Sustainable Dentistry
PREVENTATIVE DENTISTRY DEMONSTRATION CENTER (PDDC)
Organizational Vision
Citizen Base Strategy
Results
Sherifat Quadri, an Ashoka Fellow, founded the Preventative Dentistry Demonstration Center (PDDC) to make Nigerians aware of the importance of oral health. Millions of Nigerians suffer from poor oral health, which negatively impacts their overall nutrition and well being. Oral health is often overlooked in national health care and policy due to the need to focus on the most serious health issues. Most Nigerians only resort to dentists, doctors, or traditional healers in dental emergencies, long after the problem has become more serious.
Quadri, a public health officer and a trained dental hygienist, is changing the reality of oral health care by introducing preventative dental services to Nigeria. “Governments, major foundations, and worldwide organizations could be a source of financial and policy support for new kinds of oral health care,” Quadri notes,” but this commitment is generally not maintained, and there are constant fluctuations and reductions in support—most often leading to the decline and demise of the programs.” Departing radically from the prevailing public health model of education campaigns that target adults and provide free but temporary public services, Quadri’s approach targets children and charges for private services from the outset.
Quadri’s impact goes far beyond the capacity of her team of six full time and four part time staff. Given the extreme problems of underdevelopment in poor rural settings and an inadequate health system, Quadri initiated community oral health programs for the rural and suburban population by designing creating locally based, locally sustained, and locally replicated oral health services.
In 1992 Abeokuta, the capital of Ogun State, had a high rate of childhood dental disease—9 out of 10 school-aged children required treatment for tooth decay, gum disease, and other orthodontic problems. With support from the Community Action Council and a local dentist, Quadri received funding from the Ministry of Health to launch the first community managed model for dental health.
Quadri canvassed the Abeokuta community, raising awareness and creating interest in her idea. Her goal was to build local ownership by creating community stakeholders who would benefit from the services as well as contribute to them. She “sold” community members on her idea by communicating that she would serve all, regardless of economic circumstances, ethnic background, or cultural heritage. Through these community interactions, she also collected her first in-kind donations: the 5 room building that would house the first clinic; samples of dental products (from the Nigerian manufacturer of Crest toothpaste); a used dental chair; and a car for her mobile dental unit. Today, services are designed collectively with local people who best know their own problems, needs, and capacities. As a result, control of dental projects and programs rests with the community being served.
For Quadri, community control includes financial contributions. These come in the form of fees for dental and training services and donations. Her most successful fundraising is done through an annual “dental gala”, which builds awareness and creates a financial base that subsidizes patient fees, covers core costs, and contributes to the spread of the strategy.
In cooperation with school authorities, she offers free screening services to new school entrants in many of the public and private schools in Abeokuta and its environs. The free screenings lead to a stream of follow-up visits to the clinic on a fee basis for topical fluoride, diet regulation, plaque control, dental health education, diagnostic treatment, and repeat periodic screening. She solicits support and cooperation from parents and works out payment plans to help them afford needed treatment. "The client must pay," she insists, "it [impresses upon them] the value of the service and ensures its sustainability."
Quadri keeps costs low and services abundant by training community members and dental hygienists (an underemployed profession in Nigeria) in her methods. In a volunteer capacity, they assist her in cleaning teeth and are responsible for running demonstrations. Once trained, these individuals go on to start their own community managed centers. Quadri shows them how to implement her strategy with a minimal amount of capital investment (obtained through UNDP, local health ministries, national grants, and local donations).
Results
Today, Quadri’s first preventative dentistry demonstration center is 100 percent sustained through local donations (on average 35 percent of total budget) and fees from services (on average 65 percent of total budget). The clinic is a clean, fun, and educational environment—treated more as a community center by school children than a dental clinic. She has designed engaging educational materials using donated audio visual equipment and books, and a mix of games and leisure reading is also on hand. Additionally, and at no cost to Quadri, her model has been replicated in 8 communities—serving 10,000 individuals.
Quadri conducts periodic surveys to track changes in the general oral health of the children and community awareness of dental care and oral health. These surveys show that her program has succeeded in improving oral hygiene and awareness among children in Abeokuta and its environs. She is also seeing a greater demand for dental care by adults in the area as well, assuring her that her "trickle up" approach is working.
Read a profile about Sherifat Quadri, Ashoka Fellow.