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Community Oral Health Officers (COHO) in Ghana

E.T. Adjase

Community Oral Health Officers (COHO) in Ghana

In Ghana, Community Oral Health Officers, also known as Physician Assistants – Oral Health, are a group of middle level health professionals trained to be part of the dental or oral health care team. 


Full project description: 

The training of Community Oral Health Officers - key cadre of health professionals - took place at the Kintampo Rural Health Training School in the early 2000s was based on the problem of limited access to oral health care and services particularly in primary health care settings. This was partly due to the inadequate numbers and mal- distribution of Dental Surgeons in Ghana with the resultant heavy workload on the Dental Practitioners.

  • The estimated number of dental surgeons in the country at the time was about 150.


The purpose of the COHO training then was to have the analog type of the Physician Assistant Medical in the Ghana Health Systems. COHOs are thus trained in the medical/dental model by health professionals - dental and medical officers, public health experts and others. A robust curriculum designed to respond to the disease burden of the population that also fits into the culture is used for the training.


Prior to the commencement of the training, several consultative and stakeholder meetings and working sessions were organized by the Chief Dental Officer of the Ministry of Health together with a team of dental and medical doctors, trainers of health professionals and educationists, human resource experts and policy makers, members of the professional associations and regulatory bodies  among others. These steps were undertaken not only to involve key players in health workforce production and development but also for ownership and recognition.

Graduates of the two-year post-basic training programme -including internship, are awarded an advanced diploma in Community Medicine and Oral Health and deployed mainly to dental departments of district hospitals to work with and under the supervision of Dental Surgeons.

Duties / scope of practice

Their hospital and community based duties cover patient evaluation, giving oral hygiene instructions, placement of pits and fissure sealants, topical fluoride application, extraction of mobile deciduous and permanent teeth, placing simple fillings (class 1 amalgam and temporary fillings), pulp treatment of deciduous teeth(direct and indirect pulp capping pulpotomy),performing scaling and polishing, fitting preformed crowns on deciduous teeth, assisting the dental surgeon in performing oral procedures when needed, screening and treating patients in the community and in schools as well as referring to the clinic for further care.

Oral health education and promotion, teaching and conducting operational research, taking on administrative and managerial responsibilities among others are part of their job roles.

The Medical and Dental Council of Ghana (MDC) which is the statutory body established by law to secure in the public interest the highest level of training and practice of medicine and dentistry in the country serves as the Regulatory Body.

  • To date, a little over 100 COHOs have been registered by the MDC with the generic title of Physician Assistant – Oral Health. These mid-level health professionals are practicing dentistry within the prescribed scope of practice based on their training and are currently extending care to the rural, remote and marginalized populations.

 Even though a formal and scientific evaluation of COHOs’ contribution to dental services in Ghana is yet to be done, anecdotally, the outcome and possible impact is noteworthy.


E.T. Adjase - MD,MPH, DSc. honoris causa, Diploma Health Systems Management and Cert. Curriculum Design, Development and Evaluation.



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