TY - JOUR
T1 - Towards the integration of prevention and control of oral diseases within child primary healthcare
T2 - The case of Peru
AU - Melgar, Ximena Concha
AU - Azañedo, Diego
AU - Hugo, Fernando Neves
N1 - Publisher Copyright:
© 2024 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
PY - 2024/8
Y1 - 2024/8
N2 - 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.
AB - 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.
KW - access to primary care
KW - child development
KW - dental health services
KW - health policy
KW - integrated delivery of health care
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U2 - 10.1111/cdoe.12945
DO - 10.1111/cdoe.12945
M3 - Article
C2 - 38282058
AN - SCOPUS:85183843749
SN - 0301-5661
VL - 52
SP - 509
EP - 517
JO - Community Dentistry and Oral Epidemiology
JF - Community Dentistry and Oral Epidemiology
IS - 4
ER -