Assessment of the quality of oral health care in public dental clinics in the Cape Coast Municipality

Many developing countries including Ghana have made considerable effort to improve the quality of health care that is available to its people. This has however been hampered by limited budgetary allocations and resources. The application of the concept of Quality Assurance in Health Care is seen as one of the ways of improving health care delivery in the face of limited resources. The Ghana Health Service thus embarked o n a sensitization programme t o hhighlight the benefits of assuring quality in public health facilities and impress upon these facilities to incorporate quality assurance into their health delivery activities. The Central Regional Hospital and Cape Coast District Hospital adopted and incorporated Quality Assurance into their activities in 2001 and 2002 respectively. The objective of this descriptive cross sectional study was to assess the quality of oral health care in the Cape Coast Municipality under the context of quality assurance programmes in place at the Cape Coast District Hospital and the Central Regional Hospital and at their dental clinics. The Donabedian model for assessing quality of care was used in assessing the quality of oral health in the two hospitals. This model considers the delivery of health care as a system and it considers its structure, process and outcome Structure quality looked at the type, quantity and quality of staff, the equipment state of the dental clinics, instruments available, the availability and supply of materials and range of services provided. Issues studied under process quality included the actual activities undertaken in the delivery of care, provider-client relationships, barrier techniques in place and infection control and prevention including disposal of used materials and wastes. Client perception of the care provided was looked at under outcome quality. Both qualitative and quantitative sampling methods were used in the study. Systematic random sampling was used for the selection of cards for the record review and purposive sampling for the rest of the study. The data collection techniques employed in the study were key informant interviews, focus group discussions, review of records, physical inventory, observation of process of care delivery at the dental clinics and client perception survey. The results obtained showed that quality assurance programmes were in place at both hospitals with management support. Both dental clinics had adequate equipment and material supplies. Staff numbers were inadequate for both clinics as both had less than the number of dental surgeons and dental surgery assistants required for optimal operations and there were no dental technicians or hygienists/therapists. The process of care delivery was good, except that the cards used were such that the information recorded on them was inadequate and inconsistent. The majority of clients interviewed were satisfied with the oral health care they received at the two dental clinics within the Cape Coast municipality. Recommendations were made in the areas of structure and process to further enhance the quality of oral health care delivery

Source: KNUST