TABLE OF CONTENTS
ABSTRACT. ii
TABLE OF CONTENTS. v
CHAPTER ONE. 1
INTRODUCTION. 1
1.1 Background to The Study. 1
1.2 Statement of The Problem.. 3
1.3 Objectives of The Study. 4
1.4 Research Questions. 4
1.5 Research Hypothesis. 5
1.6 Significance of The Study. 5
1.7 Scope of The Study. 6
1.8 Limitations of The Study. 6
1.9 Organization of The Study. 6
1.10 Definition of Terms. 7
CHAPTER TWO.. 10
REVIEW OF RELATED LITERATURE. 10
2.1 Introduction. 10
2.2 Theoretical Review.. 10
2.2.1 Health Belief Model (Hbm) Theory. 10
2.2.2 Social Determinants of Health Theory. 11
2.2.3 Theory of Planned Behavior (TPB) 11
2.2.4 Access to Care Framework Theory. 11
2.3 Conceptual Review.. 12
2.3.1 Overview.. 12
2.3.2 Socioeconomic Status and Healthcare Access. 12
2.3.3 Educational Attainment and Awareness. 13
2.3.4 Geographic Disparities in Access. 13
2.3.5 Cultural Attitudes Towards Orthodontics. 13
2.3.6 Financial Constraints. 14
2.3.7 Government Policies and Healthcare Infrastructure. 14
2.3.8 The Role of Private Vs. Public Care. 14
2.3.9 Impact of Socioeconomic Factors on Treatment Outcomes. 15
2.3.10 Role of Community Awareness Programs. 15
2.4 Empirical Review.. 15
2.5Summary of Literature Review.. 18
CHAPTER THREE. 19
RESEARCH METHODOLOGY. 19
3.1 Research Design. 19
3.2 Study Area. 19
3.3 Population of The Study. 20
3.4 Sampling Techniques and Sample Size. 20
3.5 Instrumentation. 20
3.6 Validity and Reliability of The Instruments. 21
3.7 Methods of Data Collection. 21
3.8 Methods of Data Analysis. 21
3.9 Ethical Considerations. 22
3.10 Scope and Delimitations. 22
CHAPTER FOUR. 23
DATA ANALYSIS AND INTERPRETATION. 23
4.1 Preamble. 23
4.2 Socio-Demographic Characteristics of Respondents. 23
TABLES BASED ON RESEARCH QUESTIONS. 27
4.3 Analysis of The Respondents’ Views on Research Question One: 27
4.4 Testing Hypothesis. 38
4.5 Discussion of Findings. 40
CHAPTER FIVE. 42
SUMMARY OF FINDINGS, CONCLUSION AND RECOMMENDATIONS 42
5.1 Summary of Findings. 42
5.2 Conclusion. 43
5.3 Recommendations. 43
REFERENCES. 45
APENDICES. 50
APENDIX I; RESEARCH QUESTIONNAIRE. 50
CHAPTER ONE
INTRODUCTION
1.1 Background to The Study
Although largely preventable, dental disease remains a major public health challenge worldwide. Common oral diseases such as tooth decay, periodontitis and oral cancer are common chronic problems that have a significant negative impact on individuals' lives. Although many countries have made progress in improving oral health, the burden of these diseases is far from evenly distributed. Poorer and more disadvantaged populations are disproportionately affected by oral health problems, highlighting a persistent imbalance in health equity (Elani et al. (2012). To achieve more equitable health outcomes, this gap must be closed.
Although high- and middle-income countries have Dental health has improved due to major advances in dentistry in recent decades, but treatment of oral diseases is still very expensive for both the individuals affected and the healthcare systems are financially affected. Disparities in dental health are increasingly linked to greater social, educational and financial problems in many low-income countries. These elements highlight the need for targeted interventions to address these problems and contribute to growing inequalities in oral health (Elani et al. (2012). In Nigeria, socioeconomic factors play an important role in influencing the availability and accessibility of this care. Orthodontic problems, if left untreated, can lead to more serious dental problems and impact not only physical health but also psychological well-being and social interactions (Adeniyi et al., 2020).
In Nigeria, where socioeconomic disparities are pronounced, understanding the impact of these factors is critical to developing equitable health strategies (Ghonmode et al., 2022). Numerous studies indicate that individuals from lower socioeconomic backgrounds often face barriers to accessing orthodontic care, such as high treatment costs, limited physician availability, and inadequate health insurance coverage (Bolarinwa et al., 2018).
In agreement with Adeyemi et al. (2019), many families prioritize basic needs over dental care, resulting in large disparities in who can receive orthodontic treatment across income groups. This gap is clearly visible in rural areas, where people have difficulty accessing health facilities and often do not know what services they can use (Obi et al. 2021). The way people think about orthodontic treatment in their culture makes it even more difficult to receive medical care. Some Nigerian communities view orthodontics as something special and not something they need. This results in fewer people in these groups wanting these services (Ene et al. 2020). These ideas can discourage people from seeking treatment even when they are able, allowing health disparities to persist (Nwankwo et al., 2022).
It is based on this background that this study aims to examine socioeconomic factors and access to orthodontic treatment in Nigeria. It highlights the need to act quickly to address these disparities. By examining the causes that prevent different income groups from seeking medical care, this study will help us better understand the problems in Nigerian orthodontics. Moreso, ways to facilitate access to healthcare are also suggested (Adeola & Nwankwo 2021; Ikwuagwu et al., 2023).Top of Form
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1.2 Statement of The Problem
Access to orthodontic treatment in Nigeria is disproportionately influenced by socioeconomic factors, leading to significant disparities in dental health outcomes among different population segments. Many individuals from lower socioeconomic backgrounds face barriers such as high costs, lack of health insurance, and limited access to trained orthodontists (Bolarinwa et al., 2018). Consequently, this leads to underutilization of orthodontic services, which can exacerbate existing oral health issues and negatively impact overall quality of life. The World Health Organization (2021) emphasizes that such inequities can result in long-term health consequences, highlighting the urgent need for research focused on these socioeconomic determinants.
