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

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.