The study found that access to oral healthcare was moderate (69.0%). The acceptability (Mean = 14.93), availability (Mean = 12.93), and accommodation (Mean = 14.56) domains of access were moderate. This was contrary to studies in Nigeria, South Africa, China, India, and Saudi Arabia where access to oral healthcare was reported to be poor 6–9. However, the findings that the accessibility (Mean = 9.90) and affordability (Mean = 8.26) domains were poor had a relationship with some studies 6–9 .
The socio-demographic / economic factors revealed that dental health services were reportedly far for 88.1%. Majority of the respondents who visited a dental clinic within the past months paid out of pocket (41.7%) and a very small percentage (4.5%) had full insurance coverage. The combination of these factors do not encourage high access. Therefore, such individuals were less likely to access dental services since it meant much time and more travel cost to the facilities. Moreover, the cost of dental treatment, coupled with a number of procedures not being fully covered by health insurance negatively influence access to dental care14. Northridge15 noted that dental treatment obtained on pay for service basis was a barrier to accessing oral healthcare, compared to that offered under insurance and subsidy.
The most common treatment accessed by respondents was extraction (44%), followed by medication only (43.6%). This could be explained by a report which noted that the type of treatment was limited to the availability of resources, and where the facility was not adequately resourced, treatment options would be limited to simple ones like extraction and medications 16. This in a way could suggest that dental facilities at the district/municipal level were under resourced in terms of personnel or infrastructure or both. It could also imply clients reported late for oral healthcare, narrowing down treatment options to extraction or more expensive and time/resource demanding ones like root canal therapy. Oral health education, encouraging clients to report early for treatment can positively improve treatment options and oral health eventually.
Acceptability was high among those with previous experience and those who did not make payment for procedure. This could be that those with no dental visit history had poor perception of oral healthcare. The solution to this will be proper education on oral healthcare with a lot of demonstration or practicality, to increase the comfort level 12.
Those who had to travel a great distance reported poor accessibility. Cappelli17 argue that transportation is an important factor in accessing health facilities, especially in rural areas where distances to health care facilities are far and facilities inaccessible. Respondents who had ever had any dental problem also had poor access to oral healthcare. This could be due to the long distance they traveled with the pain/discomfort to get relief. Thus, to improve the accessibility dimension of access, there will be the need to site a dental facility close to the populace.
Accommodation was high as majority of the respondents who visited a dental facility had a pleasant experience (78.3%) coupled with the observation that none of them felt that their oral health needs were not well understood 18. A study in Kenya, found that high client satisfaction was associated with friendly and understanding service providers, which encouraged users to return, promoting access 19.
Availability was high among those with previous visit. Those with previous visit are in the know of the type of services provided and may have been pleased with the service rendered. Where human and material resources are lacking, treatment options will obviously be limited, decreasing availability of service thereby limiting clients’ interest in accessing a dental facility 16.
Affordability was poor for the majority who were far from a dental facility. The results also revealed affordability showed a significant association with oral healthcare and it was more pronounced in the groups who had to make some payment (p < 0.05). A study in India revealed that payment of dental service was the main barrier to accessing oral 20. Thus, setting up a dental facility close to the populace and ensuring full insurance coverage would improve the affordability component of access.