Moreover, cultural perceptions surrounding dental care often compound these issues, as orthodontic treatment is frequently viewed as a luxury rather than a necessity, particularly in rural communities (Ene et al., 2020). This cultural stigma can discourage individuals from seeking necessary treatment, further entrenching health disparities. Understanding the interplay between socioeconomic status, cultural attitudes, and access to orthodontic care is critical for developing targeted interventions that promote equitable healthcare access in Nigeria. Addressing these multifaceted barriers is essential for improving overall oral health and ensuring that all segments of the population receive the care they need.Top of Form
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1.3 Objectives of The Study
The main objective of the study is to examine Exploring the Impact of Socioeconomic Factors on Access to Orthodontic Treatment in Nigeria. Specific objectives of the study are:
- To Assess the Influence of Income Level on Orthodontic Treatment Access
- To Examine the Role of Educational Attainment on Awareness and Utilization of Orthodontic Services
- To Investigate Geographic Disparities in Orthodontic Care Accessibility
1.4 Research Questions
To guide the study and achieve the objectives of the study, the following research questions were formulated:
- How does household income level affect the likelihood of seeking and receiving orthodontic treatment in different regions of Nigeria?
- What is the relationship between the educational level of parents or guardians and their children's access to orthodontic treatment in Nigeria?
- How do urban versus rural settings influence access to orthodontic services, and what socioeconomic factors contribute to these disparities in Nigeria?
1.5 Research Hypothesis
The following research hypothesis was developed and tested for the study:
Ho: There is no significant relationship between socioeconomic factors and access to orthodontic treatment in Nigeria.
1.6 Significance of The Study
The study is important for many reasons. The following are the major stakeholders this paper through its practical and theoretical implications and findings will be of great significance:
Firstly, the paper will benefit major stakeholders and policy makers in the Dentistry sector. The various analysis, findings and discussions outlined in this paper will serve as a guide in enabling major positive changes in the industry and sub-sectors.
Secondly, the paper is also beneficial to the organizations used for the research. Since first hand data was gotten and analyzed from the organization, they stand a chance to benefit directly from the findings of the study in respect to their various organizations. These findings will fast track growth and enable productivity in the organizations used as a case study.
Finally, the paper will serve as a guide to other researchers willing to research further into the subject matter. Through the conclusions, limitations and gaps identified in the subject matter, other student and independent researchers can have a well laid foundation to conduct further studies.
1.7 Scope of The Study
The study is delimited to University of Uyo Teaching Hospital. Findings and recommendations from the study reflects the views and opinions of respondents sampled in the area. It may not reflect the entire picture in the population.
1.8 Limitations of The Study
The major limitations of the research study are time, financial constraints and delays from respondents. The researcher had difficulties combining lectures with field work. Financial constraints in form of getting adequate funds and sponsors to print questionnaires, hold Focus group discussions and logistics was recorded. Finally, respondents were a bit reluctant in filling questionnaires and submitting them on time. This delayed the project work a bit.
1.9 Organization of The Study
The study is made up of five (5) Chapters. Chapter one of the study gives a general introduction to the subject matter, background to the problem as well as a detailed problem statement of the research. This chapter also sets the objectives of the paper in motion detailing out the significance and scope of the paper.
Chapter Two of the paper entails the review of related literature with regards to corporate governance and integrated reporting. This chapter outlines the conceptual reviews, theoretical reviews and empirical reviews of the study.
Chapter Three centers on the methodologies applied in the study. A more detailed explanation of the research design, population of the study, sample size and technique, data collection method and analysis is discussed in this chapter.
Chapter Four highlights data analysis and interpretation giving the readers a thorough room for the discussion of the practical and theoretical implications of data analyzed in the study.
Chapter Five outlines the findings, conclusions and recommendations of the study. Based on objectives set out, the researcher concludes the paper by answering all research questions set out in the study.
1.10 Definition of Terms
1. Socioeconomic Status (SES)
A composite measure that includes an individual’s or family’s economic and social position relative to others, based on income, education, and occupation. SES can significantly influence access to healthcare services, including orthodontic treatment.
2. Access to Healthcare
The ability of individuals to obtain necessary health services. This can be influenced by factors such as availability of services, affordability, geographic location, and health insurance coverage.
3. Orthodontic Treatment
A specialized area of dentistry focused on diagnosing, preventing, and correcting misaligned teeth and jaws. Orthodontic treatments often include braces, retainers, and other corrective devices, which can be costly and time-consuming.
4. Health Disparities
Differences in health outcomes and access to healthcare between different population groups, often influenced by socioeconomic factors such as income, education level, and geographic location.
5. Public Health Policy
Government decisions and actions that aim to improve health outcomes in the population. In the context of orthodontics, policies may focus on making treatment more accessible to lower-income groups.
6. Dental Insurance
A form of insurance coverage that pays for certain dental care costs. The presence or absence of dental insurance can significantly affect an individual's ability to afford orthodontic treatment.
7. Cultural Beliefs and Practices
The shared values, norms, and practices of a community that can influence attitudes toward dental care and orthodontic treatment. Cultural perceptions of oral health may impact an individual's willingness to seek orthodontic services.
