Towards the integration of prevention and control of oral diseases within child primary healthcare: The case of Peru

Ximena Concha Melgar; Diego Azañedo; Fernando Neves Hugo

doi:10.1111/cdoe.12945

Towards the integration of prevention and control of oral diseases within child primary healthcare: The case of Peru

Community Dent Oral Epidemiol. 2024 Jan 28. doi: 10.1111/cdoe.12945. Online ahead of print.

Authors

Ximena Concha Melgar¹, Diego Azañedo¹, Fernando Neves Hugo²

Affiliations

¹ Universidad Científica del Sur, Lima, Peru.
² Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.

PMID: 38282058
DOI: 10.1111/cdoe.12945

Abstract

Objectives: The Peruvian public health norm of primary healthcare (PHC) for growth and development medical check-ups (CRED, Spanish acronym) of children under 5 years of age was updated in 2017 with the inclusion of interdisciplinary prevention and control actions for oral diseases, such as dentist referral. The aim of this study was to explore the association between CRED and oral health services utilization (OHSU), throughout the heterogeneous Peruvian territory.

Methods: A population-based cross sectional study was conducted using the 2021 Demographic and Family Health Survey of Peru and included data from 15 836 children aged 12-59 months. Poisson generalized linear models were used to evaluate the association between any CRED and OHSU, in the 6 months prior to the survey, including sociodemographic characteristics of the children and their mothers as confounding variables. A possible effect modification by natural region of residence (Metropolitan Lima/rest of the Coast/Highlands/Jungle) was evaluated. To examine the robustness of the regression model, a sensitivity analysis was performed using the cumulative number of CRED.

Results: Children who had at least one CRED were almost twice as likely to report OHSU (aPR: 1.95; 95% CI: 1.73-2.21), which was greater in the regions of rest of the Coast (aPR: 2.56; 95% CI: 2.00-3.17) and Jungle (aPR: 2.03; 95% CI: 1.64-2.56). The sensitivity analysis showed consistent results for the association CRED-OHSU. Nevertheless, within the last 6 months, attendance at CRED and OHSU were only achieved by 43.7% and 13.7% of the children respectively.

Conclusions: Integrating oral health into Peruvian Child PHC seems to be a promising public health intervention to increase children's OHSU. For a greater scope, it is crucial to drive greater attendance at CRED and continuous monitoring and strengthening of CRED-based oral health promotion in all Peruvian natural regions with an equity-focused approach.

Keywords: access to primary care; child development; dental health services; health policy; integrated delivery of health care.