背景:儿童的口腔健康是一个重要的公共卫生问题,会严重影响营养摄入,成长和发展,日常学习活动,睡眠模式,自尊,和生活质量。在尼日利亚,在减少龋齿等口腔健康问题的患病率和负担方面取得了有限的进展,Noma,和口腔癌由于缺乏国家数据,预算拨款不足,人员匮乏,政策框架/执行不力,以及获得护理的挑战。拉各斯州有一个很大的,不同的人口,受到文盲和贫困的阻碍,以学校为基础的牙科筛查是一种策略,可以潜在地降低资源匮乏地区弱势群体的口腔疾病患病率。该文件提出了通过筛查拉各斯州相当比例的儿童进行二级预防,并将成为口腔健康规划的真正数据来源。
■为卫生部提出了一项政策文件草案,以立法要求进行低成本的全面口腔健康检查,以筛查在任何一个州政府拥有的小学或中学入学的每个儿童拉各斯州的学校。每个孩子都将获得一份口腔健康教育传单和一份重复的年度牙科筛查表,以及他将提供的所有其他要求,然后在学年开始时被批准恢复。然后,预计孩子的父母将在拉各斯的任何一家国有综合医院出示表格进行牙科检查。孩子们将得到迅速的关注,在被照顾之前不会被不必要地等待。然而,有任何形式的牙科疾病的学生将被要求在诊所打开牙科卡,并尽快完成他们的治疗。除了牙科治疗被发现非常昂贵,我们会坚决鼓励家长在学年开始前完成治疗,表格可以填写和签署。如果父母不能负担费用,学校当局将得到通知,卫生部将得到适当通知。一旦孩子被检查并发现没有牙齿疾病,表格可由主治牙科医生填写和签署,并加盖公章。副本将保留在牙科诊所的专用文件中,而主要表格将退还给学校。学校会将表格保存在专门的档案中,并在每个录取周期结束时,必须向教育部和卫生部提交关于每所学校儿童口腔健康状况的报告。提交的首选格式应为Excel电子表格,其中包含生物数据以及适用于每个儿童的牙科发现和治疗摘要。
结果:将进行短期和长期评估以评估覆盖率,确定的牙科疾病的数量,完成的治疗数量,父母和子女对服务的满意度,而服务的成本效益分析将使用定性和定量相结合的方法来确定。这些分析的结果将用于证明政府对该计划的进一步资源承诺。
结论:发展中国家减轻疾病负担的战略必须侧重于政策设计/实施和预防性干预。这项拟议的政策可以帮助减少或消除准入障碍。它还可以增加接受预防性和治疗性口腔护理的儿童数量,并提高他们的口腔健康知识。
BACKGROUND: The oral health of children is a significant public health issue that considerably affects nutritional intake, growth and development, daily learning activities, sleep pattern, self-esteem, and quality of life. In Nigeria, limited progress has been made in reducing the prevalence and burden of oral health problems such as dental caries, Noma, and oral cancer due to absence of national data, inadequate budgetary allocation, dearth of personnel, poor policy framework/implementation, and challenges of care access. Lagos state has a large, diverse population, hampered by illiteracy and poverty, and school-based dental screening is a strategy that can potentially reduce the prevalence of oral diseases among a vulnerable population in resource-poor settings. This document proposes secondary prevention through screening for a significant proportion of children in Lagos State and will be a veritable source of Data for oral Health planning.
UNASSIGNED: A draft policy document is proposed for the Ministry of health for legislation mandating a low-cost comprehensive oral health examination to screen every child admitted into Primary or Secondary School in any of the State Government-owned Schools in Lagos State. Each child will receive an oral health education leaflet and a duplicated annual dental screening form in addition to all the other requirements he will provide before being cleared for resumption when the academic year commences. The parents of the child will then be expected to present the form at any of the Lagos State-owned General hospitals for dental screening. The children will receive expedited attention and will not be kept waiting unnecessarily before being attended to. Students who have any form of dental disease will however be required to open a dental card at the clinic and have their treatments done as soon as possible. Except the dental treatment is found to be very expensive, the parents would be firmly encouraged to have the treatment done before the academic year commences and the form can be filled and signed. The school authorities would be notified if the parents cannot bear the cost and the ministry of health would be duly informed. Once the child is examined and found to be free of dental disease, the form can be filled and signed by the attending dental practitioner and duly stamped. A duplicate would be retained in a dedicated file in the dental clinic while the main form will be returned to the school. The schools will keep the forms in a dedicated file and at the end of each admission cycle, a report on the oral health status of the children for each school must be submitted to the Ministries of Education and Health. The preferred format for submission should be an excel spreadsheet containing the biodata and the summary of dental findings and treatment provided as applicable for each child.
RESULTS: Short and long term evaluation will be done to assess coverage rate, the number of dental diseases identified, number of treatments done, the satisfaction of parents and children with the services while the cost-benefit analysis of the services will be determined using a combination of qualitative and quantitative methods. The results of these analyses will be utilized to justify further government commitment of resources to this program.
CONCLUSIONS: Strategies to reduce the burden of disease in developing countries must focus on policy design/implementation and preventive interventions. This proposed policy can help to decrease or eliminate barriers to access. It can also increase the number of children who will receive both preventive and curative oral care and also improve their knowledge of oral health.