Maternal Oral Health and Global Oral Health: Policy Perspective

Abstract Background and problems The findings of the last South African National Children Oral Health Survey conducted between 1999 and 2002 indicated a national prevalence of dental caries at 60% among 6-year-olds, with over 80% of untreated caries. Various studies have shown that one of the successful strategies in preventing dental caries is intervention during pregnancy by providing prenatal oral health education. Importance and opportunities To successfully mitigate the challenge of ECC, South Africa needs a holistic approach strategy that will integrate oral health services into existing general health programmes, especially into antenatal care (ANC). South Africa National Oral Health Policy and Strategy states that “Integrate oral health strategy elements and strategies into programmes and policies of all sectors that impact community health like maternal and women's health.” All government health care facilities offer free essential ANC services, identifying risk factors relating to poor maternal and birth outcomes. This existing infrastructure can be utilized to deliver oral health education and care for expecting mothers as essential ANC services. Solution The Public Oral Health Forum, a non-profit organization in South Africa, seeks to develop maternal and oral health policies that can be aligned with its research and policy development strategy. It proposes maternal oral health policy and strategies, which could be applicable in the South African context: Education of pregnant women, prenatal providers, and dental and medical students about perinatal and infant oral health, integration of oral health in primary health care services, interprofessional workforce development and research to improve oral health and access to dental care among pregnant women and new mothers. This presentation will demonstrate how such maternal oral health policy and strategy are developed, aligning with existing policy and infrastructure in South Africa.


Background and problems:
In the last decade, migration has increased due to climatic, economic, and social factors. Oral health is an integral part of overall health, but primary health packets for migrants/ refugees often neglect oral health education and care in the care delivery system. The present article aims to present a realistic approach to integrating oral health into existing structures for young migrant/refugee mothers on a community level in Switzerland. Importance: As a young child's oral health is closely related to mother's oral health status and oral health knowledge level, it would be critical that migrant/refugee mothers have access to timely oral health education and care through the primary health care system.

Solution:
We propose an integrated oral health care model for migrant/ refugee mothers that maximizes the existing primary health care system. Using existing maternal oral health resources, a training module is developed for the primary care care workforce that serve migrant/refugee mothers. This training module includes oral health needs and status assessment and delivering preventive oral health services in primary care settings. The module includes drawings and images to describe the dangers of poor oral hygiene during pregnancy related to the health of mothers and babies and how to keep the mouth healthy with low-cariogenic diet practice and home oral hygiene care. Primary health care workforce in selected migrant health centers, like nurses, medical aides, and community health care workers, is trained by this module and evaluated by a set of self-assessed questionnaires before and after the training for knowledge improvement, attainment, and clinical practice changes. Migrant mothers participate in questionnaires on oral health hygiene practice and access to dental care during pregnancy and for their young children. The questionnaires are validated by the affiliated universityhospital clinical research center. Background and problem: SDG 3.1 sets out that by 2030, the global maternal mortality ratio (MMR) should be reduced to 70 per 100,000 lives and no country should have MMR above 140 per 100,000 lives. Indonesia still has an MMR of 177 by 2017 data by the World bank. Urgent action is needed to improve the health and survival of women and babies. The main causes of MMR in Indonesia are Hemorrhage, followed by pre-eclampsia, and others, related with diabetes, stroke, etc. Importance: Previous studies have shown the association between oral dysbiosis and pre-eclampsia, preterm birth and low birth weight. Oral microbiome of the mother being a key player in pregnancy outcomes. Periodontal disease is considered a possible risk factor for the health of the mother and the newborn.

Solution:
Program goal of this program, ''Innovative AnteNatal Care, Healthy Teeth, Healthy Baby'', is to create the ecology right from the start, by incorporating oral health diagnosis and prevention into routine antenatal care. This approach achieves a healthy oral condition that can improve systemic health during pregnancy. The program also achieves a healthy and resilient family through oral health empowerment and delivering healthy babies (superior generation 2045-President Joko Widodo). Processes included avocation to provincial health districts, initial survey of the perception and oral health status of pregnant mothers, module preparation, and socialization to health districts and related officers. The program has trained midwives and dental providers and secured governmental budgets for sustainable activities, including socialization and assistance to pregnant mothers and their husbands, field penetration by health professionals, and evaluation of the programs.

Background and problems:
The findings of the last South African National Children Oral Health Survey conducted between 1999 and 2002 indicated a national prevalence of dental caries at 60% among 6-year-olds, with over 80% of untreated caries. Various studies have shown that one of the successful strategies in preventing dental caries is intervention during pregnancy by providing prenatal oral health education. Importance and opportunities: To successfully mitigate the challenge of ECC, South Africa needs a holistic approach strategy that will integrate oral health services into existing general health programmes, especially into antenatal care (ANC). South Africa National Oral Health Policy and Strategy states that ''Integrate oral health strategy elements and strategies into programmes and policies of all sectors that impact community health like maternal and women's health.'' All government health care facilities offer free essential ANC services, identifying risk factors relating to poor maternal and birth outcomes. This existing infrastructure can be utilized to deliver oral health education and care for expecting mothers as essential ANC services.

Solution:
The Public Oral Health Forum, a non-profit organization in South Africa, seeks to develop maternal and oral health policies that can be aligned with its research and policy development strategy. It proposes maternal oral health policy and strategies, which could be applicable in the South African context: Education of pregnant women, prenatal providers, and dental and medical students about perinatal and infant oral health, integration of oral health in primary health care services, interprofessional workforce development and research to improve oral health and access to dental care among pregnant women and new mothers. This presentation will demonstrate how such maternal oral health policy and strategy are developed, aligning with existing policy and infrastructure in South Africa.
iii106 European Journal of Public Health, Volume 32 Supplement 3, 2022