Oral Health Knowledge and Practices of Community Health Workers

Objectives: To determine whether the oral health knowledge and practices of community health workers (CHWs) in a primary health care setting in South Africa were adequate to offer oral health care.
Methods: A cross sectional survey was done in a health district in the Western Cape Province in South Africa. A sample of CHWs (n=149) were randomly selected from a population of 684 CHWs. Data was collected by means of a self-administered questionnaire encompassing open and closed ended questions. Variables included personal and work-related oral health knowledge, practices and attitudes. Descriptive statistics included frequencies, means and standard deviations. Open-ended questions were themed and coded.
Results: The response rate was 100% (n=149). Respondents ages ranged from 23-73years (mean age 43.5; SD=11.1) and were mostly female (94%). The most common dental problems identified were tooth decay (64.3%) and gum problems (51.6%). 20.5% could identify risk factors to problems identified, 50.8% had incomplete knowledge, 15.9% did not know the causes of the problem and 12.9% did not respond to the question. Most respondents (56.3%-61.7%) were aware of a relationship between oral and systemic health and also specified that there was a biological (85.8%) and self-esteem effect (89.6%) of oral health, with fewer being aware of how oral health could affect health status (66.7%). Their practices indicated use of a toothbrush and toothpaste (100%), a toothpick (12.3%), dental floss (5.5%) and a mouthrinse (17.8%) and cleaning their teeth at least once a day (98%). A third visited a dental practitioner within the past two years. Dental visits were primarily for pain or trouble with their teeth or gums (43.9%). The inclusion of oral health into their work role was rated as important by more than 80% of respondents.
Conclusions: CHWs require oral health training to enable them to offer appropriate care to communities in this setting.