Tobacco Use Prevention and Cessation Programme For Pregnant Women Accessing Antenatal Care In Urban Public Health Facilities In Southern India

Abstract Backgrounds and problem By 2030, tobacco use is estimated to kill more than 8 million people worldwide annually, with LMICs accounting for over 80% of those deaths. In India, about 4.6% of women continue to use tobacco mainly (> 80%) in smokeless (SLT) form during pregnancy. This may lead to: higher risk of anemia (∼ 70%), hypertension, and postpartum hemorrhage; poor fetal development; and 2-3 times higher rate of low-birth and stillbirth babies. Importance Anti-tobacco initiatives often focus on smoking over SLT, which is commonly consumed by women. Drivers of SLT use among women include: cultural appropriateness, medicinal benefits, and poor social determinants of health. These factors must be taken into account while formulating effective anti-tobacco interventions for pregnant women, ensuring safe motherhood and neonatal health. Solution We propose integrating oral health interventions in mitigating tobacco use within the existing antenatal care (ANC) model. Women enrolled in public health facilities in an urban poor neighborhood in South India receive oral health education (OHE) integrated into ANC. The intervention promotes oral hygiene habits, dietary advices, improving dental healthcare utilization, and sensitization on the ill-effects of tobacco-use. Training for ANC providers focuses on delivering antenatal tobacco screening, cessation, and referral services. This includes expanding the medical history to record tobacco use, conduct oral examination and referrals to dentists and/or tobacco cessation centres. Final outcomes of OHE will be measured using pre and post KAP surveys informed by WHO Oral Health Surveys; and training programme using in-depth interviews among providers. Desired policy change is the inclusion of tobacco prevention and cessation programme in the Indian ANC guidelines.


Background:
Achieving and maintaining good oral health during pregnancy is essential for both the oral and overall health of expecting mothers and their young children.Dental caries can negatively affect daily activities including eating, speaking, and social interaction, and when expecting mothers have active dental caries, the risk for dental caries in these children becomes higher.Another common oral disease, periodontitis, was found to be associated with systemic conditions, including cardiovascular disease, respiratory disease, diabetes, and potentially adverse birth outcomes.Importance: Some studies also showed the systemic impact of periodontal disease and the related pathogens that can lead to systemic inflammation and adverse birth outcomes.A mother's oral health status, her oral health knowledge, and beliefs also have been shown to significantly affect diet and home oral hygiene practice among her children.Problem: Despite the importance of mother's oral health and oral health knowledge to prevent dental caries in young children, maternal oral health is much neglected in primary and prenatal health discussion.This is even more significant in developing countries where oral health care infrastructure and workforce are inadequate.With increase in sugar consumption growing worldwide with this lack of oral health care infrastructure, oral diseases prevention and oral health promotion are the key to achieve oral health parity among the maternal and child population.

Solution:
In this presentation, the author will discuss literature on maternal oral health and how to position oral health as an essential part of perinatal care along with WHO oral health initiative set for 2030.This is an introduction presentation for this workshop to set a stage and make a case why maternal oral health is a critical topic to discuss in global health and public health perspectives.

Backgrounds and problem:
By 2030, tobacco use is estimated to kill more than 8 million people worldwide annually, with LMICs accounting for over 80% of those deaths.In India, about 4.6% of women continue to use tobacco mainly (> 80%) in smokeless (SLT) form during pregnancy.This may lead to: higher risk of anemia ( 70%), hypertension, and postpartum hemorrhage; poor fetal development; and 2-3 times higher rate of low-birth and stillbirth babies.Importance: Anti-tobacco initiatives often focus on smoking over SLT, which is commonly consumed by women.Drivers of SLT use among women include: cultural appropriateness, medicinal benefits, and poor social determinants of health.These factors must be taken into account while formulating effective antitobacco interventions for pregnant women, ensuring safe motherhood and neonatal health.

Solution:
We propose integrating oral health interventions in mitigating tobacco use within the existing antenatal care (ANC) model.Women enrolled in public health facilities in an urban poor neighborhood in South India receive oral health education (OHE) integrated into ANC.The intervention promotes oral hygiene habits, dietary advices, improving dental healthcare utilization, and sensitization on the ill-effects of tobacco-use.Training for ANC providers focuses on delivering antenatal tobacco screening, cessation, and referral services.This includes expanding the medical history to record tobacco use, conduct oral examination and referrals to dentists and/or tobacco cessation centres.Final outcomes of OHE will be measured using pre and post KAP surveys informed by WHO Oral Health Surveys; and training programme using in-depth interviews among providers.Desired policy change is the inclusion of tobacco prevention and cessation programme in the Indian ANC guidelines.
Abstract citation ID: ckac129.258Tobacco Use Prevention and Cessation Programme For Pregnant Women Accessing Antenatal Care In Urban Public Health Facilities In Southern India