Barriers in Access and Utilization of Dental Care: Assessment and Recommendations Using Delphi Technique

Wardah Ahmed1                                                                                       BDS, MSPH                                            

Syeda Farhat Bukhari2                                                                  BDS, MSc

Mehmil Aslam3                                                                                             BDS, MCPS

Fariha Irfan4                                                                                                   BDS

Rija Fatima5                                                                                                      BDS

Maryam Ali6                                                                                                     BDS

OBJECTIVE: Prompt access to oral health care is one of the key factors in maintaining oral health thus providing a gateway to person’s wellbeing. Access to dental care is the ability to obtain and make use of dental services. There is considerably lack of evidence in Pakistan therefore the aim of this study is to assess the barriers in access and utilization of dental care services in urban setting of Karachi among general population and proposition of recommendations using Delphi-technique.

METHODOLOGY: It was mixed methods study design conducted from December 2017- March 2018. At first stage, cross- sectional study design was used for assessing the barriers by administrating semi-structured questionnaire. The multi-stage random sampling technique used to reached the targeted sample n=535 in two towns of Karachi. In second stage, panel of experts proposed the recommendations using Delphi-technique. Data was analyzed using SPSS 21.0. Mean and standard deviations applied for demographics. Descriptive statistics determined the proportion distribution of respondents among of barriers. Pearson Chi-square test and One-way ANOVA employed for determining significance difference among barriers and demographic variables.

RESULTS: Mean age of participants was 30.6 years [SD= 12.3]. Only 14 (2.6%) have access to dental services without any identified barrier and 43 (8%) never visited any dentist. Major barriers were financial cost 166 (31.1%) and patient related barrier 169 (31.5%) followed by dentist related barriers 125 (23.4%). Social barrier was accounted by 18 (3.4%) participants. There was no significant difference of gender (p-value 0.34), age groups (p-value 0.06) and barriers.

CONCLUSION: It is concluded and recommended that robust advocacy and policies should be formulated to include dental services in primary health care delivery system of Pakistan to provide services at affordable cost. Dental health awareness programs should be conducted on  regular basis addressing masses to  remove patient and social related barriers.

KEY WORDS: Barriers in dental care, Access to dental care, Utilization of dental care, Delphi-technique in dentistry.

HOW TO CITE: Ahmed W, Bukhari SF, Aslam M, Irfan F, Fatima R, Ali M. Barriers in access and utilization of dental care: assessment and recommendations using delphi technique. J Pak Dent Assoc 2019;28(1):13-17.


Received: 30 July 2018, Accepted: 03 October 2018