261738 Baseline qualitative study for oral health development programs in Mayan villages of Toledo, Belize

Monday, October 29, 2012

Lauren Feldman, BA , Harvard School of Dental Medicine, Harvard University, Boston, MA
Camille Gannam, BS , Harvard School of Dental Medicine, Harvard University, Boston, MA
Sam A. Merabi, DMD, MPH , Oral Health Policy and Epidemiology, Harvard University School of Dental Medicine, Worcester, MA
The impact of oral disease on systemic health is evident through the clinical manifestations of nutritional deficits, developmental delays and chronic pain. In rural communities where access to health care is limited, the incidence of oral disease is high, and the effects can be devastating. A 2009 PAHO report identified the Maya as the most impoverished ethnic group in Belize, and the most isolated from the Belizean health care system. In Toledo, the least developed district that hosts the largest Mayan population in the country, there is only one dentist to provide care for more than 30,000 residents. A 2010 needs assessment performed by Child Dental Relief, Inc. found dentistry as the primary health concern in several isolated Mayan villages. Because there is limited literature on oral health in Mayan populations, we conducted a qualitative study to determine barriers to oral health care access in these communities. Economy, transport, location, education and beliefs were assessed in unstructured interviews with 75 men and women across 10 Mayan villages. The assessment showed a general lack of access to oral heath care throughout Toledo. Interviews revealed lack of finance as the overwhelming barrier to oral health care access, with finance permeating other barriers. Future studies should address means of overcoming financial barriers, specifically oral health cost reduction strategies. We propose effective measures include placement of a provider in the empty dental operatory in a central village, the regular use of mobile dental units, and increased coverage of both restorative and preventive care.

Learning Areas:
Assessment of individual and community needs for health education
Provision of health care to the public
Public health or related research

Learning Objectives:
Identify and assess barriers to oral health care access in rural Belize. Discuss means of overcoming barriers to oral health care.

Keywords: Access to Care, Indigenous Populations

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am qualified to present as I am the co-first author of this project. I spent 7 weeks in Belize interviewing the 75 participants included in this study. I completed a course on conducting research at Harvard Medical School designed to help prepare students to write a proposal and conduct a project during the summer break.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.