Questions/Answers

Phuduhudu is a small settlement which is 124kms East of Maun, between Makgadikgadi and Nxai Pan National parks. This is a Sesarwa (Bushmen/San) community with its own unique culture and traditional believes. There is only one oral health facility in the Ngamiland District which is located in the District capital village Maun. The district has a total area of 129,930 kilometre squared (km2) and population of around 149,755: 72316 males and 77,439 females (2011 population census). The facility caters for all oral health patients in the region which results in high patient influx as per the Clinic report from January- November 2015 which had a total number of 10 716 patients. The vastness of the area deprives small isolated villages with low socio-economic status of specialised health services and other amenities including oral health due to limited accessibility and unfavourable terrain such as swamps, big rivers and sandy roads. Therefore there was a need for a strategy that could improve accessibility of health services, hence Project village. The aim of this strategy was to correct the problem of limited accessibility and help improve the overall oral health status of the communities in small, isolated villages

To enable accessibility of oral health services by small, remote and isolated villages in the Ngamiland District, that is: taking services to the community. Strengthening community partnership and stakeholders’ collaboration to increase awareness and sensitization on oral health issues. To review and refine oral health programmes: School Oral Health Programme; Early Childhood and Under Five Oral health care; and community oral health programme.

Phuduhudu is one of the remotest settlements, with limited facilities for health services. The vastness of the area deprives small isolated villages with low socio-economic status of specialised health services and other amenities including oral health due to limited accessibility and unfavourable terrain such as swamps, big rivers and sandy roads. Therefore there was a need for a strategy that could improve accessibility of health services, hence Project village. The aim of this strategy was to correct the problem of limited accessibility and help improve the overall oral health status of the communities in small, isolated villages

This initiative enabled accessibility of oral health services by small, remote and isolated villages in the Ngamiland District, that is: taking services to the community. Strengthening community partnership and stakeholders’ collaboration to increase awareness and sensitization on oral health issues. To review and refine oral health programs: School Oral Health Program; Early Childhood and Under Five Oral health care; and community oral health program. Reaching out to the Phuduhudu community village increased accessibility and raised awareness and coverage in oral health issues. Essential Health Service Package (EHSP) i.e. screening, health education and treatment were provided. 92% of community members were screened out of total population of 600, and disease burden was reduced by 45.7%. Community knowledge and awareness were raised

Oral health education; reduced disease burden; improved community oral health status; informed community; partnerships; stakeholder collaboration. The oral health project improved the integrity in the public service. The initiative was about taking services to the community at the right time where ever they are in the country to ensure that every citizen rightfully benefits from oral health services.

The initiative was made for everyone in the village as it was meant to reach every individual, the most vulnerable group such as the special needs, children under five and school going, expecting mothers and elderly were given first priority. Mothers are caregivers therefore they have an upper hand in imparting knowledge and skills in the young ones We also improved dignity of the disabled by providing them with wheelchairs for easy mobility.

The purpose of this project was to leave the Phuduhudu village ‘disease free’. Therefore Adopt-a-village strategy was initiated. The oral health team lived with the Phuduhudu villagers. It exposed them to learning the community’s distinct cultural beliefs and practices, and collaboration with traditional doctor increased villagers’ participation as he plays a key role in their wellbeing. By living with them developed a sense of trust as they opened up and came forth. The trust earned from the community members built a rapport; therefore the team used this to implement Door –To –Door Campaign. For continous health education at primary school, health corners were established and student marshals were identified to man them as well as revival of Village Health Committee to help disseminate education.

The innovation is original, it was the first to be executed, it was first implanted at one of the remotest settlements villages. Phuduhudu is a small settlement which is very far from infrastructure that could enable community to fully access public services The vastness of the area deprives small isolated villages with low socio-economic status of specialised health services and other amenities including oral health due to limited accessibility and unfavourable terrain such as swamps, big rivers and sandy roads. Therefore there was a need for a strategy that could improve accessibility of health services, hence Project village. The aim of this strategy was to correct the problem of limited accessibility and help improve the overall oral health status of the communities in small, isolated villages

The strategy was initiated by collecting village profile. This was done to have knowledge about the number of community beliefs, social structure and general cultural practices. Community assessment needs was gathered through interviews and questionnaires to gauge level of knowledge on oral health issues and to determine baseline information. The team consulted with the relevant stakeholders such as the Chief, Water Utilities Cooperation, Primary School and Local Health Post. The team was able to engage the water authorities as the village water was highly fluoridated. This was evident from high numbers of community members with fluorosis. Oral health Programmes were identified and coordinators assigned. This was made for easy management, implementation, monitoring and evaluation of the objectives. Through these programmes, baseline data was obtained from community members through screening. Initially the results revealed that only 7.7% of the total population turned up for screening, which was not enough. The team therefore engaged new strategies to lure more community members. A village leaders ‘workshop was held, which aimed at sensitising and raising awareness on oral health issues as they are the crowd pullers, including the traditional doctor, this brought trust to the villagers. Adopt a village strategy gave way for the community members to gain trust in the team as they were living with them in their homesteads. They opened up and felt comfortable around them which made it possible to conduct a Door to Door campaign.

