Access to Oral health care: a focus on dental caries treatment provision in Enugu Nigeria

Nkolika Uguru,Udochukwu Ugochukwu Ogu,Obinna Onwujekwe,Chibuzo Uguru

doi:10.1186/s12903-020-01135-1

Abstract

BackgroundDental caries, despite improvement in oral health across the globe, is still a large contributor to the global burden of oral diseases and a major public health concern. In Enugu state, Nigeria, there is minimal access to adequate and proper oral health care. This study examined the determinants of dental caries treatment provision and the challenges of providing equitable access to oral health care.MethodThis was a mixed-method cross-sectional descriptive urban-rural study conducted in selected oral health facilities offering primary oral health care in Enugu state. The study was conducted in two phases over a 2 month period. Quantitative data was initially collected from all selected oral health care providers using a survey questionnaire format after which qualitative data were collected through in-depth interviews of heads of the selected oral health facilities. The determinants of dental caries treatment services were explored with a focus on provider behavior, cost of dental services, human resource availability and availability of dental equipment.ResultsQuantitative findings show that to a larger extent, the cost of raw materials (100%), human resources (98.1%), infection control resources (98.1%), geographical location (98.1), Government policies (88%) and the price of other goods (80.8%) influence provision of dental caries treatment services. Qualitative results show that location and number of oral health facilities, government funding and policies for oral health, cost of dental equipment and materials, the ability of consumers to pay, human resource availability and consumer awareness of oral health are also factors that influence the provision of dental caries treatment services.ConclusionAdequate access to oral health care services is a major concern that affects all aspects of healthcare and a determining factor in the country’s drive to achieve universal health coverage. In order to address this, oral health facilities need to be strategically located and have adequate materials, equipment and skilled staff. There is a need to incorporate oral health into the general health care system and improve government policies and funding for oral health.

Highlights

Dental caries, despite improvement in oral health across the globe, is still a large contributor to the global burden of oral diseases and a major public health concern
Qualitative results show that location and number of oral health facilities, government funding and policies for oral health, cost of dental equipment and materials, the ability of consumers to pay, human resource availability and consumer awareness of oral health are factors that influence the provision of dental caries treatment services
Adequate access to oral health care services is a major concern that affects all aspects of healthcare and a determining factor in the country’s drive to achieve universal health coverage

Summary

Introduction

Despite improvement in oral health across the globe, is still a large contributor to the global burden of oral diseases and a major public health concern. This study examined the determinants of dental caries treatment provision and the challenges of providing equitable access to oral health care. Access to oral health care in Nigeria is poor [1] and efforts made to improve access to oral health care in Nigeria have been largely unsuccessful [2]. In a bid to improve equitable access to oral health care services, The Nigerian government has included oral health care in the National health insurance scheme [3]. There are many factors that have been known to influence access to oral health care in Nigeria and these can be categorized into contextual and individual factors. The individual factors are anxiety and fear associated with dental care, low oral health literacy, perceptions and misconceptions that exist about oral health care [4, 5]

Methods

Results

Discussion

Conclusion