Quality of Care at a Pediatric Dental Clinic in Ibadan; Nigeria

Background: The quality of healthcare has become a topical issue in recent years and the introduction of quality assurance that constitute some of the tools for change is now an important development in healthcare practice. Objectives: This study aims at evaluating the quality of care provided at the Paediatric Dental Clinic of the University College Hospital (UCH); Ibadan. Materials and Methods: A descriptive study was conducted among 141 parents of children who attended the clinic over a 3-month period using a modified quality of care questionnaire by Ygge and Arnetz (2001). Results: Majority of the parents (93.6) were pleased with the registration process; while 81.6 and 66.7 were satisfied with the waiting arrangements and social amenities such as light and water respectively. Ratings of the quality of care indices revealed that 50.4 and 41.1 of the parents were happy with the information process and accessibility respectively. Over 80.0 of the respondents were pleased to a great degree with the dental treatment their children received. However; 44 (31.2) said that they felt that they could not especially/not at all contact their dentist by telephone. About a fifth; (21.2); felt they had not especially/not at all received information about how to prevent their child's dental problem. Inability of the dentists to introduce themselves was reported by 56.8 of the parents. The mean waiting time spent before being attended was 64.9 minutes while the desired average waiting time was 20.1 minutes. Conclusion: Parents were extremely satisfied with the dental treatment their children received at the UCH and had great confidence in staff competence even though they complained of long waiting time. However; there is a communication gap between the dentist; patients; and parents; since some of the dentists failed to introduce themselves and give information on prevention of dental diseases. For this reason; patients' appointments should be spread out to reduce waiting time. Furthermore; staff should introduce themselves and efforts must be made to improve health education given to parents. The dental curriculum should emphasize patient-dentist relationships

Social Stigma as an Epidemiological Determinant for Leprosy Elimination in Cameroon

Leprosy has been eliminated as a public health problem in most countries of the world according to the WHO; but the social stigma to the disease is still very high. The present study was performed to investigate the role of social stigma as a determinant for leprosy elimination in a leprosy endemic region of Cameroon. Focus group discussions; in-depth interviews and structured questionnaires were used to investigate leprosy social stigma among lepers; their contacts and a control group consisting of patients attending a health facility for reasons other than leprosy. Informed consent was sought and gained prior to starting the study. Focus group discussions and in-depth interviews identified three types of stigma: lack of self-esteem; tribal stigma and complete rejection by society. From the 480 structured questionnaires administered; there were overall positive attitudes to lepers among the study population and within the divisions (P=0.0). The proportion of participants that felt sympathetic with deformed lepers was 78.1[95confidence interval (CI): 74.4-81.8] from a total of 480. Three hundred and ninety nine (83.1) respondents indicated that they could share a meal or drink at the same table with a deformed leper (95CI: 79.7-86.5). Four hundred and three (83.9) participants indicated that they could have a handshake and embrace a deformed leper (95CI: 80.7-87.3). A total of 85.2(95.0CI: 81.9-88.4) participants affirmed that they could move with a deformed leper to the market or church. A high proportion of 71.5(95.0CI: 67.5-75.5) participants stated that they could offer a job to a deformed leper. The results indicate that Menchum division had the lowest mean score of 3.3 on positive attitudes to leprosy compared with Mezam (4.1) and Boyo (4.8) divisions. The high proportion of positive attitudes among the participants and in different divisions is a positive indicator that the elimination of leprosy social stigma is progressing in the right direction. Quantification of stigma to assess the elimination struggle is a new research area in public health