Dental Hygiene Workforce Density and Hypertension Screening Capture in Ghanaian Primary Care Clinics: A Multilevel Analysis of Task-Sharing Governance

Ghana's community-based health planning and services programme has expanded the role of non-physician cadres in chronic disease detection, yet the contribution of dental hygienists to hypertension screening remains unmeasured. The framework specifies three mechanisms—task allocation, supervisory integration, and documentation infrastructure—that condition whether dental hygienists can convert screening opportunities into recorded diagnoses. Using a conceptual synthesis of task-sharing scholarship and health workforce governance theory, the paper derives testable propositions about cross-level interactions between clinic-level workforce density and district-level governance arrangements. Workforce density alone is insufficient; the effect of dental hygienists on hypertension screening capture depends on whether district health administrations formalise screening tasks in job descriptions, integrate dental staff into chronic disease supervision, and provide shared documentation platforms. Implications for workforce policy and primary care organisation in Ghana and comparable settings are discussed.