Participatory Action Research to Improve Oral Health of Kenyan Children

Objectives: Background: Caries is the most common childhood disease worldwide. In poor areas in Kenya, such as the remote Mamba village in Kwale County, access to dental care is poor and children often suffer from tooth decay. Toothache is a leading cause of school absenteeism. To raise oral health literacy the dental charity The Healthy Teeth Foundation (THTF) conducted Participatory Action Research (PAR) into oral health amongst children in Mamba village.

Objectives: To co-create a preventive oral health intervention with the community and to evaluate how PAR contributed to the empowerment of all stakeholders.
Methods: Methods: Together with the research team and local researchers we assessed the root causes for poor oral health by: participant observation, 15 semi-structured interviews amongst stakeholders, 9 house visits, 5 work visits, and 4 dietary anamneses amongst schoolchildren. In addition we organized 4 focus group discussions to validate and deepen the findings with stakeholders from the community.
Results: Results: Key stakeholders were schoolchildren, their parents, teachers, principal, local dentists, imam, elderly, herbalist and midwife. The main root causes of poor oral health were: poor oral health literacy, strong cultural beliefs surrounding oral health, poor daily care, poor access to water and sanitation, poor diet, poor access to dental care and therefore self-medication and poverty, with school absenteeism as the worst outcome. A supervised handwashing and toothbrushing program serving 1200 schoolchildren was implemented at Mamba primary school and the community made a play about dental care, they tackled the water issues in the village, and organized train-the-trainer workshops for community health workers about oral health.
Conclusions: Conclusion: PAR successfully improved the oral health of children in Mamba Village, Kwale. Throughout the project oral health literacy in the community was improved. In the long run this might reduce tooth decay and reduce school absenteeism.