‘Fit for school’ – a school-based water, sanitation and hygiene programme to improve child health: Results from a longitudinal study in Cambodia, Indonesia and Lao PDR

BMC Public Health

Research Article

Habib Benzian¹  Martin Hobdell²  Panith Soukhanouvong³  Roswitha Heinrich-Weltzien⁴  Yung Kunthearith⁵  Denise Duijster⁶  Bella Monse⁷  Maria Carmela Mijares-Majini⁷  Jed Dimaisip-Nabuab⁷  Nicole Siegmund⁷  Katrin Kromeyer-Hauschild⁸  Pantjawidi Djuharnoko⁹ 

[1] Department of Epidemiology and Health Promotion, College of Dentistry, New York University, 433 First Avenue, 10010, New York, NY, USA;Department of Epidemiology and Public Health, University College London, Torrington Place 1-19, WC1E 6BT, London, UK;Department of Preschool and Primary Education, Ministry of Education and Sports, P.O. Box 067, Ministry of Education Building No 1, Lane Xang Ave, Vientiane Capital, Laos;Department of Preventive Dentistry and Pediatric Dentistry, University Hospital Jena, Friedrich Schiller University Jena, Bachstraße 18, 07743, Jena, Germany;Department of School Health of the Ministry of Education, Youth and Sport of the Kingdom of Cambodia, Street 380, Chao Ponheahok Primary School, BKK1, Khann Chamkarmorn, Phnom Penh, Cambodia;Department of Social Dentistry, Academic Centre for Dentistry Amsterdam, Gustav Mahlerlaan 3004, 1081LA, Amsterdam, The Netherlands;Department of Epidemiology and Public Health, University College London, Torrington Place 1-19, WC1E 6BT, London, UK;Gesellschaft für Internationale Zusammenarbeit (GIZ), L.P. Leviste cor Rufino Street, Makati City, Metro Manila, Philippines;Institute of Human Genetics, University Hospital Jena, Friedrich Schiller University Jena, Kollegiengasse 10, 07740, Jena, Germany;Social Basic Services Bureau of West Java, Governor’s Office, Jl. Diponegoro No. 22, Citarum, Bandung Wetan, 40115, Bandung, West Java, Indonesia;

关键词: School health;    Water sanitation and hygiene;    Handwashing;    Toothbrushing;    Deworming;    Dental caries;    Underweight;    Soil-transmitted helminth infection;   

DOI  :  10.1186/s12889-017-4203-1

 received in 2016-12-13, accepted in 2017-03-25,  发布年份 2017

来源: Springer

【 摘 要 】

BackgroundThe Fit for School (FIT) programme integrates school health and Water, Sanitation and Hygiene interventions, which are implemented by the Ministries of Education in four Southeast Asian countries. This paper describes the findings of a Health Outcome Study, which aimed to assess the two-year effect of the FIT programme on the parasitological, weight, and oral health status of children attending schools implementing the programme in Cambodia, Indonesia and Lao PDR.MethodsThe study was a non-randomized clustered controlled trial with a follow-up period of two years. The intervention group consisted of children attending public elementary schools implementing the FIT programme, including daily group handwashing with soap and toothbrushing with fluoride toothpaste, biannual school-based deworming; as well as construction of group handwashing facilities. Control schools implemented the regular government health education curriculum and biannual deworming. Per school, a random selection of six to seven-year-old grade-one students was drawn. Data on parasitological infections, anthropometric measurements, dental caries, odontogenic infections and sociodemographic characteristics were collected at baseline and at follow-up (24 months later). Data were analysed using the χ2-test, Mann Whitney U-test and multilevel logistic and linear regression.ResultsA total of 1847 children (mean age = 6.7 years, range 6.0–8.0 years) participated in the baseline survey. Of these, 1499 children were available for follow-up examination – 478, 486 and 535 children in Cambodia, Indonesia and Lao PDR, respectively. In all three countries, children in intervention schools had a lower increment in the number of decayed, missing and filled permanent teeth between baseline and follow-up, in comparison to children in controls schools. The preventive fraction was 24% at average. The prevalence of soil-transmitted helminth infection (which was unexpectedly low at baseline), the prevalence of thinness and the prevalence of odontogenic infections did not significantly differ between baseline and follow-up, nor between intervention and control schools.ConclusionsThe study found that the FIT programme significantly contributed to the prevention of dental caries in children. This study describes the challenges, learnings and, moreover, the importance of conducting real-life implementation research to evaluate health programmes to transform school settings into healthy learning environments for children.The study is retrospectively registered with the German Clinical Trials Register, University of Freiburg (Trial registration number: DRKS00004485, date of registration: 26th of February, 2013).

【 授权许可】

CC BY   
© The Author(s). 2017