Uhuru dental clinic directive timely

While opening an eye and dental clinic at the Tenwek Mission Hospital in Bomet County recently, President Uhuru Kenyatta directed Ministry of Health officials, led by Cabinet Secretary Sicily Kariuki, to ensure construction of four eye and dental clinics by next year — in Eldoret, Nyeri, Nairobi and Mombasa.

The directive is much welcome given the country’s health indicators, which do not paint a rosy picture of the state of oral health. This, I believe, is a step in the right direction and will go a long way in ensuring that oral health services are available, accessible and affordable to most Kenyans.

The country’s first ever comprehensive National Oral Health Survey (NOHS), whose results were released in 2015, shows a myriad unmet oral health-related treatment needs for children and adults alike.

DISEASES

The health-seeking behaviour of the general population was also found to be poor while the quality of life was adversely affected by oral diseases and conditions.

It is noteworthy that tooth decay has a prevalence of 34.3 per cent among Kenyan adults and 46.3 per cent among children. Despite this high prevalence, however, a negligible proportion of Kenyans seek dental treatment and the majority do so only when they suffer pain and discomfort.

Commissioned and sponsored by Wrigley East Africa, the survey findings cogently speak to the general lack of awareness on issues around oral health in Kenya.

Of note is that oral health is being integrated in holistic health approaches and recognised as being associated with various non-communicable diseases (NCDs) such as cancer and diabetes.

ORAL HEALTH

According to the World Health Organisation’s (WHO) manual, Promoting Oral Health in Africa 2016, oral health should be tackled at a primary healthcare level.

The President’s directive is, therefore, welcome for a number of reasons.

Firstly, it could be an indication that the government is ready and willing to give oral health more visibility and, perhaps, more prominence within the universal health coverage (UHC) plan.

The government has set aside Sh300 million for the construction of each of the four dental units, a sign that it intends to increase funding to address the otherwise grossly underfunded oral healthcare services.

UNDERESTIMATE

To demonstrate this, in the 2014/15 financial year, the Ministry of Health’s department of oral health received an operational budget of Sh392,400 — a gross underestimate of the country’s needs, considering that oral healthcare is capital- and labour-intensive. This is a reflection of country’s larger health sector financing, which falls below the 15 per cent requirement of the Abuja Declaration of 2001.

Secondly, it is a good example for county governments to emulate.

The NOHS 2015 shows that a greater proportion of oral healthcare providers work in the urban centres, making the services difficult to access for a majority of Kenyans residing in the rural areas.

DENTAL EQUIPMENT

Further, a scrutiny of the provision and distribution of dental equipment in the public health facilities indicates that most are not functional while the supply of dental materials is erratic.

The President’s directive could, therefore, serve as cue for the 47 governors — who are gathered for the annual devolution conference in Kakamega — to address this. They should ensure that every public health facility has a dental clinic that can address the oral healthcare needs of the local population.

Considering that health is a devolved function, it is expected that the heads of the county governments will take up this challenge.

Additionally, opening up of more dental clinics is likely to bring to the fore the acute shortage of dentists in the country. A Kenyan dentist treats six times more patients against the WHO-recommended ratio of 1:7,000. The country has about 1,000 dentists, meaning one dentist for every 42,000 patients.

COMPENSATION

Having many well-funded, well-equipped clinics across the country, as well as attractive compensation packages for medical personnel, will serve as an incentive for dentists to work in the rural areas. Most dentists in Kenya are based in major urban towns, leaving the rural poor underserved.

Construction of the clinics is, definitely, a step closer to increasing Kenyans’ access to quality oral healthcare. I look forward to their commissioning next year.

Ms Mwangi is Corporate Affairs Director-Africa for The Wrigley Company EA Ltd, a subsidiary of Mars Incorporated. [email protected]