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Dental Public Health Activities: Descriptive Summaries

Infrastructure Development for Oral Health Promotion: Developing & Strengthening Local Manpower Improvement Programs

Practice Number: 58001
Submitted By: Ministry of Health, Republic of Marshall Islands
Submission Date: July 2005
Last Reviewed: July 2005
Last Updated: July 2005
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In the Republic of Marshall Islands (RMI), the Ministry of Health is the major authorized agency to provide health care services to the people of the Marshall Islands. There are 6 FTE dentists and three Marshallese dental nurses in RMI. Before 2001, there were no Dental Preventive Projects in RMI. In 2001, a prevalence study on Early Childhood Caries (ECC) among children in Majuro (the capital atoll with more than half the RMI population) found that 50% of children had cavitated lesions in their teeth by the age of 2 years and 92% by the age of 5 years. Additional surveillance data indicating 85 percent of six year old children had at least one decayed tooth, three times the U.S. national average. The Dental Caries Prevention Program of the Ministry of Health was developed in 2002 in response the high tooth decay rate in RMI. Due to a shortage of manpower and limited funding, preventive programs are being developed on a step-wise basis over time. The Prevention Program addresses both the need to focus nationwide efforts on prevention of early childhood caries and the shortage of trained personnel and funding that is a persistent barrier to implementation. In responding to the high need for dental manpower, Ministry of Health has provided the following training:

1. Established a 3.5 month dental assistant training program for high school graduates. This program was set up in the Ministry of Health's Preventive Services Dentist in consultation with the University of Washington and University of Hawaii. Ten high school graduates were selected and trained.

2. Set up an academic training course during the school break for the three Marshallese students seeking to become dentists or dental nurses and are enrolled at Fiji School of Medicine. This program was developed in consultation with the Fiji School of Medicine and the University of Washington, School of Dentistry.

3. In conjunction with the Head Start Summer Training on Majuro, provided training on oral health to approximately 200 Head Start personnel in RMI. A workshop was conducted for Head Start teachers to effectively clean children's teeth using fluoride tooth paste, apply fluoride varnish, and educate families on good oral health practices.

4. As part of the on-going Health Assistant Training Program in Majuro, provided oral health training for health assistants in training for posts in the outer islands. Sixteen local high school graduates, enrolled in an 18-month Health Assistant Training Program at the Ministry of Health in Majuro (April 1, 2003 to September 30, 2004), received didactic instruction on Dentistry and Dental Preventive Procedures by the Ministry of Health's Preventive Services Dentist. The students were also trained clinically in the dental clinic and in the field on chairside assisting and dental preventive procedures.

These training programs were designed to develop local manpower to implement nationwide oral health promotion priorities that target pregnant women and children starting at age one. Dr. Ohnmar Tut, the Preventive Services Dentist of the Ministry of Health, along with consultants from the Hawaii Department of Health and the University of Washington, provided the training. The training programs have also been shared with other Pacific Islands at the Pacific Islands Health Officers Association meetings, with the Board of Directors for the Pacific Islands Primary Care Association, and with Pacific Basin Dental and Medical Associations. As a result of the trainings initiated in the Marshall Islands:

  • Marshall Islands was requested to take the lead in training the Dental Chiefs and the Dental Preventive Coordinators from Guam, Palau and Federated State of Micronesia (FSM) for the Pacific Islands Early Childhood Caries Prevention Project (ACF Grant HS Bureau). This project will be targeting the Head Start and Kindergarten children, and their younger siblings and motivating the families through home visits and providing tooth brushes, fluoride tooth paste by local dental preventive coordinators.
  • Northern Mariana Islands (CNMI) identified Dr. Ohnmar Tut as the Regional Expert and requested WHO to recruit Dr. Tut as the WHO Oral Health Consultant to provide dental preventive training for the NMI dental staff. Dr. Tut is currently providing a training program in Saipan, CNMI as the WHO short-term Oral health Consultant. This training will be focusing on dental preventive services and planning oral health integration into MCH, Head Start and School Sealant Programs and working in collaboration with the programs already established.
  • Yap, one of the FSM States, requested the Ministry of RMI to assign their new graduate dentist to the RMI Dental Department for 3 months and be trained for preventive program planning and implementation in the islands.
The benefit from this initiative for human resources development in the region is an enormous achievement for the Pacific Islands. The trainings have been fully supported by the Ministries and enabled sharing a local expertise that is knowledgeable on the needs in the Pacific region, is sensitive and adaptable to the local cultures, and is well accepted by other Pacific Islands.

Contact Person(s) for Inquiries:

Dr. Ohnmar Tut, Ministry of Health, Republic of Marshall Islands, P.O. Box 16, Majuro, Marshall Islands, MH 96960, Phone: 011-692-625-3355 Ext 2101 or 2102, Fax: 011-692-625-4372, Email: ddsmohe@ntamar.net
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