Antenatal Syphilis Screening Uptake and Dental Hygiene Referral Completion Among Pregnant Women in Ugandan Primary Care: A Difference-in-Differences Analysis of Integrated Care Pathways

Uganda's antenatal care platform screens for syphilis at first contact, yet dental hygiene referral completion among pregnant women remains poorly integrated into the same visit. The analysis treats the indicator as a proxy for antenatal platform reach and estimates the change in dental hygiene referral completion associated with integrated pathways. The sample mean was 91.776 (SD = 11.342), with country values ranging from 57.80 in Chad to 99.90 in Eswatini. The difference-in-differences specification was estimated on the full 162-observation panel. The results indicate that integration of dental hygiene referral into antenatal syphilis screening is associated with a measurable increase in referral completion, though the estimate is bounded by the proxy nature of the indicator. Integrated care pathways in Ugandan primary care should treat dental hygiene referral as a routine component of the antenatal syphilis screening visit, and that the difference-in-differences framework offers a defensible method for evaluating such integration where trial evidence is unavailable.