Chronic Disease in Urban Refugees: An Oral Health Pilot Study

Objectives: The aim of this research was to investigate the challenges that urban refugees have in accessing healthcare to address chronic disease. Dental healthcare delivery was used as a model for chronic disease prevention programs. Refugees in Dakar, Senegal completed questionnaires, were interviewed, and /or participated in dental clinical assessments. The objective of this project is to identify context-specific operating procedures for chronic disease prevention programs and provide recommendations to the governmental agencies directly responsible for urban refugee health. Methods: There were three data collection phases: 1. Survey-based. A questionnaire was distributed to 50 urban refugees to identify the perceived barriers in accessing healthcare for existing medical conditions. 2. Clinical Assessments. Oral health examinations were conducted on 35 urban refugees, following educational seminars on nutrition and oral hygiene. 3. Semi-structured interviews with policymakers representing agencies responsible for urban refugee health. Results: 21% of subjects reportedly suffer from mental illness, 36% complained of non-categorized chronic conditions and 66% reported that they suffer from oral disease. 65% of patients required urgent or non-urgent treatment for dental caries and/or head and neck lymphadenopathy yet none were able to receive financial support from the governmental agencies or implementing partners to receive referral care. Conclusions: A healthcare delivery paradigm shift must be made toward an accessible, sustainable, preventative care approach to the chronic diseases plaguing locally integrated urban refugees. Oral disease is one such chronic disease, which can be feasibly addressed through cost-effective clinical screening programs with an educational focus on Nutrition and Oral Hygiene.