scholarly journals “Got to build that trust”: the perspectives and experiences of Aboriginal health staff on maternal oral health

2020 ◽  
Vol 19 (1) ◽  
Author(s):  
Ariana C. Kong ◽  
Mariana S. Sousa ◽  
Lucie Ramjan ◽  
Michelle Dickson ◽  
Joanne Goulding ◽  
...  

Abstract Background In Australia, models of care have been developed to train antenatal care providers to promote oral health among pregnant women. However, these models are underpinned by Western values of maternity care that do not consider the cultural needs of Aboriginal and Torres Strait Islander women. This study aimed to explore the perceptions and experiences of Aboriginal health staff towards oral health care during pregnancy. It is part of a larger program of research to develop a new, culturally safe model of oral health care for Aboriginal women during pregnancy. Methods A descriptive qualitative methodology informed the study. Focus groups were convened to yarn with Aboriginal Health Workers, Family Partnership Workers and Aboriginal management staff at two antenatal health services in Sydney, Australia. Results A total of 14 people participated in the focus groups. There were four themes that were constructed. These focused on Aboriginal Health Workers and Family Partnership Workers identifying their role in promoting maternal oral health, where adequate training is provided and where trust has been developed with clients. Yet, because the Aboriginal health staff work in a system fundamentally driven by the legacy of colonisation, it has significantly contributed to the systemic barriers Aboriginal pregnant women continue to face in accessing health services, including dental care. The participants recommended that a priority dental referral pathway, that supported continuity of care, could provide increased accessibility to dental care. Conclusions The Aboriginal health staff identified the potential role of Aboriginal Health Workers and Family Partnership Workers promoting oral health among Aboriginal pregnant women. To develop an effective oral health model of care among Aboriginal women during pregnancy, there is the need for training of Aboriginal Health Workers and Family Partnership Workers in oral health. Including Aboriginal staff at every stage of a dental referral pathway could reduce the fear of accessing mainstream health institutions and also promote continuity of care. Although broader oral health policies still need to be changed, this model could mitigate some of the barriers between Aboriginal women and both dental care providers and healthcare systems.

2020 ◽  
Author(s):  
Ariana C Kong ◽  
Mariana S Sousa ◽  
Lucie Ramjan ◽  
Michelle Dickson ◽  
Joanne Goulding ◽  
...  

Abstract Background: In Australia, models of care have been developed to train antenatal care providers to promote oral health among pregnant women. However, these models are underpinned by Western values of maternity care that do not consider the cultural needs of Aboriginal and Torres Strait Islander women. This study aimed to explore the perceptions and experiences of Aboriginal health staff towards oral health care during pregnancy. It is part of a larger program of research to develop a new, culturally safe model of oral health care for Aboriginal women during pregnancy.Methods: A descriptive qualitative methodology informed the study. Focus groups were convened to yarn with Aboriginal Health Workers, Family Partnership Workers and Aboriginal management staff at two antenatal health services in Sydney, Australia. Results: A total of 14 people participated in the focus groups. There were four themes that were constructed. These focused on Aboriginal Health Workers and Family Partnership Workers identifying their role in promoting maternal oral health, where adequate training is provided and where trust has been developed with clients. Yet, because the Aboriginal health staff work in a system fundamentally driven by the legacy of colonisation, it has significantly contributed to the systemic barriers Aboriginal pregnant women continue to face in accessing health services, including dental care. The participants recommended that a priority dental referral pathway, that supported continuity of care, could provide increased accessibility to dental care.Conclusions: The Aboriginal health staff identified the potential role of Aboriginal Health Workers and Family Partnership Workers promoting oral health among Aboriginal pregnant women. To develop an effective oral health model of care among Aboriginal women during pregnancy, there is the need for training of Aboriginal Health Workers and Family Partnership Workers in oral health. Including Aboriginal staff at every stage of a dental referral pathway could reduce the fear of accessing mainstream health institutions and also promote continuity of care. Although broader oral health policies still need to be changed, this model could mitigate some of the barriers between Aboriginal women and both dental care providers and healthcare systems.


2020 ◽  
Author(s):  
Ariana C Kong ◽  
Mariana S Sousa ◽  
Lucie Ramjan ◽  
Michelle Dickson ◽  
Joanne Goulding ◽  
...  

