Figure 9 - uploaded by Pratima Singh
Content may be subject to copyright.
Predictability chart of enrolment versus graduates 3 years later. Figure 10: Practice patterns of graduates over time (percentage composition)
Source publication
Dental Therapists were introduced to the oral health team of South Africa in the 1970s by the Department of
Health in order to assist in reducing inequities in oral health service provision to disadvantaged communities.
Training occurred at two historically disadvantaged universities viz. Medical University of Southern Africa (MEDUNSA) and the Univ...
Context in source publication
Citations
... 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]. A recent 42-year (1977-2019) review of South African dental therapists reported low number of dental therapists being registered with the Health Professions Council of South Africa (HPCSA) annually, with a 40% attrition rate over the review period and a 9% attrition rate for the ten-year period between 2010 and 2019 [14]. ...
... A recent 42-year (1977-2019) review of South African dental therapists reported low number of dental therapists being registered with the Health Professions Council of South Africa (HPCSA) annually, with a 40% attrition rate over the review period and a 9% attrition rate for the ten-year period between 2010 and 2019 [14]. Another South African regional study conducted among University of KwaZulu-Natal (UKZN) graduates reported that 26% of dental therapists in their sample left the profession, of whom 19% returned to university to study dentistry, while 7% no longer worked in the dental profession due to job dissatisfaction [3]. ...
... Studies from South Africa and Australia consistently cite the lack of jobs and promotion opportunities, lack of recognition, poor salaries, limited scope, lack of career pathing, poor working conditions, and lack of resources as the main sources of frustration and job dissatisfaction [14,16,19]. Several studies have reported that this dissatisfaction led to them leaving the profession [3,15,16,19]. Studies reported that some dental therapists who leave their profession go back to university to study medicine or dentistry, while some ventured into unspecified businesses [3,16]. ...
Background
Dental therapy is a category of mid-level oral health professional that was introduced to address inequities in oral health service provision in South Africa within a constrained human resource for health context. However, low numbers of registered dental therapists and attrition threaten this strategy.
Aim
This study explored reasons for this attrition, building on the Hertzberg Two-Factor Theory.
Methods
Through a qualitative exploratory study design, in-depth interviews were conducted with former dental therapists to explore their reasons for leaving the profession. They were recruited using snowball sampling. All interviews were audio recorded, transcribed verbatim, and coded in NVIVO12. A team of researchers applied thematic analysis to agree on themes and sub-themes, guided by Hertzberg’s ideas of intrinsic and extrinsic factors.
Findings
All 14 former dental therapists interviewed expressed their passion for the profession, even though their motivations to join the profession varied. Many of their reasons for leaving aligned with extrinsic and intrinsic factors defined in Hertzberg’s Two-Factor Theory. However, they also spoke about a desire for a professional identity that was recognized and respected within the oral health profession, health system, and communities. This is a novel study contribution.
Conclusion
Dental therapist attrition in South Africa is mainly caused by job dissatisfaction and motivation issues resulting from health system level factors. While the Hertzberg Two-Factor Theory helped identify extrinsic and intrinsic factors at an individual level, we used the Human Resources for Health System Development Analytical Framework to identify solutions for dental therapist production, deployment, and retention. Addressing these issues will enhance retention and accessibility to oral health services in the country.
... 8 In South Africa, although dental therapists are trained and produced every year from the Sefako Makgatho University (SMU) and the University of KwaZulu-Natal (UKZN), the numbers of graduate dental therapists registered with the Health Professions Council of South Africa (HPCSA) remain low. 9 A regional study in KwaZulu-Natal (KZN) reported a high voluntary attrition among dental therapists 10 . The study reported that 26% of dental therapists left the profession, of whom 19% returned to university to study dentistry while 7% no longer work in the dental profession. ...
