Integration of Oral Health Services into Maternal and Child Health Programs in Ogun State: Barriers and Opportunities

Oral health is an integral but often neglected component of maternal and child health (MCH) programming. Pregnancy-related hormonal changes increase susceptibility to periodontal disease, which has been associated with adverse pregnancy outcomes including preterm birth and low birth weight. In Ogun State, South West Nigeria, oral health services are rarely integrated into antenatal care pathways, representing a missed opportunity for preventive intervention. This qualitative and quantitative mixed-methods study explores the barriers to and opportunities for integrating oral health services into MCH programs in Ogun State. Health facility surveys were conducted at 24 primary healthcare centers, supplemented by in-depth interviews with 16 maternal and child health nurses, four district dental officers, and two state-level health program managers. Results indicate that none of the surveyed facilities had a formal oral health component within their antenatal care protocols. Key barriers identified include lack of dental equipment at primary care level, absence of referral linkages to oral health services, inadequate training of MCH nurses in oral health assessment, and low prioritization of oral health in state health programming. Opportunities identified include leveraging existing antenatal contact points for oral health screening, training CHEWs in basic oral examinations, and policy advocacy for oral health inclusion in Nigeria's national MCH strategic framework. Keywords: oral health integration, maternal and child health, Ogun State, primary healthcare, antenatal care.