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Reducing Social Inequalities in Access to Dental Care in Senegal: Evaluation of a Flat-Rate Pricing Program at the Health District Level

Received: 17 December 2024     Accepted: 7 January 2025     Published: 14 January 2025
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Abstract

Objectives In Africa, profound social inequalities exist in access to oral health care, with one of the principal determinants being financial factors. To overcome this financial barrier, Senegal has implemented the Program for Support of Supply and Demand for Care (PAODES). Therefore, the aim of this study was to evaluate the impact of the program on improving access to oral health for affected people. Methods This study was conducted in the health districts of Sokone, the intervention site where PAODES was established, and Bambey, the control site where routine activities were maintained. A quasi-experimental study was conducted on 110 patients at each site who were consulted in oral health services. A questionnaire allowed us to collect sociodemographic data and data on the evaluation of intervention effects, including the renouncement of oral health and the cost of care. The relative risk (RR) and the attributable fraction (AF) were calculated. Results There was a significant difference of 13.6% at the intervention site compared to 39.1% at the control site (p=0.0001). The relative risk (RR) was 0.33 (0.19-0.57). The fraction attributable to the intervention was 33.42% (21.77-42.05) among the general population and 67.14% (43.52-80.89) among those who received the intervention. Conclusion The results of the study showed that a flat-rate pricing program aimed at reducing the financial burden on access to oral health care services had a positive impact. This demonstrated that a decrease in social inequalities regarding access to oral health can surpass financial barriers.

Published in World Journal of Public Health (Volume 10, Issue 1)
DOI 10.11648/j.wjph.20251001.12
Page(s) 13-18
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2025. Published by Science Publishing Group

Keywords

Social Inequality, Dental Care, Evaluation, Renunciation, Program

References
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[2] Dieng SN, Kanouté A, Azogui-Levy S, Lombrail P. Determinants of maternal and household social inequalities of dental caries among Senegalese children in the Department of Pikine. Pan Afr Med J. 2023; 44: 23.
[3] Onyejaka NK, Folayan MO, Folaranmi N. Barriers and facilitators of dental service utilization by children aged 8 to 11 years in Enugu State, Nigeria. BMC Health Serv Res. 2016; 16: 93.
[4] Organization mondiale de la santé. Rapport mondial de suivi sur la protection financière en santé 2021 [Global monitoring report on financial protection in health 2021]. Genève: OMS/BM; 2022. 128p. Report No.: CC BY-NC-SA 3.0 IGO.
[5] Vujicic M, Buchmueller T, Klein R. Dental Care Presents The Highest Level Of Financial Barriers, Compared To Other Types Of Health Care Services. Health Aff (Millwood). 2016; 35(12): 2176‑82.
[6] Organization mondiale de la santé – Région Afrique. L’Afrique est confrontée à la plus forte hausse des maladies bucco-dentaires dans le monde. [cité 17 janv 2024]. Disponible sur:
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[14] Blasi PR, Krakauer C, Anderson ML, Nelson J, Bush T, Catz SL, et al. Factors associated with future dental care utilization among low-income smokers overdue for dental visits. BMC Oral Health. 2018; 18(1): 183.
[15] Sass C, Runfola S. Rapport sur le renoncement aux soins des bénéficiaires de la CMU-c : Enquête dans les CES de l’Assurance maladie. Paris; 2011. 46p.
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Cite This Article
  • APA Style

    Dieng, S. N., Dieng, A., Diallo, A., Diop, M., Kanouté, A., et al. (2025). Reducing Social Inequalities in Access to Dental Care in Senegal: Evaluation of a Flat-Rate Pricing Program at the Health District Level. World Journal of Public Health, 10(1), 13-18. https://doi.org/10.11648/j.wjph.20251001.12

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    ACS Style

    Dieng, S. N.; Dieng, A.; Diallo, A.; Diop, M.; Kanouté, A., et al. Reducing Social Inequalities in Access to Dental Care in Senegal: Evaluation of a Flat-Rate Pricing Program at the Health District Level. World J. Public Health 2025, 10(1), 13-18. doi: 10.11648/j.wjph.20251001.12

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    AMA Style

    Dieng SN, Dieng A, Diallo A, Diop M, Kanouté A, et al. Reducing Social Inequalities in Access to Dental Care in Senegal: Evaluation of a Flat-Rate Pricing Program at the Health District Level. World J Public Health. 2025;10(1):13-18. doi: 10.11648/j.wjph.20251001.12