... Our study sample was dominated by African race (74.5%), which is consistent with two other studies of dental therapists in South Africa. 10,29 This is aligned with the South African racial profile, where 81% of citizens are Africans 30 and also, in part, explained by the fact that dental therapists in South Africa were and are still trained at only two historically black universities. ...
... The majority of study participants worked in the private sector, similar to a previous study on UKZN dental therapy graduates where 47% were in private practice. 10 This trend is also seen among dentists, with 70%-80% working in the private sector, which serves about 20% of South Africa's population. 31 This concentration in the private sector is partly due to limited job opportunities in the public sector. ...
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.4,5,6
... A South African regionally based study in Kwa-Zulu Natal (KZN) reported a high attrition rate among dental therapists. 27 This study reported the misdistribution of dental therapists between private and public sectors, with 47% of UKZN graduates working in private practice while only 9% work in the public sector. 27 This study also reported attrition in the profession, with 26% of dental therapists reported to have left the profession. ...
... 27 This study reported the misdistribution of dental therapists between private and public sectors, with 47% of UKZN graduates working in private practice while only 9% work in the public sector. 27 This study also reported attrition in the profession, with 26% of dental therapists reported to have left the profession. 27 This regional study further reported that out of the 26% who left the profession, 19% returned to university to study dentistry while 7% no longer work in the dental profession. ...
... 27 This study also reported attrition in the profession, with 26% of dental therapists reported to have left the profession. 27 This regional study further reported that out of the 26% who left the profession, 19% returned to university to study dentistry while 7% no longer work in the dental profession. 27 Attrition of dental therapists was also reported in an Australian study, where 28% of dental therapists left their profession. ...
Introduction
Dental therapists are mid-level oral healthcare providers introduced in 1977 to the South African health system to improve access to oral health services. There has, however, been anecdotal evidence of their unusually high rate of attrition that is cause for concern.
Aim and Objectives
This study aimed to determine the demographic profile and attrition rate among members of the South African Dental Therapy profession.
Methods
A retrospective time series review of records of all dental therapists who were previously registered and who are still registered with the Health Professions Council of South Africa (HPCSA) between 1977 and 2019 was conducted.
Results
A total of 1232 dental therapists were registered from 1977 to 2019. The majority (64%) were Africans. Most practicing dental therapists were based in KwaZulu-Natal (44%) and Gauteng (27%), which are the provinces where dental therapists are trained. The overall attrition rate between 1977 and 2019 was 40%, with a figure of 9% for the last 10 years of the study (2010 to 2019).
Conclusion
This study has provided the first evidence of the high attrition rate of dental therapists in South Africa. The high attrition warrants further investigation to address the loss of valuable human resources from an already overburdened and under-resourced public oral health sector.
... The present findings seem to be consistent with other research which found that female students comprise the majority of students in the oral health sciences. 15,16 The results of this study show that Black students constituted an overwhelming majority (96.9%) of the enrolees ( Table 2). This finding is in keeping with the legacy of SMU predecessor institutions. ...
The expansion of the scope of practice of the profession of oral hygiene necessitated the discontinuation of a two-year diploma programme. Aims and objectives To describe and compare the progress to qualification of three cohorts of oral hygiene students enrolled in the diploma and degree programmes at Sefako Makgatho Health Science University. Trends in throughputs were investigated. Design A comparative cross-sectional study. Methods Academic records of three cohorts of first year oral hygiene students enrolled in the diploma and degree programmes were followed up. Data related to the demographic characteristics, numbers enrolled, numbers who dropped out, and the numbers who graduated were acquired and then captured in Microsoft Excel software. Results There was gender parity in enrolment for the diploma programme. Female students constituted the majority of enrolees for the degree programme. The average first year pass rate (83.8% vs 75.8%) as well as average throughput (62.5% vs 56.1%) of the degree programme was higher than that for the diploma programme. Linear trends between cohort size and throughput were not observed. The difference in combined output between the programmes was not statistically significant. Conclusion The average throughput of the degree programme was higher than that for the diploma programme
... 23 At the time of the study, seven hundred and eight dental therapists were registered with the Health Professions Council of South Africa. 24 25 Training of dental therapists is also offered at Sefako Makgatho Health Science University and in view of the motivation to enhance the numbers of dental therapists in the country, a study of the contribution of that programme is warranted. ...
