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Abstract It has been proclaimed in the National Charter in 1962 that ”attainment of good health is a ligitimate right of every citizen regardless of his economic status, religion or political belief. Medical care services (including oral and dental care) should extend to reach every village in each corner of the country”. Indeed, the last thirty years had witnessed tre mendous expansion of health services in the country. Provision of oral health care in rural areas started in 1965 through the rural health centres and rural hospitals. In each g~vernorate there is the Dental Director and he is responsible for all oral health services. 9n 5 November 1979 the Minister of Health passed the order No. 569 (appendix 2) concerning the organization of the Ministry and the authorities and responsibilities of the central level and the different sectors. A new supervisory level has been created at the district level (District Health Administration) including one Senior Dental Officer (S.D.O.) to supervise the dental clinics in the district specially in rural areas. It was left to the Governors to adopt this system when the local conditions permit. Aim of the Study. This study was conducted to determine the impact of the supervisory level in the districts on the quality of dental care in the rural areas. Two governorates were c?osen for the study one with S.D.O. in the districts (Beni-Suef) and the other with no such system (Menoufia). from each district a rural health centre containing a dental clinic was chosen for study total 15 units. The methods used in the study were: 1. Visits to the two governorates and the chosen dental . clinics to assess the facilities available. 2. study of the reports of the two governorates during’ ttie last five years, 1971-1981. J. Interview questionaire for the senior dental officers and the practitioners in the dental clinics (Form A). 4. Interview questionaire for a sample of patients attending the chosen clinics (Form B). Resul ts. 1. Services provided in the two governorates were similar, and no significant difference i.e. about 50 of the services were extractions and treatments after extractions, about 30 8c~ling and gum , treatment, about )-5 filling and the rest were other services. In other words the new supervisory level did not produce noticeable change. 2. Dentist’s complaints were: low salaries and no incentives - no living accomodations - undefined working time - no transport - shortage of drugs, chemicals, anaesthesia and X-ray films. Their suggestions to improve the service were corrections for these problems. , J. Patients opinions about the service were: irregular , attendance of the dentists - the clinic is not tidy no waiting room - no prosthetic treatment and few patients asked for male dentists. Recommendations. 1. There is a ’need for a-National Oral and Dental Health Pian for urban and rural areas based on the real problems and needs of the people. 2. The central government in the Ministry in Cairo is responsible for the overall planning, supervision and guidance. Allocation of budget is based on the number of the population and magnitude of the problems. . The senior staff in the governorate, on the other hand, should carry their responsibilities and not to be completely dependent on the central government. They should make their plans, and through local admin istrations and local councils devise ways and means to increase their financial resources. They are respon sible for efficient operations of the delivery system in thegovernorate specially in the rural areas; staff~ng - supervision - training - evaluation - pro curement of drugs and chemicals etc. J. . Proper selection and training of the Senior staff in the governorates. The study has shown that the senior staff in the two governarates had no post-graduate qualification and did not recieve any training in administration and preventive dentistry. In our opinion this is a serious defect in the health care del ivery system and should be rect~fied. 4. The complaints rais”ed by the dentists are just and correct and solutions should be found for them. Dentists income in rural areas should be raised. There should be some sources for incetives. 5. There should be attractive terms for senior staff and supervisors e.g. full-timers with reasonable . compensation, incentives, living accomodation and transport. Authority should be granted parallel to the responsibilities. Good opportunities for . post-graduate training. By these terms we can attract good subjects.to work 8S seniors and super visors. 6. It is hoped that when the working conditions improve and the dentists become satisfied, the pat ients complaints will disappear. Dentists will attend t~ work regularly and treat their patients friendly and respectfully. |