Healthcare workers' perspectives on integrated oral and antenatal health care at public health facilities in southwestern nigeria: a qualitative study.

backgroundWomen experience physiological and psychological changes that can affect oral health during pregnancy. This study evaluated the current practices, barriers, and facilitators of oral health care within antenatal care services and assess the feasibility and benefits of integrating oral healthcare into antenatal care frameworks, particularly in Southwest Nigeria.

methodsThis descriptive phenomenology study that recruited participants from Osun and Ekiti States healthcare facilities in Southwest Nigeria. Data were collected from healthcare workers between July and August 2023 via in-depth interviews. Transcripts were coded and analyzed using Atlas.ti version 8. The coding frame was structured according to the research questions, with new codes added iteratively to capture emergent themes. Insights were drawn out into a Microsoft word narrative document, linking findings back to transcripts to keep track of the weight of evidence behind specific points. The teams adhered to and employed procedures that ensured rigor.

resultsSixteen healthcare workers were interviewed. Three themes emerged from the interview. The first theme - current oral health practices at antenatal care services - shed light on the existing scope of antenatal care and, the limitations of oral health assessments and care within the antenatal care units. The second theme, which focused on the uptake of preventive oral care by pregnant women, identified a variety of facilitators and barriers to oral health care access by pregnant women. Facilitators include experiences of tooth pain or bleeding, while barriers were the lack of awareness, misconceptions, and financial constraints. The third theme explored the integration of oral healthcare into antenatal care, revealing perceived benefits and measures to improve access such as early detection, prompt referral, and preventive practices.

conclusionHealthcare providers in Southwestern Nigeria perceived that access to and uptake of preventive oral health care by pregnant women is poor possibly due to the absence of protocols for integrating oral health into antenatal care services. In addition, there are individual and structural level factors that limits the access to and uptake of oral health care by pregnant women. Many of these barriers can be addressed through oral health promotion.