oral pain and barriers to use of emergency oral care facilities among adult Tanzanians. BMC Oral Health. 2008;8:28-6831-8-28.CrossRef Kikwilu EN, Masalu JR, Kahabuka FK, Senkoro AR. Prevalence of oral pain and barriers to use of emergency oral care facilities among adult Tanzanians. BMC Oral Health. 2008;8:28-6831-8-28.CrossRef
17.
go back to reference Mosha HJ, Scheutz F. Perceived need and use of oral health services among adolescents and adults in Tanzania. Community Dent Oral Epidemiol. 1993;21:129–32.CrossRefPubMed Mosha HJ, Scheutz F. Perceived need and use of oral health services among adolescents and adults in Tanzania. Community Dent Oral Epidemiol. 1993;21:129–32.CrossRefPubMed
18.
go back to reference Kikwilu E, Frencken J, Mulder J, Masalu J. Barriers to restorative care as perceived by dental patients attending government hospitals in Tanzania. Community Dent Oral Epidemiol. 2009;37:35–44.CrossRefPubMed Kikwilu E, Frencken J, Mulder J, Masalu J. Barriers to restorative care as perceived by dental patients attending government hospitals in Tanzania. Community Dent Oral Epidemiol. 2009;37:35–44.CrossRefPubMed
19.
go back to reference Kikwilu EN, Frencken JE, Masalu JR, Mulder J. Barriers to restorative care as perceived by dental practitioners in Tanzania. Community Dent Health. 2010;27:23–8.PubMed Kikwilu EN, Frencken JE, Masalu JR, Mulder J. Barriers to restorative care as perceived by dental practitioners in Tanzania. Community Dent Health. 2010;27:23–8.PubMed
20.
go back to reference Makinen M, Waters H, Rauch M, Almagambetova N, Bitrán R, Gilson L, et al. Inequalities in health care use and expenditures: empirical data from eight developing countries and countries in transition. Bull World Health Organ. 2000;78:55–65.PubMedPubMedCentral Makinen M, Waters H, Rauch M, Almagambetova N, Bitrán R, Gilson L, et al. Inequalities in health care use and expenditures: empirical data from eight developing countries and countries in transition. Bull World Health Organ. 2000;78:55–65.PubMedPubMedCentral
21.
go back to reference Russell S. Ability to pay for health care: concepts and evidence. Health Policy Plan. 1996;11:219–37.CrossRefPubMed Russell S. Ability to pay for health care: concepts and evidence. Health Policy Plan. 1996;11:219–37.CrossRefPubMed
22.
go back to reference Adegbembo A. Household utilization of dental services in Ibadan, Nigeria. Community Dent Oral Epidemiol. 1994;22:338–9.CrossRefPubMed Adegbembo A. Household utilization of dental services in Ibadan, Nigeria. Community Dent Oral Epidemiol. 1994;22:338–9.CrossRefPubMed
23.
go back to reference Varenne B, Petersen PE, Fournet F, Msellati P, Gary J, Ouattara S, et al. Illness-related behaviour and utilization of oral health services among adult city-dwellers in Burkina Faso: evidence from a household survey. BMC Health Serv Res. 2006;6:164.CrossRefPubMedPubMedCentral Varenne B, Petersen PE, Fournet F, Msellati P, Gary J, Ouattara S, et al. Illness-related behaviour and utilization of oral health services among adult city-dwellers in Burkina Faso: evidence from a household survey. BMC Health Serv Res. 2006;6:164.CrossRefPubMedPubMedCentral
24.
go back to reference Mashoto KO, Astrom AN, Skeie MS, Masalu JR. Socio-demographic disparity in oral health among the poor: a cross sectional study of early adolescents in Kilwa district, Tanzania. BMC Oral Health. 2010;10:7-6831-10-7.CrossRef Mashoto KO, Astrom AN, Skeie MS, Masalu JR. Socio-demographic disparity in oral health among the poor: a cross sectional study of early adolescents in Kilwa district, Tanzania. BMC Oral Health. 2010;10:7-6831-10-7.CrossRef
25.
go back to reference Kikwilu EN, Frencken JE, Mulder J. Barriers to the adoption of the ART approach as perceived by dental practitioners in governmental dental clinics, in Tanzania. Journal of Applied Oral Science. 2009;17:408–13.PubMedPubMedCentral Kikwilu EN, Frencken JE, Mulder J. Barriers to the adoption of the ART approach as perceived by dental practitioners in governmental dental clinics, in Tanzania. Journal of Applied Oral Science. 2009;17:408–13.PubMedPubMedCentral
26.
go back to reference Okunseri C, Born D, Chattopadhyay A. Self-reported dental visits among adults in Benin City, Nigeria. Int Dent J. 2004;54:450–6.CrossRefPubMed Okunseri C, Born D, Chattopadhyay A. Self-reported dental visits among adults in Benin City, Nigeria. Int Dent J. 2004;54:450–6.CrossRefPubMed
27.
go back to reference Kwesigabo G, Mwangu MA, Kakoko DC, Warriner I, Mkony CA, Killewo J, Macfarlane SB, Kaaya EE, Freeman P. Tanzania’s health system and workforce crisis. J Public Health Policy. 2012;33:S35-S44 Kwesigabo G, Mwangu MA, Kakoko DC, Warriner I, Mkony CA, Killewo J, Macfarlane SB, Kaaya EE, Freeman P. Tanzania’s health system and workforce crisis. J Public Health Policy. 2012;33:S35-S44
28.
