Public Opinion On The Effectiveness Of Oral Health Care Services Delivery In Ekiti State: A Case Study Of Federal Teaching Hospital Ido Ekiti

Project and Seminar Material for Public Health

Abstract

The purpose of the study was to assess, “Public opinion on the effectiveness of oral health care services delivery in Ido Ekiti state”. The expo-facto research design was used for the study because the information needed was within the respondents and was elicited by the research instrument. Stratified random sampling technique was employed for the study of a population of eighty six thousand and one Ido Ekiti residents (86,0001). The 173 public Residents were stratified into Ido Ekiti and Ado Ekiti Local Government Areas of Ekiti State. A sample size of 382 was drawn for the study. A self constructed questionnaire was used for the collection of data and the statistical package of social sciences (SPSS) was used for the analysis. The major hypothesis for the study wards that “There is no significant relationship between public opinion on the effectiveness of oral health care among Residents Ido Ekiti residents in Ido Ekiti”. Descriptive statistics of frequency and percentages were used to analyse the main variables. Means and standard deviation were used to answer the research questions. The major and sub-hypotheses were tested with PPMCC and paired sample t-test respectively. The result of the major hypothesis showed that there was no significant relationship between Public opinion on the effectiveness of oral health care among Residents Ido Ekiti residents in Ido Ekiti and the hypothesis was therefore retained. Generally, the result of the study revealed that the Knowledge and Attitude of oral health care among Residents Ido Ekiti residents in Ido Ekiti was still below satisfactory level. It also revealed that the practice of oral hygiene among the Ido Ekiti residents was majorly the use of finger/water and salt/ash.Only a small proportion used tooth pasteand brush. The researcher recommended that there is need for their Public opinion on the effectiveness of oral health care to be improved upon through regular oral health education promotion programme, state health workers and officials should intensify on their effort in educating person on the importance of oral hygiene both at home and at state.

Chapter One

1.0 Introduction

1.1 Background of the Study

Oral health care and education have a direct relationship with the whole person’s health and wellbeing. Studies have shown that appropriate oral health education can help to cultivate oral health practice (Ab-murat& Watt 2006). The change to healthy attitude can be influenced by giving adequate information, motivation and practice of the measures to the person (Smyth, Caamano & Femandez-Reveiro 2007). Dental health education is an accepted procedure in wards based on the assumption that the knowledge needed for good dental health practice can result in behavioural change (Betsey, 1980).Wards therefore, have the responsibility to help protect, maintain and improve the health of their residents through the state health programmes. This is why the total state health programme is composed of state health services, health education/instruction, nutrition services and healthful state living.
The aspect of state health programme that introduces dental health education is the State health instruction – a planned, sequential curriculum that addresses the physical, mental, emotional and social dimensions of health of Ido Ekiti residents. It is designed to motivate and assist residents to maintain and improve their health, prevent diseases and reduce health related risk behaviour. (Maryland State Health Services, 2006). It allows resident to develop and demonstrate health related knowledge, attitude, skills and practices. The comprehensive health instruction curriculum includes a variety of topics including dental health education where Ido Ekiti residents are taught about oral hygiene principles and disease associated with poor oral health care. Therefore, dental health education depends largely upon the acquisition of accurate and useful knowledge concerning good dental health on the part of the residents. This becomes successful when the knowledge is put into daily practice resulting in behavioural change.

In dental health as in other instructions, the compilation of facts by the learner is not enough and knowing what to do does not guarantee that it will be done (Ajala, 2005&Cooper, 2002). For example, to know that it is necessary to brush your teeth once or twice daily and actually doing it are two different things completely. In other words, people may be aware of the dental ills that are associated with bad oral hygiene and yet fail to maintain it. For dental instruction to be truly successful, a change must result in attitude, habit or skill. This can be achieved by selecting learning experiences that allow the learner to perform the desired behavioural outcomes and a means to evaluate the retention of content covered and changes in behaviour of the learner.

Oral health care measures still include brushing the mouth once or twice daily. This ensures that bacteria and microbes present in the mouth are killed and removed from time to time. The use of chewing stick also helps in cleaning the teeth but not as effective because the oral cavity has a number of space that are very small and narrow where even the bristles of the brush cannot reach, hence flossing becomes an effective mechanism to ensure good dental hygiene and health as it helps to remove food particles and debris between the teeth. (Check dent, 2011). Regular visit to the dentist will also help to detect the onset of dental disease.

