Household survey of access to and utilisation of emergency oral health care services in rural Tanzania

Background: Emergency oral health care, as conceived in Tanzania, is an on demand free-of-charge service provided by primary health workers called Rural Medical Aides(RMAs). Objective: To evaluate accessibility and utilisation of emergency oral health care services, Design: Cross-sectional household questionnaire survey. Setting: Rural villages forming a catchment area for rural health centres and dispensaries providing emergency oral health care in Rungwe district, Mbeya region, Tanzania, Subjects: Two hundred households containing about 1,106 persons. Half the households were randomly selected from a village where the dispensary or health centre was located. The other households were from a village distant from the health centre or dispensary. Main outcome measures: Self-reported use of emergency oral health care in a household and perceived barriers to the utilisation of this service. Results: More than 90% of the respondents knew that emergency oral health care was available at the health centre or dispensary. In 40% of the households surveyed, there was a person who had used emergency oral health care. Half the respondents perceived that there were some barrier in using emergency oral health care. Lack of money to pay for treatment or transportation and fear of dental treatment were mentioned as the perceived barriers for using emergency oral health care by thirty and seven per cent respectively. In a logistic regression model, use of emergency oral health care was explained by a positive history of dental problems in the household (OR=4.3) and the age of the household informant being more than 40 years (OR=4.5). Conclusions: The majority in the rural Tanzanian villages surveyed knew about the availability of emergency oral health care services. The proportion of housholds which had used these services were relatively high compared to the time span. Inability to pay for the services was one of the perceived barriers to their utilisation.