Yes

The initiative is sustainable and transferable. It is sustained by making regular visits and monitoring to Phuduhudu village to ensure existence and functioning of the revived village committees and give support. From the year 2017 the initiative has be replicated to Samochima village in the Ngamiland West district of population of about 1200. Village profile have collected , informed decision made, community leaders workshops done, world oral health week commemoration was done door to door campaign through adopt a village strategy are used and ongoing with the help of employed youth so as to provide essential health package to all Samochima community members. The village committees have been revived and now operational and functional. A drummer group was introduced and help disseminate oral health education.

For the country to be economically stable, there is need to look at all aspects such education, health, food security, food sufficiency etc. Therefore this project has taught us that these can be addressed using one objective and different strategies. As much as the main focus of the team was to improve oral health to the community, it did not only focus on that only, but also looked at other factors such as social and economic development and empowerment. Every individual has the right to access all these regardless of the age, tribe,gender and physical differences

The initiative is sustainable and transferable. It is sustained by making regular visits and monitoring to Phuduhudu village to ensure existence and functioning of the revived village committees and give support. From the year 2017 the initiative has be replicated to Samochima village in the Ngamiland West district of population of about 1200. Village profile have collected , informed decision made, community leaders workshops done, world oral health week commemoration was done door to door campaign through adopt a village strategy are used and ongoing with the help of employed youth so as to provide essential health package to all Samochima community members. The village committees have been revived and now operational and functional.

Yes

The initiative has been formally evaluated. Monitoring visits have been done on several occasions to assess the impact of the project. Post project interviews have been conducted and the recordings have been filed for record keeping. A team of adjudicators from Director of Public Service Management evaluated the initiative to verify the project aims goals ,objectives, impacts, results and benefits ‘ Interviews had been conducted with the kgosi (village leader) and other community member from different committees, Testimonies have been recorded and filed for future referencing, editing, review or baseline data for new development or setting new goals.

The oral health project improved the integrity in the public service. The initiative was about taking services to the community at the right time where ever they are in the country to ensure that every citizen rightfully benefits from oral health services. The initiatives helped to achieve oral health education; reduced disease burden; improved community oral health status; informed community; partnerships; stakeholder collaboration

Initially the results revealed that only 7.7% of the total population turned up for screening, which was not enough. The team therefore engaged new strategies to lure more community members. Reaching out to the Phuduhudu community village increased accessibility and raised awareness and coverage in oral health issues. Essential Health Service Package (EHSP) i.e. screening, health education and treatment were provided. 92% of community members were screened out of total population of 600, and disease burden was reduced by 45.7%. Community knowledge and awareness were raised

The Letsholathebe II Memorial Hospital oral health staff members are the implementers of this project. The project was managed and achieved through the collaboration and support of various stakeholders. The stakeholder collaboration played a key role in both the design and implementation of the initiative. Stakeholders consisted of the following: Community leaders; Chief, chief advisors; Village elders; Tribal office; Water Utilities Cooperation; Primary Schools; Health Post; Traditional doctor; Village Development Committee; Village Health Committee ; Parents and Teachers’ Association Community Trust; Community Home Based Care; Door to door campaign enabled the team to reach masses of the community members and even went beyond to go behind closed doors where it discovered the silent but needy. This also came as the opportunity to spend time with villagers to exchange and learn new things and their perspective of life especially the master of all the traditional doctor and exchange of culture and traditions. Oral health Student marshall- this is basically imparting knowledge to a selected pupil so that they as well teach their fellow pupils. This helps disseminated oral health education in their language.

Cultural myths and beliefs on OH issues-The team realised that the traditional doctor was also the dentist of the village. He was giving advices on oral health issues, but the challenge is that most of them were not evidence based and therefore not proven, therefore we collaborated with him and gave intense education. This helped as more community members were able to listen because they look up to him for advices and wellbeing. For the country to be economically stable, there is need to look at all aspects such education, health, food security, food sufficiency etc. Therefore this project has taught us that these can be addressed using one objective and different strategies.As much as the main focus of the team was to improve oral health to the community, it did not only focus on that only, but also looked at other factors such as social and economic development and empowerment. Every individual has the right to access all these regardless of the age, tribe,gender and physical differences.