Objective

Sierra Leone (SL), with a population of over 7 million people, has a critical health workforce shortage. This research explores the views of key players on population oral health needs and demands, the challenges of oral and dental care delivery, and professional careers in dentistry, in order to inform future capacity building.

Materials and methods

Semi-structured interviews were conducted with a purposive sample of key players in dentistry and healthcare, both in-country and externally. An interpretive phenomenological approach was used in exploring views of key-players on the oral needs and demands of population, challenges in the delivery of oral and dental care, professional careers of dental professionals in SL, and future workforce capacity building based on a topic guide drawn from the available literature. Interviews were audio-recorded, transcribed verbatim, anonymised and analysed using QSR NVivo 10 for data management and reported in accordance to the consolidated criteria for reporting qualitative research.

Results

Twenty-one informants, of whom 18 were male, 17 were in-country and 16 were dental professionals, participated in the research. Dental professionals reported clear consensus on a considerable level of unmet oral health needs, most notably dental caries and periodontal disease, together with life threatening oral conditions such as osteomyelitis, Ludwig’s Angina and Burkitt’s Lymphoma. Challenges associated with the delivery of dental care revolved around five themes: patients’ predisposition for traditional remedies and urgent care; practical hindrances to the delivery of care; professional isolation and weak governance; and place with pressing local crises and lack of political will. An emerging typology of dental professionals included: demonstrating loyalty to their nation and family; exhibiting resilience in challenging circumstances; embracing opportunity most notably amongst expatriates; and striving to serve the needs of the population. There was support for innovative future capacity building developments.

Conclusion

This paper provides important insights to the delivery of dental care in a low-income country with significant oral health needs and multiple challenges in the delivery of dental care, whilst also providing a vision for developing, building and retaining future human resources for oral health.

中文翻译：

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为人民服务的毅力和韧性：塞拉利昂牙科专业人员为健康而奋斗的案例研究

客观的

塞拉利昂 (SL) 人口超过 700 万，卫生人力严重短缺。这项研究探讨了主要参与者对人口口腔健康需求和要求、口腔和牙科护理服务的挑战以及牙科职业生涯的看法，以便为未来的能力建设提供信息。

材料和方法

对国内外牙科和医疗保健领域的主要参与者进行了半结构化访谈。采用解释现象学方法来探索主要参与者对口腔需求和人口需求、提供口腔和牙科护理的挑战、SL 牙科专业人员的职业生涯以及基于主题指南的未来劳动力能力建设的看法取自现有文献。访谈内容均进行录音、逐字转录、匿名化，并使用 QSR NVivo 10 进行数据管理分析，并根据报告定性研究的综合标准进行报告。

结果

21 名知情人参与了这项研究，其中 18 名是男性，17 名是国内人员，16 名是牙科专业人员。牙科专业人士报告称，人们对相当多未满足的口腔健康需求达成了明确共识，其中最引人注目的是龋齿和牙周病，以及危及生命的口腔疾病，例如骨髓炎、路德维希心绞痛和伯基特淋巴瘤。与提供牙科护理相关的挑战围绕五个主题：患者对传统疗法和紧急护理的倾向；提供护理的实际障碍；专业孤立、治理薄弱；以及当地危机紧迫且缺乏政治意愿的地方。牙科专业人士的新兴类型包括：表现出对国家和家庭的忠诚；在充满挑战的环境中表现出韧性；拥抱机会，尤其是外籍人士；并努力满足人民群众的需求。人们支持创新的未来能力建设发展。

结论

本文为低收入国家提供牙科护理提供了重要见解，这些国家具有巨大的口腔健康需求，并且在提供牙科护理方面面临多重挑战，同时还为开发、建设和留住未来口腔健康人力资源提供了愿景。