Factors determining access to oral health services among children aged less than 12 years in Peru

Abstract

Background: Understanding problems of access to oral health services requires knowledge of factors that determine access. This study aimed to evaluate factors that determine access to oral health services among children aged <12 years in Peru between 2014 and 2015. Methods: We performed a secondary data analysis of 71,614 Peruvian children aged <12 years and their caregivers. Data were obtained from the Survey on Demography and Family Health 2014-2015 (Encuesta Demográfica y de Salud Familiar - ENDES). Children’s access to oral health services within the previous 6 months was used as the dependent variable (i.e. Yes/No), and the Andersen and col model was used to select independent variables. Predisposing (e.g., language spoken by tutor or guardian, wealth level, caregivers’ educational level, area of residence, natural region of residence, age, and sex) and enabling factors (e.g. type of health insurance) were considered. Descriptive statistics were calculated, and multivariate analysis was performed using generalized linear models (Poisson family). Results: Of all the children, 51% were males, 56% were aged <5 years, and 62.6% lived in urban areas. The most common type of health insurance was Integral Health Insurance (57.8%), and most respondents were in the first quintile of wealth (31.6%). Regarding caregivers, the most common educational level was high school (43.02%) and the most frequently spoken language was Spanish (88.4%). Univariate analysis revealed that all variables, except sex and primary educational level, were statistically significant. After adjustment, sex, area of residence, and language were insignificant, whereas the remaining variables were statistically significant. Conclusions: Wealth index, caregivers’ education level, natural region of residence, age, and type of health insurance are factors that determine access to oral health services among children aged <12 years in Peru. These factors should be considered when devising strategies to mitigate against inequities in access to oral health services.

Factors Associated with Dental Service Use Based on the Andersen Model: A Systematic Review

“…The process of study selection is shown in Figure 1 (flow chart [21]). In sum, n = 41 studies were included in our final synthesis (ten studies investigating children/adolescents [22][23][24][25][26][27][28][29][30][31] and 31 studies investigating adults ). We will present an overview of included studies by age group (children/adolescents; adults) in the next two sections.…”

“…The process of study selection is shown in Figure 1 (flow chart [ 21 ]). In sum, n = 41 studies were included in our final synthesis (ten studies investigating children/adolescents [ 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 ] and 31 studies investigating adults [ 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 ]). We will present an overview of included studies by age group (children/adolescents; adults) in the next two sections.…”

“…The period of dental service use ranged from six months [ 23 , 29 ] to ever visiting a dentist in one’s lifetime (in Saudi Arabia [ 22 ] and Brazil [ 24 , 25 ]). While all studies examined predisposing characteristics, nine out of the ten studies examined enabling resources [ 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 ], eight out of the ten studies examined need factors [ 22 , 24 , 25 , 26 , 27 , 28 , 30 , 31 ] and one study examined psychosocial factors [ 30 ]. The studies included covered all age groups in childhood/adolescence.…”

An ecological study on the association between universal health service coverage index, health expenditures, and early childhood caries

“…Also, in Brazil, though access to UHC significantly reduced infant mortality rate, the prevalence of ECC in children up to 5 years of age was still very high [37]. In Peru, access to UHC had no impact on the oral health of children under 12 years of age [38]. However, studies in South Africa and Nordic countries reported that access to free oral health care reduced caries severity in children [39,40].…”

A cross sectional study of Mexican caregiver social status, dental knowledge, self‐efficacy, and caregiver/child oral health. A structural equation model

“…However, dental health‐related knowledge, attitudes, and behaviors among caregivers of high‐risk children are found to be inadequate . Lower education levels and social status of caregivers were associated with irregular child visits and poor access to dental professional services . A Mexican study showed that mothers' self‐efficacy was associated with their children's oral health …”