Dental Service Utilization by Seropositive Adults at Community Health Aids Initiative Clinic in Kampala International University-Teaching Hospital, Bushenyi District

Table of contents

DECLARATION...................................................................................................................... I

APPROVAL ............................................................................................................................II

DEDICATION.......................................................................................................................III

ACKNOWLEDGEMENT.....................................................................................................IV

LIST OFABBREVIATIONS .................................................................................................V

DEFINITION OF TERMS....................................................................................................VI

TABLE OF CONTENTS ....................................................................................................VII

ABSTRACT............................................................................................................................XI

CHAPTER ONE ......................................................................................................................1

INTRODUCTION....................................................................................................................1

1.0 INTRODUCTION......................................................................................................................1

1.1 BACKGROUND OF THE STUDY................................................................................................1

1.2 PROBLEM STATEMENT ..........................................................................................................3

1.3.1 Broad objective .................................................................................................................4

1.3.2 Specific objectives............................................................................................................4

1.4 RESEARCH QUESTIONS ..........................................................................................................4

1.5 JUSTIFICATION OF THE STUDY ...............................................................................................4

CHAPTER TWO .....................................................................................................................6

LITERATURE REVIEW .......................................................................................................6

2.0 INTRODUCTION......................................................................................................................6

2.1 PREVALENCE OF UTILIZATION OF DENTAL SERVICES BY ADULT SEROPOSITIVE PATIENTS......6

2.2 DETERMINANTS OF THE UTILIZATION OF HEALTHCARE .......................................................10

2.2.1 Familial culture and health beliefs..................................................................................10

2.2.2 Family socioeconomic status..........................................................................................11

2.2.3 Family household income ...............................................................................................12

2.2.4 Education and information..............................................................................................13

2.3 BARRIERS TO UTILISATION OF DENTAL SERVICES ................................................................13

2.4 OVERVIEW OF THE CURRENT STRUCTURE OF ORAL HEALTH SERVICES IN UGANDA:............15

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2.5.1 Theoretical framework....................................................................................................16

2.5.2 The health service utilization model...............................................................................16

2.5.4 The study variables.........................................................................................................19

CHAPTER THREE...............................................................................................................20

METHODOLOGY ................................................................................................................20

3.0 INTRODUCTION....................................................................................................................20

3.1 RESEARCH AREA .................................................................................................................20

3.1.1 Location and population .................................................................................................20

3.2 RESEARCH SITES .................................................................................................................20

3.3 RESEARCH DESIGN ..............................................................................................................20

3.4 STUDY POPULATION AND UNIT OF ANALYSIS.......................................................................21

3.4.1 Inclusion criteria .............................................................................................................21

3.4.2 Exclusion Criteria ...........................................................................................................21

3.5 SAMPLE SIZE DETERMINATION ............................................................................................22

3.6 DATA COLLECTION METHODS..............................................................................................23

3.6.1 Secondary sources...........................................................................................................23

3.6.2 The survey method..........................................................................................................23

3.6.3 Direct observation...........................................................................................................23

3.7 DATA PROCESSING AND ANALYSIS ......................................................................................24

3.8 MINIMIZATION OF ERRORS AND BIASES..............................................................................24

3.9 ETHICAL CONSIDERATIONS.................................................................................................24

3.10 STUDY LIMITATIONS .........................................................................................................24

3.11 DISSEMINATION OF RESULTS .............................................................................................25

CHAPTER FOUR..................................................................................................................26

DATA PROCESSING, ANALYSIS AND PRESENTATION...........................................26

4.1 SOCIAL-DEMOGRAPHIC CHARACTERISTICS..........................................................................26

4.2 PREVALENCE OF UTILIZATION OF DENTAL SERVICES BY ADULT SEROPOSITIVE PATIENTS....28

4.2.1 Oral status of the adult seropositive patients ..................................................................28

4.2.2 Utilization of dental services by adult seropositive patients...........................................28

4.3 DETERMINANTS OF THE UTILIZATION OF DENTAL SERVICES UTILIZATION OF DENTAL

SERVICES BY ADULT SEROPOSITIVE PATIENTS AT KIU-TH....................................................29

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4.3.1 Demographic determinants of utilization of dental services by adult seropositive

patients at KIU-TH ..........................................................................................................29

4.3.2 Other factors that determine utilization of dental services by adult seropositive patients

at KIU-TH........................................................................................................................30

4.4 BARRIERS OF UTILIZATION OF DENTAL SERVICES BY ADULT SEROPOSITIVE PATIENTS AT

KIU-TH................................................................................................................................32

4.4.1 Stigmatization from peers, family members, and health workers ..................................32

4.4.2 No access to dentists because they are few.....................................................................33

4.4.3 High costs of dental services...........................................................................................34

4.4.4 Long distance to health facilities ....................................................................................35

4.4.5 Financial problems of the adult seropositive patients.....................................................36

4.4.6 Despair by the seropositive patient.................................................................................37

CHAPTER FIVE ...................................................................................................................39

DISCUSSION, CONCLUSION AND RECOMMENDATIONS ......................................39

5.0 INTRODUCTION....................................................................................................................39

5.1 DISCUSSION ........................................................................................................................39

5.5.1 Prevalence of utilization of dental services by adult seropositive patients at KIU-TH..39

5.5.2 Determinants of the utilization of dental services utilization of dental services by adult

seropositive patients at KIU-TH ......................................................................................39

5.3 BARRIERS OF UTILIZATION OF DENTAL SERVICES BY ADULT SEROPOSITIVE PATIENTS AT

KIU-TH................................................................................................................................41

5.4 LIMITATIONS OF THE STUDY................................................................................................43

5.5 CONCLUSION.......................................................................................................................43

5.6 RECOMMENDATIONS ...........................................................................................................43

REFERENCES.......................................................................................................................45

APPENDICES........................................................................................................................52

APPENDIX I: CONSENT FORM....................................................................................................52

APPENDIX II: ENGLISH QUESTIONNAIRE FOR INTERVIEW...............................53

APPENDIX III: OBSERVATION CHECKLIST ..............................................................59