Rural Zimbabwean adults face long travel times to dental services, yet the relationship between travel-time thresholds and oral healthcare-seeking delay remains poorly specified, and the moderating role of dental-hygiene workforce density is unclear. The model treats delay as a function of the distance to the nearest dental facility, the density of dental hygienists and therapists in the district, and cross-level interactions between these factors. It formalises three propositions: that travel-time thresholds operate as discrete decision points rather than continuous costs; that workforce density attenuates the effect of travel time on delay; and that the attenuation is strongest where workforce density exceeds a critical threshold. The paper then applies the model to the Zimbabwean context, drawing on published evidence on rural travel times, dental workforce distribution and care-seeking behaviour. The analysis is conceptual and methodological: it does not report empirical estimates but derives testable predictions and specifies the data required for their evaluation. The contribution is a threshold-based multilevel framework that reframes oral healthcare-seeking delay as a function of the interaction between geographic access and workforce supply, rather than as a product of either factor alone. The framework has implications for how dental-hygiene workforce planning is evaluated and for the design of outreach services in rural Zimbabwe.
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Rakotondrabe et al. (2026) studied this question.
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