scholarly journals “Got to build that trust”: Aboriginal Health Workers’ perspectives and experiences of maternal oral health

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.

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 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.


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.


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.


2021 ◽  
pp. 238008442110119
Author(s):  
M. McNally ◽  
L. Rock ◽  
M. Gillis ◽  
S. Bryan ◽  
C. Boyd ◽  
...  

Background: The COVID-19 novel coronavirus closed oral health care in Nova Scotia (NS) Canada in March 2020. Preparing for a phased reopening, a knowledge exchange coalition (representing government, academia, hospitals, oral health professions, and regulators) developed return-to-work (RTW) guidelines detailing the augmentation of standard practices to ensure safety for patients, oral health care providers (OHPs), and the community. Using online surveys, this study explored the influence of the RTW guidelines and related education on registered NS OHPs during a phased return to work. Methods: Dissemination of R2W guidelines included website or email communiques and interdisciplinary education webinars that coincided with 2 RTW phases approved by the government. Aligned with each phase, all registered dentists, dental hygienists, and dental assistants were invited to complete an online survey to gauge the influence of the coalition-sponsored education and RTW guidelines, confidence, preparedness, and personal protective equipment use before and after the pandemic. Results: Three coalition-sponsored multidisciplinary webinars hosted 3541 attendees prior to RTW. The response to survey 1 was 41% (881/2156) and to survey 2 was 26% (571/2177) of registrants. Survey 1 (82%) and survey 2 (89%) respondents “agreed/strongly agreed” that R2W guidelines were a primary source for guiding return to practice, and most were confident with education received and had the skills needed to effectively treat patients during the COVID-19 pandemic. Confidence and preparedness improved in survey 2. Gowns/lab coat use for aerosol-generating procedures increased from 26% to 93%, and the use of full face shields rose from 6% to 93% during the pandemic. Conclusions: A multistakeholder coalition was effective in establishing and communicating comprehensive guidelines and web-based education to ensure unified reintegration of oral health services in NS during a pandemic. This multiorganizational cooperation lay the foundation for responses to subsequent waves of COVID-19 and may serve as an example for collaboratively responding to future public health threats in other settings. Knowledge Transfer Statement: The return-to-work strategy that was developed, disseminated, and assessed through this COVID-19 knowledge exchange coalition will benefit oral health practitioners, professional regulators, government policy makers, and researchers in future pandemic planning.


2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Mohamed Yunus Rafiq ◽  
Hannah Wheatley ◽  
Hildegalda P. Mushi ◽  
Colin Baynes

Abstract Background Numerous studies have examined the role of community health workers (CHWs) in improving the delivery of health services and accelerating progress towards national and international development goals. A limited but growing body of studies have also explored the interactions between CHWs’ personal, communal and professional identities and the implications of these for their profession. CHWs possess multiple, overlapping roles and identities, which makes them effective primary health care providers when properly supported with adequate resources, but it also limits their ability to implement interventions that only target certain members of their community, follow standard business working days and hours. In some situations, it even prevents them from performing certain duties when it comes to sensitive topics such as family planning. Methods To understand the multiple identities of CHWs, a mixture of qualitative and ethnographic methods was utilized, such as participant observation, open-ended and semi-structured interviews, and focus group discussions with CHWs, their supervisors, and their clients. The observation period began in October 2013 and ended in June 2014. This study was based on implementation research conducted by the Connect Project in Rufiji, Ulanga and Kilombero Districts in Tanzania and aimed to understand the role of CHWs in the provision of maternal and child health services in rural areas. Results To our knowledge, this was the first study that employed an ethnographic approach to examine the relationship between personal, communal and professional identities, and its implications for CHWs’ work in Tanzania. Our findings suggest that it is difficult to distinguish between personal and professional identities among CHWs in rural areas. Important aspects of CHW services such as personalization, access, and equity of health services were influenced by CHWs’ position as local agents. However, the study also found that their personal identity sometimes inhibited CHWs in speaking about issues related to family planning and sexual health. Being local, CHWs were viewed according to the social norms of the area that consider the gender and age of each worker, which tended to constrain their work in family planning and other areas. Furthermore, the communities welcomed and valued CHWs when they had curative medicines; however, when medical stocks were delayed, the community viewed the CHWs with suspicion and disinterest. Community members who received curative services from CHWs also tended to become more receptive to their preventative health care work. Conclusion Although CHWs’ multiple roles constrained certain aspects of their work in line with prevalent social norms, overall, the multiple roles they fulfilled had a positive effect by keeping CHWs embedded in their community and earned them trust from community members, which enhanced their ability to provide personalized, equitable and relevant services. However, CHWs needed a support system that included functional supply chains, supervision, and community support to help them retain their role as health care providers and enabled them to provide curative, preventative, and referral services.


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.


Author(s):  
Ayu Rahajeng Dianing Negari ◽  
Annisa Nurida ◽  
Musa Ghufron ◽  
Muhammad Anas

Background: Satisfaction is a feeling that the consumers feel when the service they receive meets or surpass their expectations. Public satisfaction with health care services is still a significant issue for health institutions in improving the service quality. Despite various efforts that health care providers have made, some residents in an area were unsatisfied with the health services in their environment.Objective: To determine the effect of the dimensions of health service quality on patient satisfaction at the Primary Health Care 1 Melaya, Jembrana, BaliMethod: Analytical observational study, a cross-sectional design. The total sample was 70 respondents. Data collection was performed using questionnaires. Multiple linear regression was used to analyze the average value of patient satisfaction based on the five dimensions of quality of health care.Result: The dimensions of tangibility, responsiveness, assurance, and empathy have a significance value (p<0.05), while the reliability dimension has no significance value (p>0.05). So the formula used to predict patient satisfaction with health services received is as follows:y = 0,352+0,295*X1–0,104*X2–0,201*X3+0,334*X4+0,180*X5The dimension of health services that has the largest influence on the satisfaction of inpatients is assurance. Patients feel assured and satisfied when the health workers communicate their expertise and competencies before doing their work.Conclusion: Tangibility, reliability, responsiveness, and assurance were four of five dimensions of health services that have significantly influenced the satisfaction of inpatients.


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