Page 45 - FINAL COMPENDIUM 2020-2021 27.2.2022

PROCESS AND IMPACT EVALUATIONS OF PRESCHOOL ORAL HEALTHCARE PROGRAMME
(POHP) IN SELANGOR

Nurdin MF
Introduction: The Ministry of Health (MOH), Malaysia introduced the Preschool Oral
Healthcare Programme (POHP) in 1984 to improve the oral health status of children aged
5 to 6 years who attend preschools. To date, there has been no evaluation conducted on
the POHP in terms of its process implementation and potential impacts on the oral health
parameters of preschool children. Objectives: (a) To evaluate the process implementation
of the POHP by (i) exploring the effectiveness, feasibility, and suggestions for
improvement of the POHP (ii) exploring the effectiveness, feasibility, and suggestions for
improvement of the oral health-related activities (OHRA) and oral health-related facilities
(OHRF) (b) To evaluate the impact of POHP by (i) comparing between preschools with
POHP and preschools without POHP in terms of oral health and related behaviours of
preschool children (OHRB), oral health literacy (OHL) of preschool teachers, OHRA at
preschool, and OHRF at preschool, and ii) evaluating factors associated with preschool
children’s OHRB, OHRA and OHRF at preschools. Materials and methods: In phase 1,
convenience samples of dental therapists (DT) from 9 districts in Selangor participated in
focus group discussion (FGD) and preschool teachers from 4 districts in Selangor
participated in an in-depth interview (IDI). The qualitative data were transcribed verbatim
and analysed using the framework method analysis. Phase 2 was a cross-sectional study
involving 1082 preschool children randomly selected from 2 districts in Selangor using
multistage cluster sampling method. A convenience sample of preschool teachers from
preschools with POHP and preschools without POHP self-completed a questionnaire
DHLAI. A parent self-administered questionnaire (proxy) was also completed. Data were
assessed using the SPSS version 23 software. Results: Overall 114 DTs were involved in 13
FGDs. In terms of POHP effectiveness, DTs felt the POHP was effective to improve OHK,
OHL, OHRA and OHRB of the children and teachers, Good dental workforce teamwork,
monitoring and support from dental administration, provision of financial aid, availability
of transportation, sufficient time to implement programme, cooperation form school
administration, cooperation from preschool teachers and preschool children, availability
of dental materials, and training in dealing with preschool children contribute to feasibility
of POHP. There is need to overcome barriers to implement the POHP such as lack of
manpower, lack of support from dental administration, uncooperative preschool
administration, availability of sugary food and drinks at school, lack of transportation and
driver, lack of time, uncooperative teachers, uncooperative children, lack of space for
OHRA, lack of dental materials, and uncooperative parents. Overcoming the barriers shall
improve the POHP as perceived by DTs. Response from 15 teachers interviewed indicate
that OHRA and OHRF were effective to instil positive attitudes among children and
teachers, improve OHK of children and teachers, and improve OHRB in children. Good
cooperation from school administration, provision of financial aid, availability of oral
health-related materials, cooperation from parents, oral health seminar for teachers,
helpful teacher’s assistants, good relationship with dental personnel, cooperation from
preschool children, and good time management facilitate OHRA and OHRF at preschools.
To improve OHRA and OHRF at preschools, the teachers suggested to provide them with

21