Figure 1
The Oral Health‑Care Continuum, adapted and modified with permission from Hackley et al. [12] Original text and illustration copyright FDI World Dental Federation 2015. Maps, graphics, and original concept copyright Myriad Editions 2015 [13]. The focus of this project and the development of the mOral Health training for Community Health Workers are circled.
Figure 2
WHO AFRO Competency‑Based mOral Health Curriculum Project Logic Model. DT: designated trainer; CHW: community health worker; OH: oral health; NCDs: noncommunicable diseases; WHO: World Health Organization; AFRO: Regional Office for Africa.
Table 1
mOral Health curriculum by module, including module description, themes, supporting competencies (see also Appendices 1 and 2), learning objectives, and options for integration into existing trainings for community health workers.
| WHO REGIONAL OFFICE FOR AFRICA MORAL HEALTH TRAINING FOR COMMUNITY HEALTH WORKERS | |||
|---|---|---|---|
| Module Content: PowerPoint presentation, corresponding narrated videos, video transcripts, formative assessment (multiple‑choice quiz), references; available in English, French, and Portuguese | |||
| Module | Competencies | Learning Objectives | Integration Options |
|
Module 1: Introduction to oral health Overview of oral health’s relationship and importance to overall health and well‑being across the lifespan Basic oral health foundations (anatomy and physiology) |
UHC: 1, 3–6, 10, 18, 19, 21–24 GOH: 1.1.4.,1.2.3., 2.1.2., 3.1.1., 3.2.1. |
LO 1.1 Explain, using examples, the relationship between oral health and overall health and well‑being across the life course LO 1.2 Describe healthy individual behaviors and community factors that promote overall and oral health LO 1.3 Recognize the healthy condition of infant, child, adolescent, and adult teeth and soft tissues |
LO 1.1 Within existing training modules on healthy human anatomy and physiology LO 1.2 Within existing training on the social determinants of health LO 1.3 Within existing training modules on healthy human anatomy and physiology |
|
Module 2: Introduction to oral diseases and conditions Overview of the relationship between oral diseases and conditions and other common noncommunicable diseases Common oral illnesses and conditions (caries, gingivitis, periodontal disease, oral cancers) |
UHC: 1, 3–6, 10, 18, 19, 21–24 GOH: 1.1.2., 1.1.3., 1.2.1., 1.2.2. |
LO 2.1 Explain common risk factors for oral and systemic illness/NCDs such as tobacco, alcohol, and sugar LO 2.2 Outline basic disease processes of dental caries, gingivitis, periodontal disease, and oral cancers LO 2.3 Screen for and recognize signs and symptoms of common oral diseases, including dental caries, gingivitis, periodontal disease, oral cancers, noma, and infant oral mutilation (and/or other locally relevant harmful oral health practices) |
LO 2.1 Within NCD training; within maternal and child health training LO 2.2 Within existing training on disease processes; within training on the health of children, adolescents, and older adults/geriatrics LO 2.3 Within existing training on the physical exam and disease screening; within training on the health of children, adolescents, and older adults/geriatrics, and training on neglected tropical diseases (noma); within maternal and child health |
|
Module 3: Techniques in oral health promotion and oral disease Home hygiene practices Social determinants of (oral) health Diet and nutrition Tobacco and alcohol use and cessation (general) |
UHC: 1–24 GOH: 2.1.2., 2.1.3., 2.1.6., 3.1.2., 3.2.1., 3.3.3., 3.2.3., 3.3.1. |
LO 3.1 Demonstrate proper oral hygiene techniques, including plaque removal and use of fluoridated toothpaste LO 3.2 Provide nutritional advice (meals, snacks, and drinks) and discuss the availability of foods and beverages in the community LO 3.3 Discuss tobacco (or similar) and alcohol use and guide individuals to resources that can support them in reducing use/quitting |
LO 3.1 Within primary care training, for example, vaccinations and other preventive services; within training on personal hygiene LO 3.2 Within patient care and primary care training, training on nutrition, and maternal and child health in primary care settings and household settings LO 3.3 Within primary care training, and training on tobacco and alcohol use |
|
Module 4: School and community‑based oral health promotion School setting oral health campaigns Oral health literacy campaigns and advocacy in community settings Community campaigns to reduce the availability or use of harmful products such as tobacco and alcohol |
UHC: 1, 3–7, 9, 10, 12–16, 18, 19, 21–24 GOH: 2.1.3., 2.1.6., 3.1.2., 3.2.1., 3.2.2., 3.2.3., 3.3.1. |
LO 4.1 Communicate essential oral health messages for school‑aged children in group/classroom settings (e.g. diet, tooth brushing instruction, and oral health education) LO 4.2 Support school personnel in developing oral health advocacy messages in the school setting LO 4.3 Collaborate with local leaders on oral health awareness and literacy campaigns in the community setting (e.g., identify and approach local leadership, develop print media, and hold community events) |
LO 4.1 Within training on school‑based programs LO 4.2 Within training focused on school‑based settings, and trainings on advocacy and health campaigns LO 4.3 Within training focused on community‑based settings and health promotion, and trainings on advocacy and health campaigns |
|
Module 5: Oral health monitoring and data collection at the community level Monitoring and evaluation process by way of data collection and surveillance, and referral processes in the health‑care system CHW’s role within the larger health system |
UHC: 1, 3–7, 10, 13–24 GOH: 2.1.1., 2.1.5., 2.2.1., 3.3.2. |
LO 5.1 State reasons for collecting and reporting community‑level oral health data to the national health system LO 5.2 Perform community oral health data collection for monitoring and surveillance LO 5.3 Outline the country’s oral health system LO 5.4 Demonstrate necessary steps in making a patient referral for further care into the next tier of the system (e.g., community health centers) |
LO 5.1 Within training on community‑level/school‑based data collection and data management/community monitoring training LO 5.2 Within training on community‑level/school‑based data collection and data management/community monitoring training LO 5.3 Within training on referring patients into the primary care system and on data management for health systems LO 5.4 Within training on referring patients into the primary care system |
|
Designated Trainer Module and Guide Building community health workers’ capacity in oral health promotion, and oral disease prevention and control Lesson planning, course delivery, and assessments in a local context and supportive environment |
This designated trainer guide consists of five parts: Part 1 discusses their role as the designated trainer. Part 2 describes the course syllabus and provides information about course topics, learning objectives, and potential places for embedding into existing community health workers’ training. Part 3 describes how to assess the competence of their trainees. Part 4 gives advice on course planning and delivery, including creating an enabling environment for delivering this course. Part 5 offers support for monitoring and evaluation in collaboration with chief dental officers or other oral health and health officials. The Summative Assessment Guide, Patient Cases, and Grading Rubrics are included in this module. | ||
Figure 3
Six‑step approach, outcomes, and timeline for curriculum development for the mOral Health Training Program for Community Health Workers in the WHO African Region. CHWs: community health workers; WHO: World Health Organization.