The Role of Community Health Workers in Oral Health Promotion and the Impact of their services in Sub-Saharan Africa: A Systematic Review.
Oral ailments are largely preventable but remain a significant public health concern afflicting nearly half the global population. These conditions account for 220 years of life lost per 100,000 people and about US$500 billion in health-related expenditures. SubSaharan Africa bears a significant burden of oral health problems thus exerting additional pressure on the scarce human resources for health. Community healthcare workers (CHWs) could be potentially utilised to bridge the shortage of oral health professionals in
sub-Saharan Africa, hence, this systematic review that seeks to explore their current roles in oral health and potential impact on general physical health. This review follows the PRISMA guidelines and databases searched include PubMed, Web of Science, Medline, and CINAHL published between January 2010 and December 2019. Nine studies met the study eligibility criteria. The authors
of this review established that CHWs perform variable roles cutting across primary, secondary, and tertiary prevention including providing oral hygiene education, recognising common pathologies, and treating oral lesions, administration of tooth extractions, dental pain management, and referral for advanced care. Although this could potentially improve oral health, our review did not establish the extent of the specific impact on general physical health of patients and the burden of oral condition.
Glick M, Williams DM, Kleinman D V., Vujicic M, Watt RG, Weyant RJ. A new definition for oral health developed by the FDI World Dental Federation opens the door to a universal definition of oral health. Am J Orthod Dentofac Orthop. 2017 Feb;151(2):229–31.
WHO. Oral health [Internet]. World Health Organisation. 2018. Available from: https://www.who.int/healthtopics/oral-health#tab=tab_1
Marcenes W, Kassebaum NJ, Bernabé E, Flaxman A, Naghavi M, Lopez A, et al. Global burden of oral conditions in 1990-2010: A systematic analysis. J Dent Res. 2013;92(7):592–7.
Fonseca EP da. Oral Health Challenges: Global Burden of Disease as Information Resource for Policy-Making and Health Situation Analysis. Dent Case Rep. 2018 Feb;2(1).
Skillman SM, Doescher MP, Mouradian WE, Brunson DK. The challenge to delivering oral health services in rural America. Vol. 70, Journal of Public Health Dentistry. 2010.
Petersen PE, Bourgeois D, Ogawa H, Estupinan-Day S, Ndiaye C. The global burden of oral diseases and risks to oral health. Vol. 83, Bulletin of the World Health Organization. World Health Organization; 2005. p. 661–9.
Barnett T, Hoang H, Stuart J, Crocombe L. The relationship of primary care providers to dental practitioners in rural and remote Australia. BMC Health Serv Res. 2017 Aug 1;17(1):1–13.
Chhabra N, Chhabra A. Parental knowledge, attitudes and cultural beliefs regarding oral health and dental care of preschool children in an Indian population: A quantitative study. Eur Arch Paediatr Dent. 2012 Apr;13(2):76–82.
Swati J, Ashish S, Basavaraj P, Hansa K, Khushboo S, Shilpi S. Assessing the influence of culture on oral health-a review. J PEARLDENT. 2014 Jan;2:1–8.
Smit DA, Barrie RB, Louw AJ. The burden of dental caries in the Western Cape and a recommended turnaround strategy. S. Afr. dent. j. [Internet]. 2017 Sep [cited 2022 Apr 17] ; 72( 8 ): 360-365. Available from: http://www.scielo.org.za/scielo.php?script=sci_
Ministry of Health - Uganda. Ministry of health Community Health Extension Workers Strategy in Uganda. 2016. p. 64.
Koyio LN, Van der Sanden WJM, Van der Ven A, Mulder J, Creugers NHJ, Merkx MAW, et al. A communitybased oral health promotion model for HIV patients in Nairobi, East District in Kenya: a study protocol. J Public health Res. 2013 Jun;2(1):5.
Handtke O, Schilgen B, Mösko M. Culturally competent healthcare – A scoping review of strategies implemented in healthcare organizations and a model of culturally competent healthcare provision. Todd CS, editor. PLoS One [Internet]. 2019 Jul [cited 2020 Feb
;14(7):e0219971. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6667133/
Perry HB, Zulliger R, Rogers MM. Community Health Workers in Low-, Middle-, and High-Income Countries: An Overview of Their History, Recent Evolution, and Current Effectiveness Keywords. Annu Rev Public Heal. 2014;35:399–421.
Moher D, Shamseer L, Clarke M, Ghersi D, Liberati A, Petticrew M, et al. Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015 statement. Syst Rev [Internet]. 2015 Dec 1 [cited 2019 Jul 24];4(1):1. Available from: https://systematicreviews journal.biomedcentral.com/articles/10.1186/2046-4053-4-1
Liberati A, Altman DDG, Tetzlaff J, Mulrow C, Gøtzsche PC, Ioannidis JPA, et al. The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate healthcare interventions. PLoS Med [Internet]. 2009 Jul 21 [cited 2019 Jul 11];6(7):e1000100. Available from: https://insights.ovid.com/bmj/bmjd/2009/07/250/prisma-statementreporting-systematic-reviews-meta/24/00002591
WHO Regional Office for Africa. World Health Organization. Int Organ [Internet]. 1960;14(1):212–4. Available from:https://www.afro .who.int/
Baiju R, Peter E, Varghese N, Sivaram R. Oral health and quality of life: Current concepts. J Clin Diagnostic Res. 2017 Jun 1;11(6):ZE21–6.
