Evaluation of the Doktor Muda programme on the oral health of secondary school children in Kelantan / Siti Kamilah Mohamad Kasim
Health Promoting School (HPS) concept is a strategy for health promotion by the WHO. In Malaysia, a similar concept was introduced in 1980s known as the Doktor Muda Programme (DMP) spearheaded by the Ministry of Health (MOH) and Ministry of Education (MOE). DMP was effective to promote oral healt...
Saved in:
| Main Author: | |
|---|---|
| Format: | Thesis |
| Published: |
2019
|
| Subjects: | |
| Online Access: | http://studentsrepo.um.edu.my/11694/4/kamilah.pdf http://studentsrepo.um.edu.my/11694/ |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| Summary: | Health Promoting School (HPS) concept is a strategy for health promotion by the WHO.
In Malaysia, a similar concept was introduced in 1980s known as the Doktor Muda
Programme (DMP) spearheaded by the Ministry of Health (MOH) and Ministry of
Education (MOE). DMP was effective to promote oral health in primary schoolchildren.
In 2015, DMP was introduced in secondary schools. However, no evaluation has been
conducted on its impacts on oral health. Objectives: (i) to compare the impacts of DMP
between schoolchildren attending DMP schools and schoolchildren attending non-DMP
schools after 6 months in terms children’s oral health knowledge (OHK), oral health
attitudes (OHA), oral health behaviours (OHB), oral health status (OHS) (oral hygiene,
gingival health, caries incidence), and oral health-related quality of life (OHQRoL); (ii)
to determine the associated factors for schoolchildren’s OHK, OHA, OHB, OHS, and
OHRQoL; and (iii) to explore the process implementation of DMP in terms of Doktor
Muda (DM) selection, training, DMP strengths and weaknesses, and suggestions for
improvement from the perspectives of the DMs. Method: This study utilised a mixedmethod study design with 2 phases. Phase 1 was a quasi-experimental study involving
Form 1 schoolchildren (12-13 years) in Kota Bharu and Pasir Mas Districts, Kelantan in
2018. The intervention group (IG) comprised DMP schools and the control group (CG)
comprised non-DMP schools, matched by location. The sample size for the IG and CG
was 270 and 265, respectively. Study tools included a validated questionnaire, O’Leary
plaque index, the Gingival Index for Schoolchildren (GIS), the International Caries
Detection and Assessment System (ICDAS), and the Malay Child Oral Impacts on Daily
Performances (Malay Child-OIDP) index. Baseline data were collected prior to the DMP
intervention, and again after 6 months. In Phase 2, focus group discussions (FGD) were
conducted among DMs from the DMP schools. Quantitative data were analysed using
SPSS software using descriptive, univariate and multivariate analyses. The qualitative
data were transcribed verbatim and analysed using the framework method analysis.
iv
Results: The baseline and follow up response rate was 97.6% and 90.9%, respectively.
There were no significant between-group differences in mean OHK and OHB increment
scores after 6 months. However, the mean OHA increment score was significantly higher
in the CG (p<0.001) after 6 months. Both groups had a significant decrement in mean
plaque score after 6 months but no between-group difference was observed. The mean
increment in score of GIS in the IG was significantly higher compared to the CG
(p<0.001) after 6 months. A significantly lower proportion of schoolchildren in the IG
experienced caries increment compared to schoolchildren in the CG after 6 months
(p<0.05). In terms of OHRQoL, a lower proportion of schoolchildren in the IG
experienced an increment in mean OIDP total score than schoolchildren in the CG after
6 months but no between-group difference in mean OIDP increment scores. The
associated factors for OHK increment are gender and school location; for OHA increment
are location, gender, type of school and OHK; for plaque score is school location; for GIS
increment is type of school; for cavitated caries (tooth) is OHA increment; for cavitated
surfaces are mother’s education level and OHA increment; for OIDP increment is OHK
increment; and for at least 1 OIDP present are gender, mouth-rinsing behaviours, flossing
frequency, and cavitated caries increment. From the FGDs, DMs perceived that their
appointment was made by teachers, training was quite insufficient, with mixed feedback
on support and materials provided. However, DMs perceived the programme improved
their OHK and OHB including that of their peers. Recommendations for improvement
included a dedicated health advisor, increase number of DMs, and longer time for DMP
activities. Conclusion: The DMP in secondary school has some positive impacts on
caries and OHRQoL after 6 months. Further improvements in DMP implementation are
recommended to improve the effectiveness of DMP on schoolchildren’s oral health. |
|---|