Africa Faces Urgent Oral Health Workforce Shortage; WHO Urges Immediate Action

The lack of adequate investment in oral health systems across the continent has resulted in a severe gap in the number of qualified oral health workers.

Africa is grappling with a severe shortage of oral health professionals, a situation that exacerbates the region’s escalating oral health crisis, leaving millions of people vulnerable to preventable oral diseases. This is according to the World Health Organization’s (WHO) latest workforce fact sheet on oral health, which paints a bleak picture of the challenges faced by the continent. The WHO’s report highlights that in 2021, approximately 42% of Africa’s population was affected by untreated oral diseases, such as dental caries, gum diseases, and tooth loss, a crisis that has worsened over the past three decades.

The lack of adequate investment in oral health systems across the continent has resulted in a severe gap in the number of qualified oral health workers. Between 2014 and 2019, the ratio of dentists and other oral health workers per 10,000 population in Africa was shockingly low. In fact, these numbers were only one-tenth and one-sixth, respectively, of the global average. As of 2022, Africa had a mere 57,000 oral health professionals, which constitutes just 1.11% of the region’s entire health workforce. This translates to only 0.37 oral health professionals per 10,000 people, a far cry from the 1.33 per 10,000 people needed to achieve universal health coverage (UHC) targets.

This significant shortfall is directly linked to the rising burden of oral diseases across the region. WHO's data reveals that the incidence of oral diseases in Africa has been the highest among all WHO regions in the last three decades. Oral health conditions such as cavities, gum diseases, and tooth loss are not just cosmetic issues but also have far-reaching effects on overall health, contributing to systemic diseases like cardiovascular issues and diabetes, and increasing the risk of infections and malnutrition.

The shortage of oral health professionals is compounded by the fact that oral health is often treated as a lower priority within many African health systems. The lack of comprehensive government policies and financial investments in oral health has led to isolated oral health services that are disconnected from broader healthcare frameworks. This siloed approach has created a fragmented system where oral health services are insufficiently integrated into primary healthcare services, further hindering the delivery of care and prevention services. In total, while Africa has over 4,000 health training institutions, only 84 are dedicated to dental education across 26 member states, a stark contrast to the region’s health demands.

A consequence of this lack of prioritization is the slow progress in preventive measures like the use of fluoride and sugar reduction, which are critical to reducing the burden of oral diseases. Currently, only about 17% of the African population has access to essential oral health services through major government health schemes, meaning that a majority of people are unable to access even basic care, let alone preventive or advanced treatments.

The workforce crisis also reveals the disparity in the distribution of oral health professionals. While urban centers may have some access to these professionals, rural and underserved areas are left with little to no oral health infrastructure, making it nearly impossible for the region to tackle the widespread oral diseases effectively. WHO estimates that by 2030, the region will need about 199,170 oral health workers, including 103,858 dentists and 95,312 dental assistants and therapists, to meet the growing demand for services and achieve UHC targets.

Dr. Chikwe Ihekweazu, Acting WHO Regional Director for Africa, emphasized the severity of the situation, stating, “Africa cannot afford to neglect oral health. Neglect has severe, lasting consequences for overall well-being.” He pointed out that inadequate access to oral health services negatively impacts people’s ability to eat, speak, and socialize, thereby diminishing their quality of life and long-term health.

The WHO fact sheet underscores the urgent need for a systemic change to address the oral health workforce crisis. To this end, the WHO has outlined several strategic actions for African nations. These include aligning national oral health and workforce strategies with the WHO Global Oral Health Strategy, enhancing the data management systems to better track workforce numbers, and shifting the focus from treatment-oriented approaches to preventive care models, especially at the community and primary healthcare levels. Task-sharing and innovation in workforce models, such as involving non-dental professionals in basic oral health care, are also recommended to bridge the gap.

Moreover, Dr. Ihekweazu called for the development of retention strategies to prevent the migration of trained oral health professionals out of the region, as well as improvements in training curricula to produce a sufficient number of skilled workers. “This factsheet calls for action,” he said. “Increased investment and targeted interventions are critical to closing Africa's oral health workforce gap. We must prioritize oral health as a fundamental component of Universal Health Coverage to improve health outcomes and reduce the disease burden across the region.”

The WHO's fact sheet serves as a crucial resource for policymakers, healthcare professionals, and advocacy groups who are committed to advancing oral health in Africa. It aims to guide the region’s efforts in addressing this pressing challenge by advocating for stronger national strategies, increased investment, and a more integrated approach to oral health care. Only through concerted efforts and substantial reforms will Africa be able to overcome the workforce shortages and ensure equitable access to oral health services for all its people.