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Background: Dodoma Christian Medical Center dental department initiated primary school oral health prevention programme in 2007. Before the programme implementation a baseline data was collected. The programme components included oral health education, skills, community involvement and dental services. The implementation strategy used mainly school health clubs.
This was a mid term evaluation which aimed at assessing the effectiveness of programme after 3 years of intervention. The assessment was done on April 2010.
Research question: How effective is the school oral health program at Ntyuka primary school in Dodoma municipality?
Objectives: The evaluation assessed both the process (acceptability and attitude toward the intervention, attendance to dental clinic) and the outcome (change in knowledge, oral hygiene practices and oral health status) after the intervention.
Methods: This was a pre and post intervention comparative study. A total of 300 pupils at pre and also at post intervention studies were involved in the study. In addition interviews were done to eight pupils, two programme teachers and four school parent committee members.
Results: Our findings showed that there was a significant increase in level of knowledge from 143(47.7%) at pre to 171(57%) at post intervention on causes for dental caries, from 137 (45.7%) to 170 (56.7%) on causes of gingivitis and from 178 (59.3%) to 234(78%) on prevention of both dental caries and gingivitis. Knowledge on specific causes increased significantly (p<0.01). Pupils studying in upper classes were more knowledgeable on causes and prevention of tooth decay and gum disease (p<0.01). Good oral hygiene practice has improved from 132 (44.3%) to 164 (54.7%). Proportion of pupils who use toothbrush twice per day increased from 135 (45%) to 155 (52.4%). No significant difference on use of traditional and modern tooth brush. Generally there was an improvement in oral health status. Prevalence of gingivitis has decline from 75.5% to 39.7% while mean sextant bleeding improved from 5 to 1.4. Though the DMFT value slightly increased from 90 to 119; it was due to shift of its components; missing (M) by 6.7% and filing (F) by 18.5% which were zero pre intervention. The mean DMFT changed from 0.3 to 0.4 at post intervention.
Out 930 pupils; 345 (37%) benefited free treatment at dental clinic. Pupils attended dental clinic for treatment increased from 5.4% in 2007, to 14% in 2008 and 17.6% in 2009.
In depth interview with pupils, programme teachers and school parent committee revealed that nearly all stakeholders were involved in all aspect of the intervention. The programme was very much accepted by pupils and parents. School oral health clubs were found effective for preparing the change agents.
Conclusion: The programme was effective in increasing knowledge on causes and prevention of dental caries and gingivitis. Oral hygiene practices have improved such that the gingivitis has decline significantly. The filling component of DMFT has improved. Reduction of dental caries is a long term effect; it needs more duration to see its impact. School oral health programme should be scaled up to cover other schools in the region. |
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