Development of an Oral Health Service System to improve Access to Dental Services in the Hankha District Health network, Chainat Province

Abstract

This participatory action research aimed to 1) investigate the situation and problems of access to dental services in the Hankha District health network, 2) develop an oral health service system by applying the six building blocks of the health system, and 3) evaluate the outcomes of the developed system on service accessibility and quality of oral health care. The sample consisted of 19 system development participants and 100 dental service users. Research instruments included questionnaires, interview guides, and system evaluation forms. Data were analyzed using content analysis, descriptive statistics, paired t-test, and Wilcoxon Signed-Ranks Test. The results revealed that: 

1. Prior to development, overall service accessibility was at a moderate level (Mean = 3.47, SD = 0.57), facing budgetary, managerial, and access limitations among working-age and vulnerable groups.

2. The developed system incorporated advance appointments, after-hours clinics, workforce capacity building, health information system linkage, network resource management, and the declaration of a local oral health charter for proactive care in vulnerable groups.

3.  post-implementation indicators significantly improved (p < .001), achieving all target goals: monthly service users increased during both regular and after-hours, average waiting time decreased, equipment readiness and record completeness improved, user and staff satisfaction significantly increased, and proactive mobile dental service targets for all vulnerable groups were fully achieved.

 These findings demonstrate that participatory development integrated with the Six Building Blocks framework effectively improves service accessibility, elevates service quality, enhances satisfaction, and reduces oral health service inequities in local health networks.