Factors Affecting Oral Health Service Utilization of Differently-abled School Children in Kathmandu, Nepal

Abstract

Lack of oral health care utilization is a common problem among differently- abled children. As a result, oral diseases are often identified in this cohort. This study applied the Anderson health care utilization model to examine the factors associated with the oral health service utilization (OHSU) among the differently-abled school children in Kathmandu city of Nepal. A cross-sectional study was conducted among 400 school children aged 7-18 years old enrolled in 7 schools for differently-abled children in Kathmandu. The OHSU data and the data on the predisposing factors, the enabling factors, and the need factors were self-reported by the parents/legal guardians of the children, using a self-administered questionnaire. An oral examination was performed to assess each child’s dental status. Logistic regression was used to assess the association of OHSU with the predisposing factors, the enabling factors, and the need factors. The results showed that the enabling factors (i.e., “affordability”, and “good oral health knowledge of parents”, and the need factors (“having toothache”) were positively associated with OHSU. In contrast, there was negative association between OHSU and the dental status of the children. Overall, the study showed a very low prevalence of oral health service utilization. The findings indicated that family economic status and oral health literacy of parents and their children play a crucial role in the increased usage of oral health services among differently-abled children. This suggests that, a free oral health service and health literacy programs for the parents and their disabled children in Kathmandu may increase OHSU.