Geographical and socioeconomic inequalities in dental attendance among children in Peru: Findings from the Demographic and Family Health Survey 2017.

OBJECTIVE

The aim of the study was to explore the presence of inequalities in the use of dental services among <12-year-old children residing in Peru, according to their wealth quintile and natural region of residence.

METHODS

This was a cross-sectional secondary data analysis of the 2017 Demographic and Family Health Survey of Peru (n = 39 881 children). Generalized Poisson regression models, adjusted for gender, age, maternal ethnicity, place of residence and health coverage, were used to study the association between wealth quintile and use of dental services followed by stratified models by the natural region (Metropolitan Lima, coast, Andes mountains and jungle) and predicted probability graphs to study the effect of the natural region on inequalities in the use of dental services.

RESULTS

Inequalities in the use of dental services among children were observed according to the wealth quintile and natural region. A social gradient was present in the Andes mountains, coast and jungle regions. The greatest inequalities were observed in the coast (richest vs poorest quintile PR = 1.81 95% CI = 1.56-2.11) and jungle regions (richest vs poorest quintile PR = 1.81 95% CI = 1.53-2.14). The jungle presented the lowest proportion of children using dental services, while Metropolitan Lima had the highest proportion. No significant differences were observed between wealth quintiles among children from Metropolitan Lima.

CONCLUSIONS

Differences in socioeconomic inequalities in the use of dental services among natural regions were observed. The distribution of dental centres and personnel, and the geographical and demographic characteristics of each region, may play an important role in the presence of the inequalities observed.