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Stakeholders' Perspectives on Attrition in the Dental Therapy Profession in South Africa
Pumla Pamella Sodo1, Yolanda Malele-Kolisa2, Aneesa Moolla2
1Department of Family Medicine and Primary Care University of the Witwatersrand Johannesburg South Africa.
Background:
Dental therapists play a critical role in addressing oral health needs, especially in underserved areas. However, the South African health system faces workforce shortages and challenges retaining mid-level oral health professionals. Understanding attrition from the perspective of stakeholders involved in training, policy and regulation is key to addressing systemic barriers and improving retention.
Aim:
This study aimed to explore the perspectives of key stakeholders on the factors contributing to attrition among dental therapists in South Africa, focusing on intrinsic and extrinsic influences as guided by Herzberg's two-factor theory.
Methods:
Through a qualitative exploratory study design, in-depth interviews were conducted with stakeholders to explore their perspectives on dental therapists' attrition. They were recruited using snowball sampling. All interviews were audio recorded, transcribed verbatim, and coded in NVivo 12. A team of researchers applied thematic analysis to agree on themes and sub-themes, guided by Hertzberg's ideas of intrinsic and extrinsic factors.
Findings:
Thirteen stakeholders participated in the study. Both extrinsic (policy implementation gaps, inadequate remuneration, limited recruitment opportunities and lack of professional identity) and intrinsic (limited career growth and unclear career pathways) factors were identified as key contributors to attrition. Despite the recognition of their essential role in primary healthcare (PHC), systemic challenges undermined professional satisfaction and retention.
Conclusion:
The study fulfils its aim by providing a nuanced understanding of attrition from the perspective of stakeholders. Addressing both systemic (extrinsic) and motivational (intrinsic) factors is critical to strengthening workforce sustainability. Policy reforms, structured career pathways and enhanced professional recognition are necessary to retain dental therapists and ensure their integration into South Africa's PHC vision.
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