Determinants of Oral Health System Effectiveness for Preschool Children in Decentralized Child Development Centres: A Cross-Sectional Study in Northeastern Thailand.

BACKGROUND

Early childhood oral health remains a major public health concern in Thailand despite the implementation of preventive oral health programs. Understanding the factors influencing oral health care system effectiveness is essential for improving oral health outcomes among preschool children. This study aimed to assess oral health care system factors and identify determinants associated with the effectiveness of oral health care services for preschool children in child development centres under local administrative organizations in Ubon Ratchathani Province, Thailand.

METHODS

A cross-sectional analytical study was conducted among 270 stakeholders involved in the preschool oral health care system, including administrators, teachers, health professionals, village health volunteers, and parent representatives. Data were collected using a structured questionnaire developed based on the Input-Process-Output framework. Oral health outcome data were obtained from routine dental examination records of 498 preschool children. Descriptive statistics, Pearson's correlation analysis, and multiple linear regression were used to analyse the data.

RESULTS

Overall oral health care system effectiveness was rated at a high level (mean = 4.01, SD = 0.44). Service delivery processes showed the highest mean score (mean = 4.19, SD = 0.39), while monitoring and evaluation activities demonstrated the lowest performance. The prevalence of dental caries among preschool children was 57.83%. Multiple linear regression analysis identified service delivery processes (β = 0.239, p < 0.001) and home visits by public health and dental personnel (β = 0.165, p = 0.006) as significant predictors of oral health care system effectiveness. The final model explained 11.1% of the variance in system effectiveness (R2 = 0.111, p < 0.001).

CONCLUSIONS

The effectiveness of oral health care systems for preschool children was primarily influenced by the quality of service delivery processes and community-based outreach activities. These findings indicate that strengthening service implementation and home-visit programs may enhance oral health system effectiveness in child development centres operating within decentralized local government settings.