Linking Health Financing to Oral Health Coverage and Disease Burden in SEARO Countries: A Cross-Sectional Analysis of Country Level Data.

Abstract

Introduction: The Southeast Asian region of World Health Organization (SEARO) comprising 11 countries, that is Bangladesh, Bhutan, Democratic People's Republic of Korea, India, Indonesia, Maldives, Myanmar, Nepal, Sri Lanka, Thailand, and Timor-Leste is home to a quarter of the world's population where severe oral health disparities persist.

Aim: This study aims to collate the oral health financing landscape, evaluate the relationship between government health expenditure and the burden of oral diseases, assess the proportionality of oral health spending relative to its share of the overall disease burden, and examine the inclusion and funding of dental care within Universal Health Coverage (UHC) benefit packages in the SEARO region.

Materials and methods: Data for this study were sourced from publicly available databases and relevant national health statistics repositories of SEARO countries. These datasets provided information on health financing indicators, oral health coverage, and oral disease burden. Descriptive statistics were used to summarize indicators across SEARO countries. Correlation analyses were done to examine the interrelationship between health financing indicators and oral health outcomes and oral health coverage.

Results: Increased government expenditure on health was significantly and positively correlated with insurance and oral health coverage. It was inversely correlated with out-of-pocket expenses (OOPE), private health expenditure, borrowing money to cover health expenses, and 'All cause' DALYs (Disability Adjusted Life Years). There was no significant correlation between government health spending and 'Oral Disorders' DALYs. Increased private expenditure was inversely correlated with domestic general government health expenditure as a percentage of current health expenditure and oral health coverage and positively correlated with Out-of-pocket expenses and borrowing money for covering health expenses. The allocation of government spending did not correspond proportionately to the burden of oral diseases.

Discussion and conclusion: The lack of correlation between government health funding and the oral disease burden and the disproportionately low government expenditure on oral health relative to the burden of oral diseases when compared to their share of the total disease burden indicates not only a significant deficiency in funding but also misplaced funding priorities. There is a need to focus on the prevention of oral diseases and direct resources towards prevention, regular training, and education of healthcare workers and the public to identify early signs and symptoms of oral disease, rather than solely on treatment.