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Dental Education in the Rural Community: a Nigerian Experience

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Dental Education in the Rural Community: a Nigerian Experience PROJECT REPORT Dental education in the rural community: a Nigerian experience O Ibiyemi, JO Taiwo, GA Oke Department of Periodontology and Community Dentistry, Faculty of Dentistry, University of Ibadan, Ibadan, Nigeria Submitted: 30 May 2012; Revised: 3 August 2012, Accepted: 4 December 2012 Published: 18 February 2013 Ibiyemi O, Taiwo JO, Oke GA Dental education in the rural community: a Nigerian experience Rural and Remote Health 13: 2241. (Online) 2013 Available: http://www.rrh.org.au A B S T R A C T At the University of Ibadan, Ibadan, Nigeria, dental students are prepared not only to provide skilled care to individual patients, but also to assume responsibility for the community as a whole. In establishing the rural posting program for dental students, it was planned that all fifth year dental students would undertake a rural posting at Igboora, approximately 80 km from Ibadan, the capital of Oyo State. During this 6 week immersion experience students learn about living in a rural area where they provide community oral health services. This report provides recommendations for initiating, sustaining and expanding rural dental education programs. Key words: dental education, Nigeria, rural posting, underserved and underprivileged areas. Context preventive and promotive care 2. This has produced medical doctors and dentists who are able only to work in secondary and tertiary health centers, leaving primary healthcare (PHC) Despite worldwide adoption of the UN Alma-Ata declaration centers underserved or neglected. Further, this traditional as a strategy for achieving ‘Health For All’, some medical medical education does not prepare doctors in developing education systems are still ‘ivory towers’, remote from their countries for a leadership role in meeting the healthcare health service system 1. In African countries, basic medical needs of an entire population, particularly those who live in education has been largely hospital-based, technologically rural areas 1. oriented and focused on curative therapies at the expense of © O Ibiyemi, JO Taiwo, GA Oke, 2013. A licence to publish this material has been given to James Cook University, http://www.rrh.org.au 1 Fortunately some governmental and non-governmental Southwestern Nigeria. Igboora is situated approximately agencies support the establishment of community-oriented 80 km west of Ibadan and has a population of approximately medical schools where doctors are trained to offer broad- 60 000 whose main occupations are farming and trading 4. based community care and preventive medicine3. To this end, many medical schools have established rural- or remote-area This rural dental posting program was established to provide postings for medical students with the aim of addressing oral health care for the population in and around Ibarapa, community health needs 3. Similarly, some dental schools, while also providing community based dental education such as the Dental School, University of Ibadan Ibadan, where students can observe the determinants of ill-health for Nigeria, have addressed the need to establish rural dental those in disadvantaged communities. The program was education postings for dental students, with the aim of funded by the US MacArthur Foundation and is strongly providing preventive and curative oral health services to rural supported by the Vice Chancellor of the University of Ibadan, underserved and disadvantaged communities. In addition, this the Provost College of Medicine, and the Director of the rural undergraduate dental curriculum exposes dental Ibarapa Community Health Programme. A committee students to rural practice and lifestyle, and so encourages a consisting of consultants in community dentistry, resident desire to work as graduates in areas of unmet oral health doctors in community dentistry, dental officers, a public need. health nurse and an administrative officer was assembled to manage the activities of the Programme. In early meetings the The clinical dental training program of the Dental School committee mapped strategies to achieve Programme aims and University of Ibadan, Nigeria is based at the Dental Center objectives. The committee also met with the management of University College Hospital Ibadan, the capital of Oyo State. the Ibarapa Community Health Programme, a collaborative Although community dentistry is part of the undergraduate program between Ibarapa communities, administrators of the curriculum, there has been no rural or remote area exposure three Ibarapa Local Government Areas (LGAs), the Oyo for dental students to apply didactic knowledge and skills. State Government, University College Hospital Ibadan and This report provides information about the establishment of a the University of Ibadan to ensure effective integration of the rural dental posting program from the Dental School oral health