Abstract Background: In Australia, models of care have been developed to train antenatal care providers to promote oral health among pregnant women. However, these models are underpinned by Western values of maternity care that do not consider the need to ensure cultural safety for Aboriginal and Torres Strait Islander women. This study aimed to explore the perceptions and experiences of Aboriginal Health Workers and Family Partnership Workers towards oral health care during pregnancy. It is part of a larger program of research to develop a new, culturally appropriate model of oral health care for Aboriginal pregnant women and new mothers.Methods: A participatory action research methodology informed the study. Focus groups were convened to yarn with Aboriginal Health Workers, Family Partnership Workers and Aboriginal management staff at two antenatal health services in Sydney, Australia. Results: A total of 14 people participated in the focus groups. There were four themes that were constructed. These focussed on the importance of trust to build relationships with clients, and the need to receive training to better address the oral health needs of Aboriginal pregnant women and new mothers. Further, the staff work in a system fundamentally driven by the legacy of colonisation and its subsequent effects of integenerational trauma on Aboriginal people and communities. This has significantly contributed to the systemic barriers Aboriginal continue to face in accessing health services, including dental care. The participants recommended that a priority dental referral pathway, that supported continuity of care, could provide increased accessibility to dental care for Aboriginal pregnant women and new mothers.Conclusions: There is the need for an individual and systems approach to promote oral health among Aboriginal pregnant women and new mothers. This approach should cultivate trust between Aboriginal women and both care providers and healthcare systems. A new model of care is needed that provides oral health training to Aboriginal Health Workers and addresses the systemic factors that create barriers to accessing dental care for Aboriginal women.


Author(s):  
Ariana Kong ◽  
Michelle Dickson ◽  
Lucie Ramjan ◽  
Mariana S. Sousa ◽  
Joanne Goulding ◽  
...  

The aim of this study was to explore whether oral health was an important consideration for Aboriginal and Torres Strait Islander women during pregnancy, whether oral health could be promoted by Aboriginal health staff, and strategies that would be appropriate to use in a new model of care. A qualitative descriptive methodology underpinned the study. All participants in this study identified as Aboriginal, with no Torres Strait Islander participants, and were from New South Wales, Australia. The interviews were analysed using inductive thematic analysis. From the data, two themes were constructed. The first theme identified that oral health was not always the first priority for participants as poor accessibility alongside other competing commitments were challenges to accessing oral health services. The second theme highlighted how relationships with personal networks and healthcare providers were essential and could be used to support maternal oral health during pregnancy. Effective strategies to promote oral health during pregnancy for Aboriginal and Torres Strait Islander women should involve key stakeholders and health care providers, like Aboriginal Health Workers, to facilitate culturally safe support and tailored oral health advice.


2020 ◽  
Author(s):  
Ariana C Kong ◽  
Mariana S Sousa ◽  
Lucie Ramjan ◽  
Michelle Dickson ◽  
Joanne Goulding ◽  
...  

Abstract Background Aboriginal Health Workers provide a unique insight into understanding the health needs of the Aboriginal peoples in the community on account of their cultural knowledge, experiences and understanding of the health services. The aim of this study was to explore the perceptions and experiences of Aboriginal Health Workers towards oral health care to inform the development of an oral health care program to better meet the oral health needs of Aboriginal pregnant women and new mothers.Methods A participatory action research methodology informed the study. Focus groups were conducted with Aboriginal Health Workers at two antenatal health services in Sydney, Australia.Results A total of 14 people participated in the focus groups. The four themes that emerged from the focus groups provided insight on the importance of trust in the building of empowering relationships with Aboriginal women and highlighted the need for Aboriginal Health Workers to receive additional training to better address the oral health needs of Aboriginal pregnant women and new mothers. However, the Aboriginal Health Workers worked in a system fundamentally driven by the legacy of colonisation and integenerational trauma that has created systemic barriers to access of health services, including dental care. The participants recommended that a priority dental referral pathway, that supported continuity of care, could provide increased accessibility to dental care for Aboriginal pregnant women and new mothers.Conclusions The oral health of Aboriginal pregnant women and new mothers is supported by Aboriginal Health Workers, who outlined both a systems and an individual approach in delivery of existing dental care. The Aboriginal Health Workers provided recommendations to develop a program of dental care that could break down the systemic factors that create barriers to accessing dental care for Aboriginal women.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Sadika Akhter ◽  
Feroza Akhter Kumkum ◽  
Farzana Bashar ◽  
Aminur Rahman

