Factors influencing adoption of oral health promotion by antenatal care providers in Moyo district

Abstract

Introduction: Oral health promotion during pregnancy has been recognized as an important global public health issue and number of statements and guidelines have been published emphasizing the need for improved oral health care of pregnant mothers and prenatal care providers have this critical opportunity to promote oral health. In Uganda in the year 2009, the prevalence of tooth loss among pregnant mothers was 35.7%, with63.4% bleeding calculus and 67.0% in 2012 had periodontal diseases. In Moyo district, there is limited data on the level and factors associated with adoption of Oral health promotion by antenatal care providers. The objective of this study was to establish factors influencing adoption of oral health promotion by Antenatal care providers. Methods: Descriptive Cross-sectional study employing both quantitative and qualitative data collection methods and analysis was used. Data was obtained from 152 antenatal care providers using Yamane’s formula. A population proportionate to simple size sampling was used to estimate the number of health providers interviewed in the selected health facilities and simple random sampling was employed to obtain required participants at the selected health facilities. Three FGDs were held among antenatal care providers and six key informant interviews were held for healthcare managers. For quantitative data, univariate, bivariate and multivariate analysis was performed in SPSS version 20.0, while qualitative were transcribed verbatim, coded and organised in themes in ATLAS.ti. Results: It was observed that 42(28%) ANC providers had adopted oral health promotion (OHP). ANC providers with moderate knowledge were three times more likely to adopt oral promotion (aOR=3.205, 95%CI=1.050-9.785, p= 0.041*) and there was statistically significant association between having moderate knowledge and adoption of oral health promotion. Having good understanding between dentists and antenatal care providers contributed to 25.1% adoption of OHP (aOR=0.251, 95%CI=0.0093-0677, p=0.006*). Management being at influencing new practices contributed to 50.8% adoption of oral health promotion and there no statistically significant relationship (aOR=0.508, 95%CI=0.187-1.384, p=0.186).There was some level of misconception about prenatal oral health care among Health managers, ANC providers, although ANC providers, including health managers were willing to stand out to advocate adoption of Oral health promotion. Both national and local negligence of oral health issues, limited continuous staff training on oral health, poor dissemination of National oral health policy and no local oral health care guideline for ANC providers were some of key issues that emerged from the qualitative results. Conclusion: Adoption of Oral health promotion by antenatal care providers was low. Being Knowledgeable and having good understanding with dentists and management being good at influencing new practices contributed to increased level in adoption of oral health promotion. However, having misconception, knowledge gap, and poor dissemination of National oral health policy and lack of prenatal oral health guideline where some of the barriers to decreased level of adoption by antenatal care providers. Recommendation: Ministry of health, district and sub-districts need to enhance the knowledge of ANC providers through training, need for deliberate effort to initiate good understanding and collaboration between ANC providers and dentists, need to review and implement the current National Oral health policy involving different cadres to easy dissemination and clearly indicating how to promote oral health of pregnant mothers.