This study investigates student and stakeholder perceptions of the role of the dental hygienist in Nepal. The impact of these perceptions on the professionalization of dental hygienists is described whilst exploring the consequences for oral health workforce planning.
Dentistry and dental hygiene students from one dental college in Nepal were asked to complete an anonymous questionnaire; 171 students returned the questionnaire containing a mix of forced response and open-ended items. Quantitative data were analysed using SPSS® 22. These data were complemented with qualitative information from survey open questions and from semi-structured interviews with key informants from several relevant organizations. Qualitative data were manually analysed and coded. Data were triangulated to contextualize quantitative data.
A high level of positive regard for the role of the dental hygienist in Nepal was evident amongst dentistry and dental hygiene students in this college. Both groups believe that the dental hygienist can play a major role in raising oral health awareness in Nepal. The scope of practice of the dental hygienist was unclear with issues surrounding the scope of practice and reports of illegal practice by dental hygienists. Significant differences (P < 0.001) were noted between dental hygiene and dentistry students in relation to their opinion regarding independent practice and the need of supervision by a dentist.
Discussion and conclusion
Supervision of the dental hygienist by dentists and issues surrounding the scope of practice are polarizing the relationship between dentists, dental hygienists and the relevant professional organizations. This could hinder cooperation between these oral health professionals and might lead to underutilization of the dental hygienist. To improve the understanding about the roles of each oral health professional, establishing functional relationships and intraprofessional education involving dentistry and dental hygiene students needs to be introduced. This will benefit the introduction of preventative oral health services in Nepal. Government jobs and incentives to increase the retention and distribution of oral health professionals should be created. The government and professional organizations need to consider professionalizing the dental hygiene workforce and formalize the scope of practice. The unique demographic details of Nepal require a paradigm shift in oral health workforce management in Nepal.