Factors influencing utilisation of dental services among pregnant women with symptoms of dental disease receiving antenatal care from Kampala City Council Authority Health Centres, Kampala, Uganda

Abstract

Background: Anecdotal evidence from dental practitioners in Uganda indicates that pregnant women seldom utilize dental services even when studies have shown a high burden of dental diseases among them with the prevalence of over 65% (Wandera et al., 2009). Current evidence indicates the importance of dental care during pregnancy however, many pregnant women are reluctant to seek dental care services. Little is known about the level of dental care utilisation and the factors that influence dental care utilisation among pregnant women receiving antenatal care from Kampala Capital City Authority health centres (KCCA). Objective: To determine the factors that influence level of dental care utilization among pregnant women with symptoms of dental disease receiving antenatal care services from KCCA health centers. It was anticipated that this study would generate the much-needed information which will be used to improve the delivery of dental health care services to pregnant women. Methods: This was a cross-sectional study involving 695 pregnant women attending antenatal care from six selected KCCA health canters that offered both antenatal and dental services from the five KCCA divisions of Kampala. Data concerning the level of dental care utilization among pregnant women and the factors that influence dental care utilization among pregnant women was self-reported and captured using a structured questionnaire. The dependent variable in this study was the level of dental care utilization during pregnancy and the independent variables were individual characteristics, societal factors and oral health system factors. Data was summarized into tables and a bar graph. Modified poison regression was used to analyse the factors associated with utilisation of dental care services among pregnant women receiving antenatal care from KCCA health centres and the measure of association was prevalence risk ratios. Results: A total of 695 pregnant women attending ANC at 6 KCCA Health facilities were interviewed in this study, with a median age of 25 years (IQR: 22-29), of whom 7.2% of them were above 35years and 69% of them lived within 1-2kms from the health facility. The level of dental care utilization among respondents was found to be 21.7%, (95% CI:18.8 – 25) though 31.8% of the pregnant women reported having experienced toothache, 23.5% of them reported having experienced tooth sensitivity and 18.8% reported have experienced jaw pain. The factors that were found to influence the level of utilization of dental care among pregnant women were tooth ache Adjusted PRRs (95% CI) 2.31 (1.75 - 3.05) specific health facility from which to get treatment Adjusted PRRs (95% CI) 4.39 (3.18 - 6.06). Conclusion: The level of dental care utilization is low among pregnant women in Kampala. Tooth ache and having a specific health facility from where to receive dental services are the major factors that influence dental care utilization among pregnant women receiving antenatal care from Kampala Capital City Authority health centres.