program into existing health facilities at the University of Ibadan, Nigeria in 2007. This will assist the General Hospital Igboora. Additional discussions, strongly establishment of such a program in other dental schools, supported by the Dean Faculty of Dentistry University of especially those in developing countries. It will also provide Ibadan, centered on ensuring that dental and medical information relevant to the community engagement and rural students’ rural postings coincided, in order to promote the oral health programs of local and international governmental sharing of ideas and knowledge about the healthcare needs of and non-governmental organizations that have an interest in this population. providing oral health services, especially for people in underserved locations. A familiarization visit to the General Hospital Igboora was made by both the Ibarapa Community Oral Health and Community Health teams. During this visit the teams Program inspected facilities such as consulting clinics, laboratories, pharmacy, wards, theatres, lecture rooms, staff In 2007, the Department of Periodontology and Community accommodation and recreation areas, and water collection Dentistry, Faculty of Dentistry at the University of Ibadan points. established the Ibarapa Community Oral Health Programme at Igboora (Fig1), a rural community and headquarters of Ibarapa Central Local Government Area of Oyo State, © O Ibiyemi, JO Taiwo, GA Oke, 2013. A licence to publish this material has been given to James Cook University, http://www.rrh.org.au 2 20 45'E 3 000'E 3 015'E 3 030'E 3 045'E 40 00'E 40 15'E 40 30'E 9 000'N 9 000'N Irepo E AT ST RA Orelope 0 A Olorunsogo 0 8 45'N KW 8 45'N Saki East 0 Saki West 0 8 30'N K 8 30'N C W I Orire L A B R A U Atisbo P Atiba S E T A R 0 T 0 N E 8 15'N I 8 15'N N E Itesiwaju B Ogbo North Kajola Iwajowa Ogbo Surulere South 80 00'N 80 00'N Oyo West Ogo Oluwa Oyo east O Iseyin G U N 0 S 0 7 45'N T Afijo 7 45'N A T E Ibarapa North Ibarapa Akinyele OSUN STATE East Ido 70 30'N Lagelu 70 30'N Ibarapa Key Central 4 1 Igboora Egbeda Study Area 5 2 3 1 Ibadan North LGA 2 Ibadan North East LGA 0 0 7 15'N Ona Ara 3 Ibadan South East LGA 7 15'N Oluyole 4 Ibadan North West LGA 5 Ibadan South West LGA 10 0 10 20 30 20 45'E 3 000'E 3 15'E 3 030'E 3 045'E 40 00'E 40 15'E 40 30'E Figure 1: Map of Ibarapa Central Local Government Area, Oyo State, Nigeria. Following this visit, two rooms were allocated to the dental University of Ibadan. This was followed by oral healthcare clinic, appropriate accommodation was provided for the training for school teachers and community health workers in dental surgeons, and female and male dormitories were Ibarapa Central LGA in order to create awareness of oral allocated to the dental students participating in the Ibarapa health care, and to develop their capacity to identify and refer Community Oral Health Programme. It had been noted that people with oral disease from the community. a report on rural practice preferences among medical students in Ghana showed that the students valued rural job Issues attributes that enabled them to perform well clinically and live comfortably 5. Therefore, the allocated accommodation Each year, towards the end of the academic session, 35 to 40 facilities were renovated to assist in motivating students. At fifth-year dental students who have acquired adequate clinical the same time dental materials, instruments and equipment training in dentistry and medicine are scheduled for a six- were purchased for the dental clinic, and an Indigenous in- week rural dental posting. The posting usually coincides with house trained clinic assistant from the local community was medical students’ rural medical posting to encourage employed. interaction between the two groups of students. Prior to travelling to Igboora, dental students spend the first week of The dental clinic was commissioned by the traditional ruler the posting at the Dental Center, University College Hospital and chiefs of Igbo-ora in the presence of the administrative Ibadan, receiving lectures on research methodology and heads of the Ibarapa Central LGA and the Dental School, © O Ibiyemi, JO Taiwo, GA Oke, 2013. A licence to publish this material has been given to James Cook University, http://www.rrh.org.au 3 developing a group research project relevant to the needs of The dental students commence their group research project, the community. At this time they are also briefed on the rural guided by the senior registrar who assists with organizing dental education program and collect their posting booklets. surveys and interpreting findings. However, the main initiative remains with the students. All posting activities are On arrival at Igboora at the beginning of the second week, performed under the supervision of lecturers and consultants students are received by a senior registrar in community in community dentistry, assisted by dental officers on dentistry, and the administrative officer of the Ibarapa rotation in community dentistry.
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