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DALBY, Australia: Outplacement programmes focused on prevention and education are an established approach to improving oral healthcare access for communities living in remote and rural areas. Partnerships in the provision of this care can effectively enhance the quality of public health services and delivery of care. An Australian study has looked at the benefits of such a partnership between the University of Queensland’s School of Dentistry in Brisbane and an Indigenous health service in an underserved rural Indigenous community from the viewpoint of the community. It found this to be a good means of addressing oral health disparities by delivering culturally safe oral healthcare.
Partnering with Indigenous organisations can promote efficacy in healthcare provision, encourage community self-determination and help ensure that the healthcare is provided in a culturally appropriate manner specific to that community. The dental school thus worked with an Indigenous federally funded non-profit organisation in the towns of Dalby and St George, providing free dental care via a student outplacement clinic.
A recent systematic review of the literature revealed that, while the causes of reduced oral health in Indigenous populations are numerous, the dramatic difference between Indigenous and non-Indigenous populations cannot be ignored. The review stated that between 46% and 93% of Aboriginal and Torres Strait Islanders in Australia had caries compared with 28% of non-Indigenous people in the country. The numbers are similar the world over; for example, 19% of non-Indigenous Canadians and 35% of Indigenous Canadians had caries.
Typically, the evaluation of such strategies has focused on outcomes of outplacements for students. However, there has been little assessment of whether access to culturally appropriate care is improved from the community’s perspective.
Through voluntary focus group discussions with Indigenous representatives as advocates to ensure culturally safe and appropriate research conduct, the researchers sought community opinions on perceived health and accessibility benefits of the clinic and the social value placed by the community on the dental services provided and to discover the interprofessional benefits of locating the clinic alongside the local Indigenous health service.
The study found that the health behaviours and attitudes towards oral health of Indigenous people in the community had been positively influenced by attending the dental student clinic and that the community had reported increased oral health awareness and literacy, which can also improve general health outcomes, and improved access to care in what they experienced as a culturally safe and appropriate model of care. Participants also expressed that effective and open communication enhanced their experience.
The dental student clinic in Dalby has become a fundamental part of the community and has built a reputation as a source of excellent dental care for Indigenous people with no access to health services in the surrounding rural area, thanks to ongoing communication and cooperation with local community members.
The partnership is unique in Australia. This model of care could be replicated in other areas of the world where Indigenous populations struggle with barriers to oral healthcare.
Although funding such outplacement programmes can be difficult, government financial support can be viewed as a long-term investment in population health and a cost-effective approach to public healthcare services.
The study, titled “Positive oral health outcomes: A partnership model improves care in a rural Indigenous community”, was published on 30 December 2022 in the Australian Journal of Rural Health, ahead of inclusion in an issue.
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