What makes inequality in the area of dental and oral health in developing countries? A scoping review

Peivand Bastani,Sajad Delavari,Sisira Edirippulige,Gholamhossein Mehraliain,Mohammadtaghi Mohammadpour

doi:10.1186/s12962-021-00309-0

Abstract

BackgroundEquity in health is an important consideration for policy makers particularly in low and middle income developing country. The area of oral and dental health is not an exception. This study is conducted to explore the main determinants that make inequality in oral and dental health area in developing countries.MethodsThis was a scoping review applying the framework enhanced by Levac et al. Four databases of Scopus, PubMed, WOS and ProQuest were systematically searched applying to related keywords up to 27.11.2020. There restriction was placed in the English language but not on the study design. All the related studies conducted in the low or middle income developing countries were included. A qualitative thematic analysis was applied for data analysis and a thematic map was presented.ResultsAmong 436 articles after excluding duplications, 73 articles were included that the number of publications from Brazil was greater than other developing countries (33.33%). Thematic analysis of the evidence has led to 11 determinants that may result in inequality in oral and dental health services in developing countries including personal characteristics, health status, health needs and health behaviours, social, economic, cultural and environmental factors, as well as insurance, policies and practices and provided related factors.ConclusionThe policymakers in the low and middle income developing countries should be both aware of the role of inequality determinants and also try to shift the resources to the policies and practises that can improve the condition of population access to oral and dental services the same as comprehensive insurance packages, national surveillance system and fair distribution of dentistry facilities. It is also important to improve the population’s health literacy and health behaviour through social media and other suitable mechanisms according to the countries’ local contexts.

Highlights

Equity in health is an important consideration for policy makers in low and middle income developing country
While some evidence emphasizes that the prevalence of dental caries is decreased among both developing and developed countries [2], other studies show the high prevalence of dental diseases among those populations with
Thematic analysis of the evidences has led to 11 determinants that may result in inequality in oral and dental health services in developing countries including personal characteristics, health status, health needs and health behaviours, social, economic, cultural and environmental factors, as well as insurance, policies and practices and provided related factors (Table 2)

Summary

Introduction

Equity in health is an important consideration for policy makers in low and middle income developing country. Bastani et al Cost Eff Resour Alloc (2021) 19:54 low socioeconomic status [3] Such these contradictions can indicate that the issue of oral and dental health needs to be considered yet. Because of the intensive costs and due to the relationship among the frequency of these diseases and the social, behavioural and environmental factors [1], it seems that this issue needs more consideration among low and middle income developing countries. In this regard, the previous studies have shown the inequalities in the area of oral and dental health. Such an expenditure is varied from one country to the others and in many regions is funded by out of pocket payments at the time of patients’ needs [6] that can intensify the inequality and access to the dental services

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