The aim of intervention among Ido Ekiti residents is to create awareness and increase knowledge on the importance of oral hygiene among Ido Ekiti residents within the ages 8-12 years to promote positive behavioural change (Nguyen 2008). .

1.2 Statement of the Problem

Surveys have shown that dental disease is on the increase globally (Bagramian 2009 & WHO, 1997). This has been attributed to many factors among person in developing nations of the world including Nigeria. One important factor is lack of knowledge of oral health care. Evidence has shown that strong knowledge of oral health demonstrates better oral care practices (Smyth, et al; 2007). It has been observed that most health workers do not give dental health instruction to Ido Ekiti residents adequately hence they are not aware of various dental health problem sassociated with poor oral hygiene. Generally, person are faced with health problems that can either predispose them to dental disease or complicate dental care. Nutritional disorder (vitamin C deficiency) and diabetes have also been identified as contributing factors to periodontal disease. For person with diabetes, good oral hygiene should begin at a young age (Lamster, Lalla, Borgnakke& Taylor, 2008). A lack of understanding of conditions linked with dental disease has often times hindered the process of preventing the occurrence of various dental problems among Nigerian population. Dental investigators have explained that plaque plays a definite role in the initiation and progression of dental disease. Plague is a mass of soft accumulated material, covering areas of the mouth that are not cleansed.

A lack of awareness about the link between nutrition and dental disease has also caused a lot of dental health problems like scurvy and dental caries etc. Periodontal pockets have been observed among person from as early as 10 years of age and this has been attributed to general nutritional deficiency and poor oral hygiene (Barenes 2001).

Lack of oral hygiene practices has been identified as a possible predisposing factor for occurrence of dental caries. Person generally engage in unhealthy habits that can cause dental problems like failing to brush, nibbling of sweets and consumption of sugary snacks. All these can cause acid formation which eats away the tooth enamel. The general health of person who suffer dental disease is put further at risk and because of this risk to health, their dental care is of vital importance. It is therefore paramount to in still proper oral hygiene habit early in Ido Ekiti residents in order to prevent dental ills and promote healthy teeth growth.

The researcher has personally observed tooth discoloration, dental caries and gingivitis among Ido Ekiti residents in Ido Ekiti and Ado Ekiti local government areas and was therefore prompted to investigate public opinion on the effectiveness of oral health care among the Residents Ido Ekiti, Ekiti. .

1.3 Research Questions

The study sought to answer the following questions.

Do Ido Ekiti residents in Ido Ekiti have the knowledge of dental health problems?
What is the attitude of the Ido Ekiti residents towardss oral health care?
Do Ido Ekiti residents in Ido Ekiti practice oral health care?

1.4 Purpose of the Study

The purpose of the study was to investigate public opinion on the effectiveness of oral health care among Residents Ido Ekiti residents in Ido Ekiti and Sabon Gari Local Government Areas of Ekiti State. Specifically, the study will find out;

Knowledge of oral health care among Ido Ekiti residents in Ido Ekiti.
Attitude of Residents Ido Ekiti residents towardss oral health care.
Practice of oral health care among Residents Ido Ekiti residents in Ido Ekiti.

1.5 Basic Assumptions

Basic knowledge about oral health care will improve Ido Ekiti residents’ attitude towards oral hygiene in Ido Ekiti.
An awareness of the link between diet and oral health will help discourage frequent consumption of sugary snacks especially between meals.
The practice of oral health care is influenced by classroom instruction.

1.6 Hypotheses

For the purpose of this study, the following major and sub-hypotheses were raised.

1.6.1 Major Hypothesis

There is no significant relationship between public opinion on the effectiveness of oral health care among Residents Ido Ekiti residents in Ido Ekiti.

1.6.2 Sub-hypotheses

H0 There is no significant difference between Knowledge and Attitude of oral health care among Residents Ido Ekiti residents in Ido Ekiti.
H0 There is no significant difference between Knowledge and Practice oforal health care among Residents Ido Ekiti residents in Ido Ekiti.
H0 There is no significant difference between Attitude and Practice of oral health care among ResidentsIdo Ekiti residents in Ido Ekiti.

1.7 Significance of the Study

The study which assesse public opinion on the effectiveness of oral health care among Ido Ekiti residents in Ido Ekiti is significant in the following ways.