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  • @article{10.11648/j.wjph.20251001.12,
      author = {Serigne Ndame Dieng and Amadou Dieng and Alimatou Diallo and Mbathio Diop and Aïda Kanouté and Massamba Diouf},
      title = {Reducing Social Inequalities in Access to Dental Care in Senegal: Evaluation of a Flat-Rate Pricing Program at the Health District Level},
      journal = {World Journal of Public Health},
      volume = {10},
      number = {1},
      pages = {13-18},
      doi = {10.11648/j.wjph.20251001.12},
      url = {https://doi.org/10.11648/j.wjph.20251001.12},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.wjph.20251001.12},
      abstract = {Objectives In Africa, profound social inequalities exist in access to oral health care, with one of the principal determinants being financial factors. To overcome this financial barrier, Senegal has implemented the Program for Support of Supply and Demand for Care (PAODES). Therefore, the aim of this study was to evaluate the impact of the program on improving access to oral health for affected people. Methods This study was conducted in the health districts of Sokone, the intervention site where PAODES was established, and Bambey, the control site where routine activities were maintained. A quasi-experimental study was conducted on 110 patients at each site who were consulted in oral health services. A questionnaire allowed us to collect sociodemographic data and data on the evaluation of intervention effects, including the renouncement of oral health and the cost of care. The relative risk (RR) and the attributable fraction (AF) were calculated. Results There was a significant difference of 13.6% at the intervention site compared to 39.1% at the control site (p=0.0001). The relative risk (RR) was 0.33 (0.19-0.57). The fraction attributable to the intervention was 33.42% (21.77-42.05) among the general population and 67.14% (43.52-80.89) among those who received the intervention. Conclusion The results of the study showed that a flat-rate pricing program aimed at reducing the financial burden on access to oral health care services had a positive impact. This demonstrated that a decrease in social inequalities regarding access to oral health can surpass financial barriers.},
     year = {2025}
    }
    

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  • TY  - JOUR
    T1  - Reducing Social Inequalities in Access to Dental Care in Senegal: Evaluation of a Flat-Rate Pricing Program at the Health District Level
    AU  - Serigne Ndame Dieng
    AU  - Amadou Dieng
    AU  - Alimatou Diallo
    AU  - Mbathio Diop
    AU  - Aïda Kanouté
    AU  - Massamba Diouf
    Y1  - 2025/01/14
    PY  - 2025
    N1  - https://doi.org/10.11648/j.wjph.20251001.12
    DO  - 10.11648/j.wjph.20251001.12
    T2  - World Journal of Public Health
    JF  - World Journal of Public Health
    JO  - World Journal of Public Health
    SP  - 13
    EP  - 18
    PB  - Science Publishing Group
    SN  - 2637-6059
    UR  - https://doi.org/10.11648/j.wjph.20251001.12
    AB  - Objectives In Africa, profound social inequalities exist in access to oral health care, with one of the principal determinants being financial factors. To overcome this financial barrier, Senegal has implemented the Program for Support of Supply and Demand for Care (PAODES). Therefore, the aim of this study was to evaluate the impact of the program on improving access to oral health for affected people. Methods This study was conducted in the health districts of Sokone, the intervention site where PAODES was established, and Bambey, the control site where routine activities were maintained. A quasi-experimental study was conducted on 110 patients at each site who were consulted in oral health services. A questionnaire allowed us to collect sociodemographic data and data on the evaluation of intervention effects, including the renouncement of oral health and the cost of care. The relative risk (RR) and the attributable fraction (AF) were calculated. Results There was a significant difference of 13.6% at the intervention site compared to 39.1% at the control site (p=0.0001). The relative risk (RR) was 0.33 (0.19-0.57). The fraction attributable to the intervention was 33.42% (21.77-42.05) among the general population and 67.14% (43.52-80.89) among those who received the intervention. Conclusion The results of the study showed that a flat-rate pricing program aimed at reducing the financial burden on access to oral health care services had a positive impact. This demonstrated that a decrease in social inequalities regarding access to oral health can surpass financial barriers.
    VL  - 10
    IS  - 1
    ER  - 

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Author Information
  • Institute of Dentistry and Stomatology, Cheikh Anta Diop University, Dakar, Senegal

  • Institute of Dentistry and Stomatology, Cheikh Anta Diop University, Dakar, Senegal

  • Pasteur Institute, Dakar, Senegal

  • Institute of Dentistry and Stomatology, Cheikh Anta Diop University, Dakar, Senegal

  • Institute of Dentistry and Stomatology, Cheikh Anta Diop University, Dakar, Senegal

  • Institute of Dentistry and Stomatology, Cheikh Anta Diop University, Dakar, Senegal

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