Operational Capacity of Public Dental Health Services in Tunisia: A pilot study

Auteurs: Nada Alouani, Amira Besbes, Wafa Nasri, Safa Jemli, Youssef Blaiech.

Abstract

Background:

Oral diseases are a significant public health problem globally, especially in developing countries where the availability of basic oral healthcare is limited. In Tunisia, the high prevalence of dental caries and periodontal diseases, with low public-sector dentist density and inequitable distribution of resources, raises concerns about the operational capacity of public dental services. Operational capacity, including equipment performance, material availability, and service readiness, is an important but understudied factor influencing access to care.

Objective:

The objective of this study was to evaluate the operational capacity of public dental health services in Tunisia and its influence on access to care in first- and second-line public healthcare facilities.

Materials and Methods:

A pilot cross-sectional study was carried out among dentists in public primary and secondary oral healthcare services. A structured online questionnaire was used to collect data on sociodemographic variables, the functionality of the dental chair, the availability of equipment and materials, the frequency of service refusal, and the perceived effect on access to care. A convenience sample was used from August to October 2023. Descriptive and analytic results were analyzed using SPSS version 20, and statistical significance was set at p ≤ 0.05.

Results:

The study included 78 participants. The majority were general practitioners (97.4%), and the majority had professional experience of more than five years (88%). The majority of the dentists had access to the basic parts of the dental chair, although 89% of them reported service refusal due to equipment failure, which happened more than six times a year. The majority of the services were for emergency care only, and access to radiology, prosthetic care, and pediatric and surgical care was severely restricted, at 42%, 11%, and less than 2%, respectively. The shortage of materials was also reported by 87.2% of dentists

Conclusion:

Public dental services in Tunisia face substantial operational constraints that significantly limit access to essential oral healthcare. Strengthening equipment maintenance, supply chain management, and equitable resource allocation is essential to improve service delivery and support universal health coverage for oral health

Key words: pilot study, operational capacity, public dental services.

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