Primary oral health care in Nigeria; four decades after the Alma Ata declaration

Abstract

It´s over 4 decades since the Alma-Ata declaration of comprehensive health care for all by a congregation of leaders from 67 nations across the world. Though this step was revolutionary, Primary Oral Health Care delivery is still lacking in many Primary Health Centres in Nigeria. The delivery of essential health services in the country has undergone many transitions. From a spread in just 52 local governments areas in the 80s to a ward system coverage in all the 774 local governments with over 30,000 facilities by the 90s. Despite this progress, only 20% of these facilities are functional and the delivery of primary oral health care in these centres is grossly limited. State governments have thus been encouraged to seize ownership and expand health care delivery. The burden of oral diseases remains high and has been linked with systemic conditions like diabetes, HIV and even delayed gravidity. The integration of oral health care with existing primary health care has been challenged by the limited number of human resources especially available at the rural communities. Poor funding has also hindered oral health care delivery because of the specialized nature of oral care. The National Oral Health Policy issued in 2012 stipulates the need for the integration of oral health services but lacked proper implementation guidelines and a revised edition is expected in 2020. Experts have advocated the need to have a higher proportion of dental auxiliaries to complement the demand for human resource for dental care delivery. Similarly, encouraging task-shifting at the grassroots will also provide an efficient route to expanding the coverage for oral health care in the Nigerian population. Finally, the goal of universal health coverage in Nigeria can be better served by prioritizing Primary oral health Care and full implementation of the National Oral Health Policy in Nigeria.