Improving Oral Health Service Uptake Among Urban Informal Sector Workers in Nigeria: Trader Perspectives on Affordability, Accessibility, and Delivery Innovations

Background:Urban Informal Sector Workers face unique barriers to preventive healthcare; however, little is known about their oral health behaviors in rapidly growing market economies. This study examined the patterns, determinants, and perceived facilitators of dental service utilization among traders in an urban marketplace. Methods:A cross-sectional survey was conducted among traders and businessmen in Lagos State, collecting demographic, occupational, and behavioral data, along with self-reported oral health status, service utilization, and perceived barriers. Associations between occupational demands, symptom frequency, and care-seeking behaviors were analyzed using chi-square test. Open-ended responses were analyzed thematically. Results:Among the participants (n= 123), most were aged 30–39 years (45.5%), with a balanced gender distribution and predominant engagement in gadget and equipment sales (61.8%). Although 66.7% rated dental check-ups as important, 83.7% had not visited a dentist in the past year, with the absence of perceived dental problems (54.4%), work-related time constraints (22.3%), and cost (15.5%) cited as the main reasons. The most reported access challenges were the cost of care (34.5%) and long wait times (26.8%). Symptom frequency was significantly associated with dental visits (p=0.021) and treatment delays (p=0.002). Qualitative data revealed three main intervention priorities: financial accessibility (e.g., subsidized/free services, HMO inclusion), targeted outreach and education (e.g., quarterly market-based programs, workplace health promotion), and service innovations aligned with traders’ schedules (e.g., mobile clinics, extended/24-hour services). Mobile dental clinics (33.2%) and extended clinic hours (56.9%) were the most favored solutions, with 70.7% of the participants willing to participate in on-site outreach near their business premises. Conclusion:Despite awareness of the value of preventive dental care, utilization remains low among traders due to cost, time constraints, and symptom-driven care-seeking behavior. Interventions should integrate occupationally compatible service models, financial subsidies, and targeted outreach to bridge the knowledge–action gap in this population. Policy efforts addressing both perceptual and structural barriers may substantially improve preventive oral health care uptake in urban informal economies.