Healthcare providers’ perspectives on service delivery and utilisation in public dental outpatient centres in Thiruvananthapuram, Kerala

The burden of oral diseases is rising in India, affecting individuals across all socioeconomic strata. Although the National Oral Health Policy and Programme aim to improve access to affordable and quality healthcare through public facilities, challenges in implementation persist. In Kerala, oral disease prevalence is high despite a dentist-to-population ratio four times higher than the WHO’s recommendation. In a context where private healthcare providers dominate service delivery and out-of-pocket expenditure remains high, it is essential to explore the perspectives of public sector dental professionals on the delivery and utilisation of existing services in government dental outpatient centres - to reinforce current capacities and develop strategies to address service gaps. A qualitative study was conducted through interviews (key informant and in-depth) with public sector dental healthcare providers. Thematic analysis was used to interpret the data. Providers identified facilitators such as affordability of services, responsive administration, outreach activities, and additional government schemes in the service of vulnerable groups. Key barriers identified were staffing shortages, infrastructural limitations, and insufficient oral health literacy. To address these gaps, providers recommended expanding the dental workforce, upgrading infrastructure with dental laboratories, and promoting oral health awareness in schools and communities. Insights from public sector dental healthcare providers highlight important systemic and policy-level factors underlying service provision and utilisation. These perspectives are vital for developing contextually responsive strategies to enhance the capacity of existing public dental services amidst growing disease burden.