Availability and utilization of oral healthcare services at rural community health centers in South India: a mixed methods study.

Background: The National Oral Health Programme, launched by the Government of India, aims to provide comprehensive oral healthcare through public healthcare system. We conducted this study to assess availability and utilization of oral healthcare services at Community Health Centers (CHCs) in Prakasam district, Andhra Pradesh, India.

Methods: Between January-June 2024, we conducted a mixed methods study comprising of facility survey of CHCs (n = 12), in-depth interview of CHC dentists (n = 12), and survey of individuals from randomly sampled households in the CHC catchment areas (n = 360). Facility survey and in-depth interviews were employed to study the availability of oral healthcare services, while household survey enabled assessment of their utilization. Survey data were analyzed employing descriptive and multivariate procedures. Qualitative interviews were analyzed using thematic analysis. We computed Adjusted odds ratios (AORs) for identifying factors associated with oral healthcare utilization.

Results: All CHCs had a dentist, dental room, and dental chair, but none had dental assistants/hygienists. Services were limited to health education, scaling and root planing, and restorations. Demand deficit, health system preparedness, and operational constraints emerged as key themes. Only 13.9% sought oral healthcare from CHCs in the past year. Multiple symptoms (AOR = 3.19), awareness (AOR = 10.35), and perceived accessibility (AOR = 4.89) were significantly associated with oral healthcare utilization.

Conclusions: Utilization of oral healthcare services is limited. Improving service utilization requires investment in infrastructure, human resources, and enhancing demand through education and outreach.