Abstract Background Like many countries, the government of Bangladesh also imposed stay-at-home orders to restrict the spread of severe acute respiratory syndrome coronavirus-2 (COVID-19) in March, 2020. Epidemiological studies were undertaken to estimate the early possible unforeseen effects on maternal mortality due to the disruption of services during the lockdown. Little is known about the constraints faced by the pregnant women and community health workers in accessing and providing basic obstetric services during the pandemic in the country. This study was conducted to explore the lived experience of pregnant women and community health care providers from two southern districts of Bangladesh during the pandemic of COVID-19. Methods The study participants were recruited through purposive sampling and non-structured in-depth interviews were conducted. Data was collected over the telephone from April to June, 2020. The data collected was analyzed through a phenomenological approach. Results Our analysis shows that community health care providers are working under tremendous strains of work load, fear of getting infected and physical and mental fatigue in a widely disrupted health system. Despite the fear of getting infected, the health workers are reluctant to wear personal protective suits because of gender norms. Similarly, the lived experience of pregnant women shows that they are feeling helpless; the joyful event of pregnancy has suddenly turned into a constant fear and stress. They are living in a limbo of hope and despair with a belief that only God could save their lives. Conclusion The results of the study present the vulnerability of pregnant women and health workers during the pandemic. It recognizes the challenges and constraints, emphasizing the crucial need for government and non-government organizations to improve maternal and newborn health services to protect the pregnant women and health workers as they face predicted waves of the pandemic in the future.


2018 ◽  
Vol 11 (1) ◽  
pp. 66
Author(s):  
Ni Nengah Arini Murni ◽  
Suwanti Suwanti

Abstract : The study aimed to determine the correlation among knowledge and attitude with the behavior of pregnant women in dental and oral health care during pregnancy. The research was analytic observational and in terms of time used crossectional approach. The population in this study were pregnant women at Narmada Community Health Center whereas the sample obtained by 34 people who came to check Antenatal Care (ANC) in June 2015 taken by accidental sampling technique. Data collection of knowledge, attitude and behavior variables used questionnaire and Statistical analysis was performed by using Chi Square test. The research finding indicated that from 34 respondents, 17 pregnant women (50%) had lack knowledge level about oral and dental health care during pregnancy. The attitude of pregnant women in dental and oral care during pregnancy was 73.5% (poor attitudes), and in terms of respondents’ behaviour was the same like respondents’ attitude by 73.5% (poor attitude). Therefore, it can be concluded that there was a significant correlation between knowledge with pregnant women behavior in dental and oral health care (P value = 0.013) and there was significant correlation between attitude with respondents behaviour in oral and dental care during pregnancy (P value = 0.004). Suggestion: It is expected for Health Care Institutions and health workers need to do an effort of sustainable counselling to communities, especially pregnant women about risk factors that can cause dental caries which can affect the health of both fetus and mother, increasing promotive efforts, for instance the improvement and maintenance of health and preventive efforts for communnities and pregnant women in order to have a good knowledge and attitude in maintaining oral an dental health care during pregnancy can be preserved and further enhanced, hence the sense of responsibility in terms of a behavior in the community or pregnant women concerning dental and oral health increases in line with knowledge improvement and developing attitudes.


2021 ◽  
Vol 39 (1) ◽  
pp. 50-59
Author(s):  
Mumtahana Nabi ◽  
Abul Masud Md Nurul Karim ◽  
SM Mamun Ur Rashid

Background: Oral health care in pregnancy is often neglected by women and is also not appropriately addressed by prenatal and other health care providers and justify appropriate attention. The purpose of this cross sectional study was to describe percentage of oral disease occurrence and underlying causes in this sample of pregnant women. Methods: The study included 147 women aged between 15 to 49 years receiving prenatal care at the outdoor department of Azimpur Maternal and Child Health Training Institute in Dhaka, Bangladesh were invited to participate in this study from January 2013 to April 2013. Semi-structured interviews were conducted for data collection. Clinical exam data were recorded using validated scales in a special form. Results: Majority (72%) of the women were  between  20 to 24 years.  57%  had secondary  school  education.  88% of the women were unemployed and 52% women had very low family income of BOT s;10000. More than 90% of the women had good oral hygiene practices. However, 68% liked to  have  sugary  snacks  or  drinks  in  between  main meals, 7% visited their dentists during pregnancy , only 3% received advice  for  routine  oral  health  screening  from their prenatal care providers and only 4% women started their antenatal check-up during first trimester.  All  these negative influences might expose expecting mothers to high level of dental caries (54%), dental  erosion  (52%),  gingivitis (100%) and periodontitis (27%). This study also showed that majority of the women acquired oral health information through watching television (61%) or reading  newspaper  (12%)  while  only  4%  received  information from doctors/dent ists throughout their lifetime. Conclusion: The undertaken research highlighted the importance of using media in modifying Bangladeshi pregnant woman's behaviours toward oral health. It also emphasizes the need for inclusion of oral health preventive programme as part of pre and postnatal care. Further study in this area on a large scale will facilitate formulation of appropriate oral health policy to achieve satisfactory oral and general health outcomes during pregnancy and ensure optimum oral health conditions of their offspring. JOPSOM 2020; 39(1): 50-59


Author(s):  
Ariana Kong ◽  
Michelle Dickson ◽  
Lucie Ramjan ◽  
Mariana S. Sousa ◽  
Nathan Jones ◽  
...  

