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The Midwifery Initiated Oral Health (MIOH) programme was started by Western Sydney University’s Professor Ajesh George in 2008, to increase awareness of the importance of good oral health during pregnancy, which benefits both mothers and babies. "Although poor maternal oral health is linked to adverse pregnancy outcomes and increases the risk of early dental decay in children, many don’t see it as a priority and very few women visit the dentist during pregnancy," says George, a Professor of Interprofessional Oral Health in Western’s School of Nursing and Midwifery.
As a pregnant woman’s first point of contact within the Australian health system, midwives are well positioned to play a role in providing advice about oral health, says George, so the MIOH programme was designed to equip them with the training, resources, and referral pathways to do just that. In the years since the start of the programme it has been adopted by health systems across Australia as a cost-effective model and has contributed to a significant improvement in the uptake of oral health advice and health outcomes in mothers and children.
Now MIOH is going global, with several other countries and jurisdictions adopting their own versions of the programme, including Iran, Saudi Arabia, Pakistan, and several U.S. states. Dr Juhani Brodkin, a dentist in Finland, helped to bring the programme to Tanzania, where he was involved in oral health projects through the Rotary Club.
Need to know
- The Midwifery Initiated Oral Health Programme aims to increase knowledge about the importance of oral health during pregnancy.
- After an initial rollout in Australia, the programme has been introduced in several countries including the U.S. and Tanzania.
"Very few women visit the dentist during pregnancy."
Brodkin discovered MIOH in 2020 while searching for a model that integrates oral health into maternity clinics, which could be applied to Tanzania. While the pandemic and a lack of funding slowed things down, Brodkin and his partners in Tanzania worked with George to develop an informational brochure and short training seminar in the Swahili language for health workers, which ran in September and October 2022. Now they are seeking funding to develop more comprehensive training for midwives based on MIOH, about why oral health is important and how to advise pregnant women about it.
The participants in last year’s training seminars were very enthusiastic, says Brodkin. The training was shown to significantly improve the oral health knowledge and confidence of participants, adds George. Brodkin has since had discussions with the Ministry of Health, and the Dean of the Dar es Salaam School of Dentistry about expanding the programme. "Phase two will be much bigger," he says.
Beyond Tanzania, the World Health Organization has also taken an interest in MIOH, says George, and is using it as a case study of an effective strategy to integrate oral health into primary health care. "MIOH is one of the only programmes to actually prove non-dental professionals can play an effective role in oral health care," he says.
As the programme gains recognition around the world, it will help both mothers and children maintain healthy smiles for years to come.
Meet the Academic | Professor Ajesh George
Dr Ajesh George (BDS, MPH, PhD) is a Professor of Interprofessional Oral Health in the School of Nursing and Midwifery, Western Sydney University and Honorary Professor in the School of Dentistry at the University of Sydney. He is a dentist with extensive experience in integrated oral health care and is a renowned expert globally in providing oral health training to non-dental professionals and translating oral health guidelines into their practice.
Professor George is also the Director and Co-founder of the Australian Centre for Integration of Oral Health (ACIOH) which is a leading national research centre led by Western Sydney University in collaboration with various partners including universities, health services and professional organisations. Over the last decade he has been coordinating multidisciplinary teams in implementing effective and sustainable models of care across the lifespan and his work has been recognised by key bodies including the World Health Organisation. He has also been instrumental in training nurses and midwives to promote oral health by integrating oral health into undergraduate midwifery and nursing courses at Australian universities as well as developing nationally recognised oral health professional development training programs.
Professor George has over $5.4M in funding including NHMRC grants, more than 140 publications (90% Q1/Q2 journals), 145 conference presentations (40 international), 19 research awards and a H-index of 31 with 3600 citations. He has 7 PhD completions and currently supervises 11 Higher Degree Research students (PhD and Masters) most of whom have received scholarships to undertake studies around integrated oral health care. In 2021 he was recognised as one of the top 2% of scientists worldwide.
Credit
Future-Makers is published for Western Sydney University by Nature Research Custom Media, part of Springer Nature.
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