Essential professional duties for the sub-Saharan medical/dental graduate: An Association of Medical Schools of Africa initiative.

BACKGROUND - Globally, human resources for health are being optimized to address the increasing health burden and concomitant increased demands on health professionals. These demands are even more exacting in Sub-SaharanAfrica considering the shortage of health care workers, especially physicians. The noteworthy efforts at deploying task-shifting to address this situation not-withstanding, the situation also signals the need to re-define the objectives of medical instruction to ensure effective and contemporary medical practice in a mostly physician-led health workforce across the sub-continent. In this regard, medical and dental graduates must be educated to perform certain minimum essential professional duties competently. Essential Professional Duties are locally relevant professional activities of international standard that represent identifiable outcomes against which the effectiveness of physicians in a specific community can be measured to ensure social accountability. PROCEDURE AND PRODUCT - The Association of Medical Schools of Africa has developed the 'Essential Professional Duties for sub-Saharan medical and dental graduates' to ensure these physicians provide safe and effective contemporary medical/dental practice on the sub-continent. The duties have been grouped into those required for basic patient care, basic administrative skills, basic emergency care, communication, inter-professional relationships, self-directed learning and social responsibilities. Their relevance and suitability have been evaluated prior to their adoption by the Association. CONCLUSION; These Essential Physician Duties have been developed to serve as targets for health professionals training instruments and thus give direction to health system strategies. It is hoped that they will be adopted by medical and dental schools across sub-,. Saharan Africa.

Factors influencing career choice among high school students in Tanzania.

The aim of this study was to identify factors that influenced career choice among high school students in Tanzania. The information obtained would be used to formulate effective recruitment strategies and counseling students on their career expectations in dentistry. All 352 high school students who were studying in five randomly selected high schools completed a pre-tested questionnaire containing twenty-four items addressing five factors. Image of a profession (good experiences from the work of professionals, professionals who are attractive to respondents, and professionals who command high respect in the community) was perceived as an important factor in career choice by the majority of respondents (over 88 percent). Work/profession characteristics (knowledge about work to be done, treating patients, giving medicines to patients, helping relatives, etc.) was ranked as the second most important factor, and course characteristics (availability of postgraduate studies, size of annual intake, pass rate, geographic location, etc.) was ranked third. Direct gains and advice from important persons were perceived as least important in career choice.

Tanzanian high school students' attitude towards five university professional courses.

OBJECTIVE: To determine the attitude of high school students majoring in Physics, Chemistry and Biology (PCB) towards Medicine, Pharmacy, Dentistry, Veterinary Medicine and Nursing as professions at university. DESIGN: A cross sectional study of a representative sample of high school students using a pretested attitudinal questionnaire. Attitude components tested were degree of liking, degree of admiration and intentions to visit a professional at work. SETTING: High schools in Tanzania mainland majoring in PCB. SUBJECTS AND METHODS: All 352 high school students from a representative sample of five schools: two boy-schools; two girl-schools; and one mixed gender-school participated by filling in a questionnaire. The questionnaire consisted of demographic variables on age, sex, class, education and employment status of father and mother as background variables, and questions on the degree of liking, admiration and preference to visit a particular professional at work. All the attitudinal questions were scored on a 5-point scale. Scores for the three-attitudinal components were summed to group subjects into positive, neutral and negative attitude. MAIN OUTCOME MEASURE: Attitude of students to five professions they could study at a higher level. RESULTS: Eighty seven percent of the high school students had a positive attitude towards medicine, 66% towards pharmacy, 40% dentistry, 12% veterinary and 9% nursing. Dentistry and veterinary had the highest percentage of students (46.5% and 37.3%) who had a neutral attitude towards the professions, and the highest percentage of students (11.7% and 9.9%) who reported to have had no sufficient information to enable them indicate whether they admired dentistry and veterinary medicine or not. Significantly more girls than boys liked, admired and preferred to study nursing (chi2 varied from 11.39 to 12.99; p-value < 0.005). CONCLUSION: Medicine was the most liked profession while nursing was the least liked. Pharmacy, dentistry and veterinary medicine fell in between. There was insufficient knowledge about dentistry and veterinary medicine among the high school students.

