Sri Lanka - School based public health programme in Jaffna

by J. Stjernswärd and S. Balakumar

Introduction

Following the end of internal civil disturbances in the Jaffna district, several developmental initiatives have been introduced to help the people in this area.
An oral healthcare project was initiated by the Jaffna Regional Health Service, Ministry of Health, and WHO, Jaffna, to provide sustainable, cost effective oral healthcare to children of Jaffna peninsula mainly through the schools. With funds from the Canadian Medical Dental Development Association (NGO) (http://www.cmdda.ca ), an Oral Health Education Programme was launched in nine Schools in this District.

Map from The World Factbook

Background
As part of preparation for this programme, School Dental Therapists (SDTs) were trained to perform Atraumatic Restorative Treatment (ART) for the children attending school dental clinics in Jaffna in December 2010. (see more)

All nine School Dental Therapists (SDTs), under the supervision of Dr Balakumar (Regional Dental Surgeon) and Dr Sivarajah (WHO, Jaffna) participated in the programme below.

Programme Outline

Initially in May 2011, an “Introduction Programme” was organised in the Regional Health Service office in Jaffna for all the participating school Principals, teachers, Education Ministry staff and the Programme staff which included Drs Balakumar, Sivarajah and Ketheeswaran (Regional Director, Health Services) and the nine SDTs.

The purpose of this meeting was to introduce the proposed programme and have a discussion involving all the participating schools and organizations.


Meeting the school teachers and schoolchildren

A total of nine schools were identified. These schools were picked because the SDTs had their clinics in the premises of these schools. (base schools). ´
The primary school children in these base schools were the study group. The children who visited the SDT clinics from the other schools in the area were known as the Feeder School children and were designated as the control group. (see Table 1 below).

Table 1. School Dental Therapist, Base and Feeder Schools and the number of students invoved in the programme

Name of the school Dental Therapist

 

Base (B) / Feeder (F) school

 

No of students Principal's name
Mrs. Shobana Thayaparan

B: J/Dreiberg College, Chavakachcheri

F: J/Ladies College, Dhavakachcheri

65 

(2 Div)

60
(2 Div)

 

Mr K. Arunthvapalan
Mrs. S. Sivanathan

 

Mrs. Nanthini Uthayakumar

B: J/Udupiddi Girls College

F: J/Udupiddi A.M College

 

60
(2 Div)

70
(2 Div)

Mrs. T. Joseph
Mrs. S. Tharmalingam

Mrs. Nalinasany Rajadurai 

 

B: J/Sothi Vembadi M. V, Manipay

F:J/Vivekanantha M.V, Manipay

40
(1 Div)

40
(1 Div)

 

 Mrs. Sivakuman

Mrs. Gowry Paraparan

B: J/CCTMS, Kondavil

F:J/Kondavil Hindu M.V

 


40
(1 Div)

60
(2 Div)

 Mr. Shanmugakumar

 

Mrs. Pushpavathi Kanagaratnam

B:J/RamanathanCollege, Maruthanarmadam

F: J/Inuvil Central College

 

60
(2 Div)

60
(2 Div)

Mrs. A. Sivagnanasudaram

Mrs. Nagarani Sothiroopan

B: J/Central College, Jaffna

F: J/Holy Family Convent, Jaffna

140
(4 Div)

140
(4 Div)

Mr.Ongaramoorthi

Mrs. Anesta Gnanachandran

B: J/Arunothaya College, Alaveddy

F: J/Alaveddy RC School

60
(2 Div)

25
(1 Div)

Mr.Ketheeswaran
Mrs. S. Elilarasi

 

B: J/ Saraswathy Vidyalayam
Velanai

F: J/Velanai Iyanar Vidyalayam

30
(1 Div)

40
(1 Div)

Mrs.Nanthini Panchalingam
Mrs.P.Rajanayagam
Mrs. Mansuladevi Pansalingam

B: J/Vaddu Hindu College

F: J/Sithankerni Sri Ganesha Vidyalayam

30
(1 Div)

35
(1 Div)

Mr.S.Sivashanmugasundaram
MrsJ.Jeyarani
Total

B=9; F=9

 

1 055

 

Base (B) = study group

Feeder (F) school = control group  

The base schoolchildren would receive oral health education and will brush their teeth under supervision at school five days a week.


Training and supervising tooth brushing

The control group children from feeder schools would receive routine examination, oral health education and treatment if indicated but will not be receiving supervised tooth brushing at school.

Achievements

  • Dr Balakumar visited each base school and together with the SDT and teachers and introduced the programme to each class and initiated the programme in June - Sep 2011 in 9 schools.
  • All together an astimated total of 525 children participated in this programme, with about 500 children from the feeder schools were used as controls.
  • Dr Balakumar also visits each school every month to discuss problems and to motivate the childre, teachers and SDTs.
  • An evaluation of the Programme will be conducted in the end of 2012.
  • It was decided to extend the supervised toothbrushing programme to ALL primary schools in Jaffna district from January 2013.

 

Conclusion
Introduction of the supervised tooth brushing programme in the primary schools in the Jaffna area has been a success story. Collaboration with the Ministries of Health and Education and the committed participation of the school staff and the SDTs are the main reason for the successful implementation of this programme. It is hoped that in the future other health related habits like washing hands in running water and healthy eating habits including healthy snacks could be incorporated in this programme.