go back to reference Maharani DA, Rahardjo A. Is the utilisation of dental care based on need or socioeconomic status? A study of dental care in Indonesia from 1999 to 2009. Int Dent J. 2012;62:90–4.CrossRefPubMed Maharani DA, Rahardjo A. Is the utilisation of dental care based on need or socioeconomic status? A study of dental care in Indonesia from 1999 to 2009. Int Dent J. 2012;62:90–4.CrossRefPubMed
29.
go back to reference Khalifa N, Allen PF, Abu-bakr NH, Abdel-Rahman ME, Abdelghafar KO. A survey of oral health in a Sudanese population. BMC Oral Health. 2012;12:5-6831-12-5.CrossRef Khalifa N, Allen PF, Abu-bakr NH, Abdel-Rahman ME, Abdelghafar KO. A survey of oral health in a Sudanese population. BMC Oral Health. 2012;12:5-6831-12-5.CrossRef
30.
go back to reference Maina SW, Ng’ang’a PM. Root canal treatment and pulpotomy in Kenya. East Afr Med J. 1991;68:243–8.PubMed Maina SW, Ng’ang’a PM. Root canal treatment and pulpotomy in Kenya. East Afr Med J. 1991;68:243–8.PubMed
32.
go back to reference Ntabaye M, Scheutz F, Poulsen S. Patient satisfaction with emergency oral health care in rural Tanzania. Community Dent Oral Epidemiol. 1998;26:289–95.CrossRefPubMed Ntabaye M, Scheutz F, Poulsen S. Patient satisfaction with emergency oral health care in rural Tanzania. Community Dent Oral Epidemiol. 1998;26:289–95.CrossRefPubMed
33.
go back to reference Sanya B. Causes of pattern of missing permanent teeth among Kenyans. East Afr Med J. 2004;81:322–5.CrossRefPubMed Sanya B. Causes of pattern of missing permanent teeth among Kenyans. East Afr Med J. 2004;81:322–5.CrossRefPubMed
34.
go back to reference Mashoto KO, Astrom AN, David J, Masalu JR. Dental pain, oral impacts and perceived need for dental treatment in Tanzanian school students: a cross-sectional study. Health Qual Life Outcomes. 2009;7:73.CrossRefPubMedPubMedCentral Mashoto KO, Astrom AN, David J, Masalu JR. Dental pain, oral impacts and perceived need for dental treatment in Tanzanian school students: a cross-sectional study. Health Qual Life Outcomes. 2009;7:73.CrossRefPubMedPubMedCentral
35.
go back to reference Sarita PT, Witter DJ, Kreulen CM, Matee MI, van’t Hof MA, Creugers NH. Decayed/missing/filled teeth and shortened dental arches in Tanzanian adults. Int J Prosthodont. 2004;17:224–30.PubMed Sarita PT, Witter DJ, Kreulen CM, Matee MI, van’t Hof MA, Creugers NH. Decayed/missing/filled teeth and shortened dental arches in Tanzanian adults. Int J Prosthodont. 2004;17:224–30.PubMed
36.
go back to reference Mwakatobe A, Mumghamba E. Oral health behavior and prevalence of dental caries among 12-year-old school-children in Dar-es-Salaam, Tanzania. Tanzania Dental Journal. 2007;14:1–7.CrossRef Mwakatobe A, Mumghamba E. Oral health behavior and prevalence of dental caries among 12-year-old school-children in Dar-es-Salaam, Tanzania. Tanzania Dental Journal. 2007;14:1–7.CrossRef
37.
go back to reference Ntabaye MK, Scheutz F, Poulsen S. Household survey of access to and utilisation of emergency oral health care services in rural Tanzania. East Afr Med J. 1998;75:649–53.PubMed Ntabaye MK, Scheutz F, Poulsen S. Household survey of access to and utilisation of emergency oral health care services in rural Tanzania. East Afr Med J. 1998;75:649–53.PubMed
38.
go back to reference Brennan DS, Spencer AJ. The role of dentist, practice and patient factors in the provision of dental services. Community Dent Oral Epidemiol. 2005;33:181–95.CrossRefPubMed Brennan DS, Spencer AJ. The role of dentist, practice and patient factors in the provision of dental services. Community Dent Oral Epidemiol. 2005;33:181–95.CrossRefPubMed
39.
go back to reference Millstein SG. Utility of the theories of reasoned action and planned behavior for predicting physician behavior: a prospective analysis. Health Psychology. 1996;15:398.CrossRefPubMed Millstein SG. Utility of the theories of reasoned action and planned behavior for predicting physician behavior: a prospective analysis. Health Psychology. 1996;15:398.CrossRefPubMed
40.
go back to reference Poulsen S, Fubusa F, Gemba PM, Lema PA, Mosha HJ, Ntabaye MK. Distribution of dental therapists and assistant dental officers trained under the Tanzania-Danida Dental Health Programme 1981–1993. Odontostomatol Trop. 1999;22:19–22.PubMed Poulsen S, Fubusa F, Gemba PM, Lema PA, Mosha HJ, Ntabaye MK. Distribution of dental therapists and assistant dental officers trained under the Tanzania-Danida Dental Health Programme 1981–1993. Odontostomatol Trop. 1999;22:19–22.PubMed
Metadata
Title
The relative patient costs and availability of dental services, materials and equipment in public oral care facilities in Tanzania
Authors
Kasusu K. Nyamuryekung’e
Satu M. Lahti
Risto J. Tuominen
Publication date
01-12-2015
Publisher
BioMed Central
Published in
BMC Oral Health / Issue 1/2015
Electronic ISSN: 1472-6831
DOI
https://doi.org/10.1186/s12903-015-0061-3

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