Department of Dental Sciences, Faculty of Health Sciences, University of Nairobi, P.O Box 48792-00100, Nairobi, Kenya.
Institute of Anthropology, Gender & African Studies, University of Nairobi, Uhuru Gardens, P.O. Box 474-00517, Nairobi, Kenya.
BMC Health Serv Res. 2022 Jul 29;22(1):964. doi: 10.1186/s12913-022-08260-3.
The healthcare system in any republic can cause inequalities in health outcomes if they do not take into account the needs of deprived populations. Children with HIV/AIDS are known to have a high vulnerability to oral diseases; yet, they continue to face limitations in the utilization of oral healthcare. While other determinants of healthcare utilization may co-exist, possible gaps in the oral healthcare system can collectively affect a vulnerable group disproportionately in the utilization of oral healthcare.
To explore qualitatively, the perspectives, experiences and attributions of a cohort of caregivers of children with HIV/AIDS and their Health Care Providers (HCPs), on the utilization of oral healthcare within the structure of the oral healthcare system in Nairobi City County (NCC).
A cross-sectional explorative mixed methods study design of two hundred and twenty one (221) female caregivers of children with HIV/AIDS and their HCPs using a survey, Focus Group Discussions (FGDs) and In-depth Interviews (IDIs). The study setting was the HIV-Care Facilities (HIV-CCFs) at three large hospitals in NCC.
Caregivers mainly utilized independent 'nearby' private dental clinics for oral healthcare services, attributing their selection to cheaper user-fees, proximal service location, and recommendations from social networks. Wait time, opening and closing hours, health workers' attitudes and inferred opportunity costs were perceived as important quality issues in the utilization of oral healthcare.
The oral healthcare system in NCC does not support the utilization of oral healthcare within the context of providing comprehensive healthcare for children with HIV/AIDS. Absence of 'in-house' oral health services at the HIV- CCFs is viewed as a defining structural barrier.
如果医疗体系不考虑贫困人群的需求，任何共和国的医疗体系都可能导致健康结果的不平等。患有艾滋病病毒/艾滋病的儿童已知易患口腔疾病；然而，他们在利用口腔保健方面仍然面临限制。虽然其他医疗保健利用的决定因素可能同时存在，但口腔保健系统中可能存在的差距可能会共同对弱势群体在利用口腔保健方面产生不成比例的影响。
在奈洛比郡（NCC）的口腔保健体系结构内，从艾滋病毒感染者儿童的护理人员及其保健提供者的角度出发，定性探讨他们对口腔保健利用的看法、经验和归因。
一项横断面探索性混合方法研究设计，共纳入 221 名艾滋病毒感染者儿童的女性护理人员及其保健提供者，使用问卷调查、焦点小组讨论（FGD）和深入访谈（IDI）。研究地点是 NCC 三家大医院的艾滋病毒护理设施（HIV-CCFs）。
护理人员主要利用独立的“附近”私人牙科诊所提供口腔保健服务，将其选择归因于较低的用户费用、较近的服务地点以及社交网络的推荐。等候时间、开放和关闭时间、卫生工作者的态度和推断的机会成本被认为是利用口腔保健服务的重要质量问题。
NCC 的口腔保健体系无法支持在为艾滋病毒感染者儿童提供全面医疗保健的背景下利用口腔保健服务。HIV-CCFs 缺乏“内部”口腔卫生服务被视为一个决定性的结构障碍。
