Barriers to the Utilization of Government Dental Health Services Among Low-Income Families in Ugwuaji, Enugu South LGA of Enugu State, Nigeria: A Cross-Sectional Survey

Abstract

Background: Oral health, a cornerstone of overall well-being, remains a neglected global public health priority despite its profound impact on quality of life. Despite the availability of public dental facilities, underutilization persists, contributing to preventable oral health disparities in peri-urban communities and low-income countries. This study assessed barriers to the utilization of government dental health services among low-income families in Ugwuaji, Enugu South LGA, Nigeria. Methods: A descriptive cross-sectional survey study design was employed, where 437 participants aged 18 years and above from low-income households (≤₦70,000 monthly) took part. Households were selected using stratified sampling. The participants were selected using Statistical Package for Social Sciences (SPSS) version 23 which was used to analyse quantitative data. Inferential statistics of Chi Square were used. Chi-Square Tests examined sociodemographic associations and utilization with key outcomes (p<0.05). Results: The study concluded that 79.9% were non-users (never or last visit >3 years ago) showing a utilization crisis. Participants showed agreement in their barriers to utilization in Financial (fees, transport, lost wages: >79% agreement), structural (distance, wait times: >65% agreement), and perceptual (pain fear: 82.6%; herbal remedy preference: 58.1%). Education level, travel time, income level, and occupation were statistically significant. The participants' recommended free check-ups (81.7%), mobile clinics (74.6%), and extended hours (62.2%) as the solutions. Around 68.4% volunteered for community dental outreach if need be. Conclusion: Ugwuaji's underutilization of dental services mirrors financial challenges which lead health inequities across rural Nigeria. There is a need for the government to increase healthcare financing to ensure free access to basic health care services to miminize out of pocket health expenses.