Agbor AM, Naidoo S, Mbia AM. The role of traditional healers in tooth extractions in Lekie Division, Cameroon. J Ethnobiol Ethnomed. 2011 May 30;7.
Agbor AM, Naidoo S. Knowledge and practice of traditional healers in oral health in the Bui Division, Cameroon. J Ethnobiol Ethnomed. 2011 Jan 15;7.
Jordan RA, Gaengler P, Markovic L, Zimmer S. Performance of Atraumatic Restorative Treatment (ART) depending on operator-experience. J Public Health Dent. 2010 Jun;70(3):176–80.
Rudolph MJ, Ogunbodede EO, Mistry M. Management of the oral manifestations of HIV/AIDS by traditional healers and care givers. Curationis [Internet]. 2007 [cited 2020 Oct 6];30(1):56–61. Available from: http://curationis.org.za/index.php/curationis/article/view/1051
Lewis HA, Rudolph MJ, Mistry M, Monyatsi V, Marambana T, Ramela P. Oral health knowledge and original practices
of African traditional healers in Zonkizizwe and Dube, South Africa. SADJ [Internet]. 2004 [cited 2020 Oct 31];59(6). Available from: https://europepmc.org/article/med/15457910
Molete MP, Daly B, Hlungwani TM. Oral health promotion in Gauteng: A qualitative study. Glob Health Promot [Internet]. 2013 [cited 2020 Oct 6];20(1):50–8. Available from: http://www.sagepub.co.uk/journalsPermissions.navDOI:10.1177/1757975913476906http://ped.
Frencken JE, Borsum-Andersson K, Makoni F, Moyana F, Mwashaenyi S, Mulder J. Effectiveness of an oral health education programme in primary schools in Zimbabwe after 3.5 years. Community Dent Oral Epidemiol. 2001;29(4):253–9.
Jamieson L. Using qualitative methodology to elucidate themes for a traditional tooth gauging education tool for use in a remote Ugandan community. Health Educ Res [Internet]. 2006 [cited 2020 Oct 6];21(4):477–87. Available from: https://academic.oup.com/her/
Braimoh OB, Umanah AU. Basic package of oral care: a veritable tool for promotion of primary oral health care by community health officers. Odontostomatol Trop [Internet]. 2014 [cited 2020 Oct 6];37(147):51–6. Available from: https://europepmc.org/article/
Olaniran A, Smith H, Unkels R, Bar-Zeev S, van den 292 > REVIEW www.sada.co.za / SADJ Vol. 77 No.5Broek N. Who is a community health worker? - A systematic review of definitions. Vol. 10, Global Health Action. Co-Action Publishing; 2017.
Svensson L, Hakeberg M, Wide U. Dental pain and oral health-related quality of life in individuals with severe dental anxiety. Acta Odontol Scand [Internet]. 2018 Aug 18 [cited 2021 Feb 11];76(6):401–6. Available from: https://www.tandfonline.com/doi/full/10.1080/0
Tjakkes GHE, Reinders JJ, Tenvergert EM, Stegenga B. TMD pain: The effect on health related quality of life and the influence of pain duration. Health Qual Life Outcomes [Internet]. 2010 May 2 [cited 2021 Feb 11];8(1):1–8. Available from: https://link.springer.com/
Frazão P, Marques D. Effectiveness of a community health worker program on oral health promotion. Rev Saude Publica. 2009;43(3):463–71.
Birur Np, Gurushanth K, Patrick S, Sunny S, Raghavan S, Gurudath S, et al. Role of community health worker in a mobile health program for early detection of oral cancer. Indian J Cancer [Internet]. 2019 Apr 1 [cited 2021 Feb 11];56(2):107–13. Available from: http://www.indianjcancer.com/text.asp?2019/56/2/107/257547
Willcox ML, Peersman W, Daou P, Diakité C, Bajunirwe F, Mubangizi V, et al. Human resources for primary health care in sub-Saharan Africa: Progress or stagnation? [Internet]. Vol. 13, Human Resources for Health. BioMed Central Ltd.; 2015 [cited 2021 Feb
. p. 76. Available from: http://human-resourceshealth.biomedcentral.com/articles/10.1186/s12960-015-0073-8
Hermann K, Van Damme W, Pariyo GW, Schouten E, Assefa Y, Cirera A, et al. Community health workers for ART in sub-Saharan Africa: Learning from experience - Capitalizing on new opportunities [Internet]. Vol. 7, Human Resources for Health. BioMed Central Ltd.; 2009 [cited 2021 Feb 11]. p. 1–11. Available from: https://link.springer.com/articles/10.1186/1478-4491-7-31
Kisia J, Nelima F, Otieno DO, Kiilu K, Emmanuel W, Sohani S, et al. Factors associated with utilization of community health workers in improving access to malaria treatment among children in Kenya. Malar J [Internet]. 2012 Dec 30 [cited 2021 Feb 11];11(1):248.
Northridge ME, Wu Y, Troxel AB, Min D, Liu R, Liang LJ, et al. Acceptability of a community health worker intervention to improve the oral health of older Chinese Americans: A pilot study. Gerodontology [Internet]. 2020 Dec 27 [cited 2021 Feb 11];ger.12522. Available
Mobula LM, Okoye MT, Ebony Boulware L, Carson KA, Marsteller JA, Cooper LA. Cultural competence and perceptions of community health workers’ effectiveness for reducing health care disparities. J Prim Care Community Heal [Internet]. 2015 Jan 1 [cited 2021 Feb
;6(1):10–5. Available from: http://journals.sagepub.com/doi/10.1177/2150131914540917
How to Cite
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.