Exploring barriers and facilitators in primary oral health services: step towards Universal Health Coverage

Despite the Alma-Ata Declaration's emphasis on primary health care (PHC) to achieve universal health coverage (UHC), oral diseases remain prevalent and costly. In Iran, health reforms have expanded PHC, yet oral health services lag. This study explored barriers and facilitators of primary oral health service delivery in Tehran.

This qualitative study employed semi-structured, face-to-face interviews with dentists, heads of comprehensive health centers (CHCs), healthcare providers and visitors to the health centers in Tehran from November 2021 to January 2022. Data were analyzed using inductive content analysis with MAXQDA2020 and interpreted through the WHO Health Systems Framework, complemented by patient access dimensions, guiding understanding of system-level and user-level barriers and facilitators in oral health service delivery.

Thirty participants (10 healthcare providers, eight dentists, six CHC heads, and six visitors; aged 24-60) identified inadequate education, staffing shortages, equipment problems, financial difficulties, and poor attitudes toward oral health as major barriers. Facilitators included broad community coverage, dentist availability, and free patient education.

This study highlights barriers and facilitators in oral health services within Tehran's health networks. Policymakers and practitioners should use these insights to improve education, infrastructure, and financial support, and foster a culture prioritizing oral health.