期刊论文详细信息
BMC Oral Health
The relative patient costs and availability of dental services, materials and equipment in public oral care facilities in Tanzania
Risto J. Tuominen2  Satu M. Lahti1  Kasusu K. Nyamuryekung’e1 
[1] Department of Community Dentistry, University of Turku, Turku, Finland;Department of Public Health, University of Turku and Hospital District of Southwest Finland, Turku, Finland
关键词: Patient charges;    Material availability;    Equipment availability;    Dental services;    Cost;   
Others  :  1216526
DOI  :  10.1186/s12903-015-0061-3
 received in 2014-12-08, accepted in 2015-06-17,  发布年份 2015
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【 摘 要 】

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.

【 授权许可】

   
2015 Nyamuryekung'e et al.

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【 参考文献 】
  • [1]Gottret PE, Schieber G. Health financing revisited: a practitioner’s guide: World Bank Publications, Washington DC; 2006
  • [2]Boutayeb A. The double burden of communicable and non-communicable diseases in developing countries. Trans R Soc Trop Med Hyg. 2006; 100:191-9.
  • [3]Everybody’s business--strengthening health systems to improve health outcomes: WHO’s framework for action. World Health Organization, Geneva; 2007.
  • [4]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.
  • [5]Boutayeb A, Helmert U. Social inequalities, regional disparities and health inequity in North African countries. Int J Equity Health. 2011; 10:23. BioMed Central Full Text
  • [6]Musgrove P, Zeramdini R, Carrin G. Basic patterns in national health expenditure. Bull World Health Organ. 2002; 80:134-46.
  • [7]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.
  • [8]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.
  • [9]World Health Organization. Tanzania, Service Availability Mapping. http://apps.who.int/healthinfo/systems/datacatalog/index.php/catalog/8 (2006). Accessed 27 Feb 2015.
  • [10]The World Bank. Tanzania, World Development Indicators. http://data.worldbank.org/country/tanzania (2015). Accessed 27 Feb 2015
  • [11]National Bureau of Statistics. Tanzania Household Budget Survey. http://www.nbs.go.tz/nbs/index.php?option=com_content&view=category&id=54&Itemid=153 (2012). Accessed 27 Feb 2015.
  • [12]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.
  • [13]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. BioMed Central Full Text
  • [14]National Bureau of statistics. Basic Demographic and Socioeconomic profile, Tanzania. http://www.nbs.go.tz/nbs/index.php?option=com_content&view=article&id=499:tanzania-basic-demographic-and-socio-economic-profile-&catid=57:censuses&Itemid=82 (2012). Accessed 27 Feb 2015.
  • [15]Proceedings of the Learning from Experience: Health Care Financing in Low-and Middle-Income Countries. Global forum for health research, Geneva; 2007.
  • [16]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. BioMed Central Full Text
  • [17]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.
  • [18]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.
  • [19]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.
  • [20]Makinen M, Waters H, Rauch M, Almagambetova N, Bitrán R, Gilson L, McIntyre D, Pannarunothai S, Prieto AL, Ubilla G. 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.
  • [21]Russell S. Ability to pay for health care: concepts and evidence. Health Policy Plan. 1996; 11:219-37.
  • [22]Adegbembo A. Household utilization of dental services in Ibadan, Nigeria. Community Dent Oral Epidemiol. 1994; 22:338-9.
  • [23]Varenne B, Petersen PE, Fournet F, Msellati P, Gary J, Ouattara S, Harang M, Salem G. 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. BioMed Central Full Text
  • [24]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. BioMed Central Full Text
  • [25]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.
  • [26]Okunseri C, Born D, Chattopadhyay A. Self-reported dental visits among adults in Benin City, Nigeria. Int Dent J. 2004; 54:450-6.
  • [27]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]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.
  • [29]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. BioMed Central Full Text
  • [30]Maina SW, Ng’ang’a PM. Root canal treatment and pulpotomy in Kenya. East Afr Med J. 1991; 68:243-8.
  • [31]Medical Stores Department. Price catalogue 2014–15. http://www.msd.or.tz (2014). Accessed 27 Feb 2015
  • [32]Ntabaye M, Scheutz F, Poulsen S. Patient satisfaction with emergency oral health care in rural Tanzania. Community Dent Oral Epidemiol. 1998; 26:289-95.
  • [33]Sanya B. Causes of pattern of missing permanent teeth among Kenyans. East Afr Med J. 2004; 81:322-5.
  • [34]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. BioMed Central Full Text
  • [35]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.
  • [36]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.
  • [37]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.
  • [38]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.
  • [39]Millstein SG. Utility of the theories of reasoned action and planned behavior for predicting physician behavior: a prospective analysis. Health Psychology. 1996; 15:398.
  • [40]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.
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