Background: this study aimed to develop and pilot test the model of care, Grinnin’ Up Mums & Bubs, to train Aboriginal Health Workers to promote oral health among Aboriginal and Torres Strait Islander pregnant women. Methods: Participatory Action Research was employed to develop the different components of the model (oral health promotion resources, training workshop, and a culturally safe referral pathway to dental services). The model was piloted (pre-post), using an embedded mixed-methods design, to determine the acceptability, satisfaction, and any recommendations made by seven Aboriginal Health Workers at an antenatal service in Western Sydney, Australia. Results: there was a high level of satisfaction with the components of the model of care among the participants, who believed that the model could be integrated into practice. The training showed some improvement in oral health knowledge and confidence. The participants recommended strategies for discussing oral health with Aboriginal and Torres Strait Islander pregnant women, and changes in public health dental policy to ensure that all women would be able to access affordable dental services through the referral pathway. Conclusion: the findings suggest a high level of satisfaction with the model of care among the Aboriginal Health Workers. Further evaluation is needed to confirm the short and long-term impact of the model.


2021 ◽  
Author(s):  
Ariana Kong ◽  
Michelle Dickson ◽  
Lucie Ramjan ◽  
Mariana S. Sousa ◽  
Nathan Jones ◽  
...  

Abstract Background: This study aimed to develop and pilot test the model of care, Grinnin’ Up Mums and Bubs, to train Aboriginal Health Workers to promote oral health among Aboriginal and Torres Strait Islander pregnant women. Methods: Participatory Action Research was employed to develop the different components of the model (oral health promotion resources, training workshop, and a culturally safe referral pathway to dental services). The model was piloted (pre-post) using an embedded mixed-methods design with seven Aboriginal Health Workers at an antenatal service in Western Sydney, Australia. Results: There was a high level of satisfaction with the components of the model of care among the participants, who believed that the model could be integrated into practice. The training showed some improvement in oral health knowledge and confidence. The participants recommended strategies for discussing oral health with Aboriginal and Torres Strait Islander pregnant women, and changes in public health dental policy to ensure that all women would be able to access affordable dental services through the referral pathway. Conclusion: The findings suggest a high level of satisfaction with the model of care among the Aboriginal Health Workers. Further evaluation is needed to confirm the short and long-term impact of the model.


Author(s):  
Pearl Pei Liu ◽  
Weiye Wen ◽  
Ka Fung Yu ◽  
Xiaoli Gao ◽  
May Chun Mei Wong

Background: Pregnant women are at risk of oral health problems. This qualitative study aims to understand dental care-seeking behaviours of pregnant women and their oral health-related information acquisition, to identify barriers to and motivators for, dental visits, and further explore their expectations and possible strategies to improve oral health care during pregnancy. Methods: Semi-structured interviews were conducted with 30 pregnant women (after 32 gestational weeks) enrolled in the antenatal care programme in a public hospital in Hong Kong. Two main areas of interest were probed: Dental care-seeking behaviour and oral health information acquisition. Their expectations and suggestions on oral health care service for pregnant women were also explored. An inductive thematic approach was adopted to analyse the data. Results: Pregnant women’s dental care-seeking behaviour was deterred by some internal factors, such as misunderstandings on oral health, and priority on other issues over oral health. External factors such as inconvenient access to dental service during pregnancy also affected their care-seeking behaviours. Oral health information was passively absorbed by pregnant women through mass media and the social environment, which sometimes led to confusion. Oral health information acquisition from antenatal institutions and care providers was rare. Greater attention was paid to dental visit when they obtained proper information from previous dental visit experience or family members. A potential strategy to improve oral health care suggested by the interviewees is to develop a health care system strengthened by inter-professional (antenatal-dental) collaboration. Efficient oral health information delivery, convenient access to dental service, and improved ‘quality’ of dental care targeting the needs of pregnant women were identified as possible approaches to improve dental care for this population. Conclusion: Dental care-seeking behaviour during pregnancy was altered by various internal and external factors. A lack of, or conflict between, information sources result in confusion that can restrict utilisation of dental service. Integrating dental care into antenatal service would be a viable way to improve dental service utilisation.


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