Illness-related behaviour and utilization of oral health services among adult city-dwellers in Burkina Faso: evidence from a household survey.
BACKGROUND
In sub-Saharan Africa, the availability and accessibility of oral health services are seriously constrained and the provision of essential oral care is limited. Reports from the region show a very low utilization of oral health care services, and visits to dental-care facilities are mostly undertaken for symptomatic reasons. The objectives of the present study were to describe the prevalence of oral symptoms among adults in Ouagadougou, capital city of Burkina Faso and the use of oral health services and self-medication in response to these symptoms and to measure the associations between predisposing, enabling and needs factors and decisions to seek oral health care.


METHODS
The conceptual design of the study was derived from both the Andersen-Newman model of health care utilization and the conceptual framework of the WHO International Collaborative Study of Oral Health Outcomes. Data were obtained by two-stage stratified sampling through four areas representative of different stages of urbanization of Ouagadougou. The final study population comprised 3030 adults aged 15 years or over and the response rate was 65%.


RESULTS
Overall, 28% of the respondents had experienced an oral health problem during the past 12 months; a high proportion (62%) reported pain or acute discomfort affecting daily life. In response to symptoms, only 28% used oral health facilities, 48% used self-medication and 24% sought no treatment at all. Multivariate analyses revealed that several socio-economic and socio-cultural factors such as religious affiliation, material living conditions and participation in a social network were significantly associated with the use of oral health care services by adults who had experienced oral health problems during the previous year.


CONCLUSIONS
The proportion of people who have obtained oral health care is alarmingly low in Ouagadougou and self-medication appears to be an important alternative source of care for adult city-dwellers. Decision-makers in sub-Saharan countries must seek to ensure that access to essential oral health care is improved.
Varenne
Benoît
B
UR178, Institut de Recherche pour le Développement, 01 BP 182 Ouagadougou 01, Burkina Faso. benoit.varenne@ird.bf
Petersen
Poul Erik
PE
Fournet
Florence
F
Msellati
Philippe
P
Gary
Jean
J
Ouattara
Seydou
S
Harang
Maud
M
Salem
Gérard
G
D000293:Adolescent; D000328:Adult; D000368:Aged; D002050:Burkina Faso / Q000453:epidemiology; D003752:Dental Health Services / Q000706:statistics & numerical data*; D005260:Female; D005843:Geography; D019538:Health Care Surveys; D006306:Health Surveys; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000208:ethnology*; D015995:Prevalence; D011320:Primary Health Care / Q000706:statistics & numerical data*; D012651:Self Medication / Q000706:statistics & numerical data; D012803:Sick Role; D017062:Small-Area Analysis; D012959:Socioeconomic Factors; D014076:Tooth Diseases / Q000453:epidemiology* / Q000628:therapy; D019037:Urban Health Services / Q000706:statistics & numerical data*; D014507:Urbanization