‘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

Abstract Background The 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...

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Main Authors: Denise Duijster, Bella Monse, Jed Dimaisip-Nabuab, Pantjawidi Djuharnoko, Roswitha Heinrich-Weltzien, Martin Hobdell, Katrin Kromeyer-Hauschild, Yung Kunthearith, Maria Carmela Mijares-Majini, Nicole Siegmund, Panith Soukhanouvong, Habib Benzian
Format: Article
Language:English
Published: BMC 2017-04-01
Series:BMC Public Health
Subjects:
Online Access:http://link.springer.com/article/10.1186/s12889-017-4203-1
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language English
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sources DOAJ
author Denise Duijster
Bella Monse
Jed Dimaisip-Nabuab
Pantjawidi Djuharnoko
Roswitha Heinrich-Weltzien
Martin Hobdell
Katrin Kromeyer-Hauschild
Yung Kunthearith
Maria Carmela Mijares-Majini
Nicole Siegmund
Panith Soukhanouvong
Habib Benzian
spellingShingle Denise Duijster
Bella Monse
Jed Dimaisip-Nabuab
Pantjawidi Djuharnoko
Roswitha Heinrich-Weltzien
Martin Hobdell
Katrin Kromeyer-Hauschild
Yung Kunthearith
Maria Carmela Mijares-Majini
Nicole Siegmund
Panith Soukhanouvong
Habib Benzian
‘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
School health
Water sanitation and hygiene
Handwashing
Toothbrushing
Deworming
Dental caries
author_facet Denise Duijster
Bella Monse
Jed Dimaisip-Nabuab
Pantjawidi Djuharnoko
Roswitha Heinrich-Weltzien
Martin Hobdell
Katrin Kromeyer-Hauschild
Yung Kunthearith
Maria Carmela Mijares-Majini
Nicole Siegmund
Panith Soukhanouvong
Habib Benzian
author_sort Denise Duijster
title ‘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
title_short ‘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
title_full ‘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
title_fullStr ‘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
title_full_unstemmed ‘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
title_sort ‘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
publisher BMC
series BMC Public Health
issn 1471-2458
publishDate 2017-04-01
description Abstract Background The 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. Methods The 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. Results A 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. Conclusions The 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).
topic School health
Water sanitation and hygiene
Handwashing
Toothbrushing
Deworming
Dental caries
url http://link.springer.com/article/10.1186/s12889-017-4203-1
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spelling doaj-afe3d6f15a53425f9606fd34fde5b1592020-11-24T20:55:57ZengBMCBMC Public Health1471-24582017-04-0117111510.1186/s12889-017-4203-1‘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 PDRDenise Duijster0Bella Monse1Jed Dimaisip-Nabuab2Pantjawidi Djuharnoko3Roswitha Heinrich-Weltzien4Martin Hobdell5Katrin Kromeyer-Hauschild6Yung Kunthearith7Maria Carmela Mijares-Majini8Nicole Siegmund9Panith Soukhanouvong10Habib Benzian11Department of Social Dentistry, Academic Centre for Dentistry AmsterdamGesellschaft für Internationale Zusammenarbeit (GIZ)Gesellschaft für Internationale Zusammenarbeit (GIZ)Social Basic Services Bureau of West Java, Governor’s OfficeDepartment of Preventive Dentistry and Pediatric Dentistry, University Hospital Jena, Friedrich Schiller University JenaDepartment of Epidemiology and Public Health, University College LondonInstitute of Human Genetics, University Hospital Jena, Friedrich Schiller University JenaDepartment of School Health of the Ministry of Education, Youth and Sport of the Kingdom of CambodiaGesellschaft für Internationale Zusammenarbeit (GIZ)Gesellschaft für Internationale Zusammenarbeit (GIZ)Department of Preschool and Primary Education, Ministry of Education and SportsDepartment of Epidemiology and Health Promotion, College of Dentistry, New York UniversityAbstract Background The 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. Methods The 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. Results A 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. Conclusions The 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).http://link.springer.com/article/10.1186/s12889-017-4203-1School healthWater sanitation and hygieneHandwashingToothbrushingDewormingDental caries