Globally health care is constantly changing to adapt to the change in the burden of diseases. The need to find innovative ways to make optimal use of human resources with the aim of achieving quality output in terms of service delivery is fundamental to address this increasing disease burden. The change in burden of disease has heightened discussions about the impact of the scope of practice to improve access to health care. Improving access to health care can be done through the expansion in the scope of practice of mid-level professionals to enable task shifting. Despite this, the expansion in the existing scope of practice must not be taken lightly but rather should be evidence based whilst respecting the parameters of training, competency and the core philosophy of the profession.


Optimizing the skills of diploma holder dental hygienists in the Seychelles to address the burden of oral diseases was recently discussed with the Health Professional Council (HPC) of Seychelles. This was part of a project currently under discussion. As a regulatory body which recognize new professions, directs and modify the scope of practice henceforth indirectly informing local training, it was fundamental to engage the HPC in the consultative discussions. Present during the meeting at the HPC Headquarters was Mrs. Patricia Rene (Registrar -HPC), Mrs. Jeanne Fanny Al-Abdulla (HPC -Member), Professor Priscilla Brijlal (University of the Western Cape – South Africa), and Dr. Cynthia Noshir (Dental Hygienist – Oral Health Services). The meeting was fruitful as it highlighted (i) the need to engage in more consultative discussions with all relevant stakeholders in regards to scope of practice, (ii) the necessity to remain grounded towards the core philosophy of professions when exploring the expansion scope of practice, in the case of dental hygienist which is oral disease prevention and oral health promotion, (iii) the need to consider lessons learnt from other cadres who have upgraded their qualification to improve service delivery, (iv) the importance to recognize the needs of the country (v) the need to understand the pros and cons of encroachment in  scope of practice amongst cadres, and (vi) the necessity to identify and tackle possible hindering factors which may pose restriction in practice or the implementation in scope of practice as per training plan.