Integrating oral health into primary health care--experiences in Bangladesh, Indonesia, Nepal and Tanzania.

When primary health care (PHC) was developed and implemented in developing countries, oral health was not included. The present consequences are marked disparities in the distribution of oral health care, since conventional dentistry can only serve relatively few people and at high costs. Oral health care is virtually non-existent in rural areas of most developing countries where more than 80 per cent of the population live. More recently, community based oral health programmes have been initiated in some countries to fill the gap. These programmes give more emphasis on oral health promotion and on the prevention of oral diseases than on treatment of its consequences, since history has shown that the latter is ineffective in preventing oral diseases. Unfortunately, most of these oral health programmes have been implemented next to the existing PHC system and hence they face enormous management, logistic and financial problems, which seriously threaten their sustainability. This paper presents a proposal to counteract the problems that many countries face in developing an adequate primary oral health care (POHC) service.

Caries experience amongst 12- and 15-year-old Tanzanian children residing on a sugar estate.

A study to assess the caries experience in 12- and 15-year-old children living on a sugar estate was carried out in Kilombero, Tanzania. The average sugar distribution figure per capita per year was estimated to be six times higher for the estate population than for the Tanzanian population at large. No restorations were found. The mean DMT scores (+/- SD) for 12- and 15-year-old children were 0.48 +/- 0.82 and 1.02 +/- 1.61 respectively. The mean DMT score in 12-year-old children did not differ significantly from results recently reported in other Tanzanian studies carried out on the same age groups. The data suggest that care should be taken in explaining changes in caries prevalence over time on the basis of sugar sales figures alone.

Occlusal and space characteristics among 12-year-old school children in Bukoba and Moshi, Tanzania.

The aim of the study was to investigate the frequency of occlusal and space characteristics in Bukoba and Moshi, two towns in North-Western and Eastern parts of Tanzania. The entire sample consisted of 47% boys and 53% girls. Angle's and Foster's classifications were used in the study. Sagittal, vertical and transversal occlusion variables were included in the classification. Most of the children had Angle's class I in both townships. No child had distal occlusion in Bukoba but 8% of the school children had Angle's class III which was present in only 5% of the Moshi children. The most prevalent occlusal anomalies in both populations were large overjet and deep bite (greater than or equal to 3.5 mm), the prevalence of which was significantly higher in Moshi. Open bite also occurred more often in Moshi girls than Bukoba girls. No child had scissors bite in Moshi. Open bite and scissors bite in Bukoba girls and cross-bite in Moshi girls were rare. Diastema mediale prevailed mostly in the maxilla in the whole sample. About one fifth of the whole sample had crowding. The results suggest that different occlusal and space characteristics are present in Bukoba and Moshi children.

Oral health status of employees in sugar and sisal estates in Tanzania.

Adults aged 25-54 years residing in a sugar and a sisal estate in Tanzania were examined dentally. The mean DMFT score for sugar cane cutters, clerical employees and sisal plant workers was 3.5, 3.1 and 2.0 respectively. Plaque, calculus and gingival bleeding were observed in 53-98%, 45-79% and 13-30% of the surfaces examined, respectively. It is concluded from this study that, in the age groups of Tanzanians studied, most teeth are lost as a result of caries.

The effect of sugar cane chewing on the development of dental caries.

In Tanzania, the effect of sugar cane chewing on the development of caries was investigated. Two groups were selected; those who had easy access to sugar cane (sugar cane cutters) and those who did not (sisal plant workers). These groups had a similar socio-economic background, had similar levels of fluoride in drinking water, consumed similar amounts of refined sugar per day, but had a significant difference in number of pieces of sugar cane chewed per day. The caries prevalence in both groups was low compared with that in adult populations in Western countries. Sugar cane cutters had significantly higher mean DMT/S scores than sisal plant workers. Analysis of Variance revealed a weakly significant effect of sugar cane chewing on the caries scores (p = 0.02 from DMT and p = 0.05 for DMS). Results of the study suggest that sugar cane chewing in large quantities over a long period has a caries-promoting effect in populations with a low caries prevalence, and further, that sugar sales figures reported for such populations are of questionable reliability.