Theorization regarding access to oral health care for Brazilian prisoners: A qualitative study

Abstract

The Brazilian prison system has faced difficulties in guaranteeing the fundamental rights of the population deprived of liberty, including access to oral health. In view of this, the aim of our study was to formulate a theory concerning access to oral health and the influencing factors, grounded in the perspectives of incarcerated men. We carried out a qualitative study with men deprived of liberty, who were serving their sentences in a closed regime in a state prison unit in Minas Gerais (Brazil). The data collection was conducted through semi-structured interviews and processed utilizing Grounded Theory. The categories produced in this qualitative analysis using Grounded Theory were interpreted and organized based on the Patient-Centered Access Conceptual Framework. We conducted interviews with 16 men, and analysis allowed the creation and bringing closer together of the following categories related to the patient: 1) Ability to perceive 2) Ability to seek 3) Ability to reach 4) Ability to pay 5) Ability to engage, and dimensions related to the service offered: 1) Approachability 2) Acceptability 3) Availability and accommodation 4) Affordability 5) Appropriateness. For men deprived of liberty, barriers to accessing oral health result from state negligence, which promotes overcrowding and a lack of qualified professionals. This scenario creates a micropolitics of access, breaking the logic of equity.