Electronic oral-health records and dental hygiene therapy recall intervals in Namibian public clinics: a regression-discontinuity estimation of risk-stratified scheduling thresholds

Namibian public dental clinics have increasingly adopted electronic oral-health records (EORs) that embed risk-stratified recall rules, yet the causal effect of these scheduling thresholds on hygiene-therapy utilisation remains unquantified. The estimand is the local average treatment effect at each threshold, identified under the assumption that risk scores are continuous at the cut-off and that clinicians do not manipulate scores to alter scheduling. The design is illustrated with a secondary analysis of 150 country-survey observations from 36 African countries (1990–2025) drawn from the DHS Program indicator on current users' most recent supply or information from a government health centre, which serves as a contextual benchmark for public-sector care contact. The mean of this indicator was 25.261 (SD = 18.895), ranging from 1.50 in Morocco to 51.89 in Zambia.