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

AbstractBackground: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.