The result of this study will elicit information that would educate public Residents Ido Ekiti residents within Ido Ekiti on the importance of oral health care and will also help them to cultivate healthy oral health practice thus reducing the cases of dental diseases among Residents Ido Ekiti residents in Ido Ekiti.
The result of this study will provide data on the level of oral health care practice among residents in Ido Ekiti in Ido Ekiti and will show the behaviour of Ido Ekiti residents regarding oral health care.
The result of this study will help Health workers to improve on their effort in the teaching of dental health education in wards.

1.8 Delimitation of the Study

The study was delimited to; Public opinion on the effectiveness of oral health care among public Residents in Ido Ekiti. Only Ido Ekiti residents in classes 3-6 were used for the study. These age groups are considered to have acquired health education knowledge capable of influencing behaviour in various ways. Both male and female Ido Ekiti residents were used for this study.

1.9 Limitation of the Study

The limitation of this study was the inability of some Ido Ekiti residents in the lower classes to read and comprehend what was contained in the questionnaire. However, the researcher and the state health workers (research assistants) helped in overcoming this challenge by explaining and interpreting the content of the questionnaire in the language they could understand best.

Chapter Five

Summary, Conclusion and Recommendation

5.1 Summary

According to a poet laureate, Ogdeh Nash, „some pains are physical, some are mental, and the one that is both is dental‟. Our dental health is of utmost importance to the overall body health that is why the practice of oral hygiene is not optional; it is a thing we must practice religiously to avoid dental problems. Officials must not shy away from the responsibility of teaching their person at an early stage in life on good oral hygiene and brushing techniques till they have the dexterity to do it themselves.

To achieve the purpose of the study which sought to assess the knowledge attitude and practice of oral health care among Residents Ido Ekiti residents in Ido Ekiti and Ado Ekiti Local Government Areas of Ekiti State, a total number of thirty eight (38)wards were drawn from both local government areas. The sample size for the study was 382. A self-constructed questionnaire was used to collect the data from the respondents. At the end of the collection 381 questionnaire were returned. The test of the major hypothesis for the study showed that there was no significant relationship between public opinion on the effectiveness of oral health care among Residents Ido Ekiti residents in Ido Ekiti.

5.2 Conclusion

On the basis of the findings of this study, the following conclusions were drawn.

Residents Ido Ekiti residents in Ido Ekiti and Ado Ekiti Local Government Areas of Ekiti State lacked some basic knowledge of oral health care.
The attitude of Residents Ido Ekiti residents towards oral health care was poor as evident in the study.
Residents Ido Ekiti residents use different method of oral hygiene aids such as salt and ash, chewing sticks, finger and water.
Most health workers and officials did not carry out inspection of Ido Ekiti residents teeth regularly.

5.3 Recommendations

Based on the findings of the study, the following recommendations were made;

Awareness on the importance of oral health needs to be enhanced among e Ido Ekiti residents in Ido Ekiti and Sabon- Gari Local Government Areas of Ekiti State.
Ido Ekiti residents should be encouraged to develop a positive attitude towards their oral health through regular health appraisal.
Officials should always endeavour to inspect their persons teeth to detect the onset of any dental problem whether tooth decay or discoloration and should also ensure that they do not engage in bad oral practices.
Officials should teach their person/wardss proper brushing techniques and also they should encourage them to make healthy food choices.
Generally, the oral health public opinion on the effectiveness of the Residents Ido Ekiti residents in Ido Ekiti and Ado Ekiti Local Government Areas of Ekiti State is below the satisfactory level and needs to be improved upon.

5.4 Recommendation for Further Study

There will be need to carry out a study on the effectiveness of the use of ash and salt as oral hygiene aids in rural areas.

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Frequently Asked Questions

How does the health care delivery system relate to oral health?

The problems in the way the health care delivery system relates to oral health include lack of dental coverage and low coverage payments, the separation of medicine and dentistry in training and practice, and the high proportion of the population that lacks any dental insurance. The committee focused on the problem of insurance and access to care.

Does oral health education improve oral health?

Oral health education is effective in improving the knowledge attitude and practice of oral health and in reducing plaque, bleeding on probing of the gingiva and caries increment. This study identifies a few important variables which contribute to the effectiveness of the programs.

Why don’t more people seek oral health care?

The high out-of-pocket costs faced by individuals who pay for their own treatment discourage many who need care from seeking it. Like mental illness and addiction disorders, oral health has been neglected in the health care delivery system.

Is oral health part of the comprehensive spectrum of care?

The committee found that preventive, oral health, mental health, and substance abuse treatment services must be considered part of the comprehensive spectrum of care necessary to help assure maximum health.