Brighter Smiles Africa--translation of a Canadian community-based health-promoting school program to Uganda.
PROJECT GOAL: To adapt a successful Canadian health-promoting school initiative to a Ugandan context through international partnership.


BACKGROUND
Rural children face many health challenges worldwide; health professionals in training understand these better through community-based learning. Aboriginal leaders in a Canadian First-Nations community identified poor oral health as a child health issue with major long-term societal impact and intervened successfully with university partners through a school-based program called "Brighter Smiles". Makerere University, Kampala, Uganda (MUK) sought to implement this delivery model for both the benefit of communities and the dental students.
MUK identified rural communities where hospitals could provide dental students with community-based learning and recruited four local schools. A joint Ugandan and Canadian team of both trainees and faculty planned the program, obtained ethics consent and baseline data, initiated the Brighter Smiles intervention model (daily at-school tooth-brushing; in-class education), and recruited a cohort to receive additional bi-annual topical fluoride. Hurdles included: challenging international communication and planning due to inconsistent internet connections; discrepancies between Canadian and developing world concepts of research ethics and informed consent; complex dynamics for community engagement and steep learning curve for accurate data collection; an itinerant population at one school; and difficulties coordinating Canadian and Ugandan university schedules.
Four health-promoting schools were established; teachers, children, and families were engaged in the initiative; community-based learning was adopted for the university students; quarterly team education/evaluation/service delivery visits to schools were initiated; oral health improved, and new knowledge and practices were evident; an effective international partnership was formed providing global health education, research and health care delivery.
Macnab
A  J
A
University of British Columbia, Vancouver, British Columbia.
Radziminski
N
N
Budden
H
H
Kasangaki
A
A
Zavuga
R
R
Gagnon
F  A
F
Mbabali
M
M
D002170:Canada; D002648:Child; D002669:Child Welfare; D003695:Delivery of Health Care / Q000458:organization & administration; D003752:Dental Health Services / Q000458:organization & administration*; D003813:Dentistry; D006266:Health Education / Q000458:organization & administration*; D006293:Health Promotion; D006297:Health Services Accessibility; D006301:Health Services Needs and Demand; D006801:Humans; D007391:International Cooperation; D007858:Learning; D009909:Oral Health; D011203:Poverty; D016730:Program Development; D019035:Rural Health Services / Q000458:organization & administration; D012572:School Health Services / Q000458:organization & administration*; D012959:Socioeconomic Factors; D014454:Uganda