... This study produced results which corroborate the findings of a great deal of work in the field of oral health research. [28][29][30] The 60:40 female: male ratio in the third year of study is consistent with that reported by Singh and Combrink (2011). 25 A possible explanation for the change in gender distribution might be that more male than female students either repeat or drop out of the course. ...
... [28][29][30] The 60:40 female: male ratio in the third year of study is consistent with that reported by Singh and Combrink (2011). 25 A possible explanation for the change in gender distribution might be that more male than female students either repeat or drop out of the course. ...
INTRODUCTION: The urgent need to train a great many dental therapists to alleviate the shortage of oral health personnel has long been recognised. AIMS AND OBJECTIVES: To describe trends in enrolments, examination pass rates and graduations of cohorts of dental therapy students at Sefako Makgatho Health Science University during the decade 2004 to 2014. The number of students who completed their degree and graduated within the regulation time was also determined. DESIGN: A cross-sectional descriptive study. METHODS: Academic records of cohorts of dental therapy students for the period 2004 to 2014 were reviewed. Data related to demographic characteristics, numbers enrolled, numbers who dropped out, and numbers who graduated were acquired and then captured in Microsoft Excel software. RESULTS: The median number of enrolled students in all years was 36. The maximum number of first year enrolment was 21. More female students than male students enrolled and graduated. The aggregate examination pass rate was in the low 80s. The number of graduates was less than a third of the number enrolled. Less than half of all students who had registered initially successfully completed the course in the regulation time. CONCLUSIONS: Both student enrolment and graduations are on an upward trajectory.
The distribution and accessibility of healthcare professionals as well as the quality of healthcare services that the healthcare system is able to deliver are significantly affected by the choices of the medical and other health science graduates. To describe the career and practice intentions of final-year dental therapy students’ classes of the years 2017 and 2018 at Sefako Makgatho Health Sciences University Design A cross-sectional survey. A structured, closed, self-administered, questionnaire was used to collect data. Data related to demographic characteristics, work preferences and career intentions were acquired and then captured in Microsoft excel software. Female students constituted the majority (54.05%). The average age of the population was 23 years old. 64.86% of the students preferred to work in the public sector. A little more (18.9% vs 13.5%) students had been offered jobs than had applied. Twice as many (54.05% vs. 27.03%) preferred to work in the Gauteng province as the percentage who resided there. No fewer than 59.46% saw themselves owning private practices in five years’ time. The majority of students preferred to work in the public sector after graduating with the intention of owning a private practice in the medium term.
Objectives:
This article forms part of a larger research project on the dental therapy profession in South Africa. The objective of this study was to determine the level of job satisfaction among dental therapists trained at one South African university.
Methods:
This study was conducted using the qualitative research approach, where purposive and convenience sampling was used to select interviewees. They were asked a single question: "Do you think that dental therapists in South Africa are satisfied within their present careers?" The narrative data was interpreted using thematic analysis, and the data was validated by using the markers of trustworthiness.
Results:
All stakeholders believed that dental therapists trained at this university were not satisfied in the private and public sectors. In the private sector, they expressed frustration with their limited scope of practice. In the public service, lack of posts, poorly functioning dental facilities, and inadequate remuneration caused high levels of dissatisfaction. Many dental therapists chose this profession as a stepping stone to dentistry.
Conclusions:
The roles and scope of practice of all members of the oral health team needs to be redefined within the context of the primary health care approach. Universities need to recruit students appropriately to fulfill their role within this team. Dental services in the public sector need to be upgraded to meet the oral health needs of the country.
