Impact of an education training package to Anganwadi workers for improving oral health knowledge among mother-child dyads in Kerala, India.

Anganwadi workers (AWW) are community-based health workers, under the Integrated Child Development Scheme (ICDS) of the Government of India, trained to provide services at the grassroots level. Anganwadi workers are primarily women, and they are selected from the local community. In India, Anganwadi workers, predominantly local women serving as community-based health workers, play a crucial role in delivering maternal and child healthcare services. Oral health promotion has been shown to be effective when implemented early in life. The National Oral Health Program is being piloted in many states in India, and the use of grassroot workers for oral health promotion has been envisaged. While this approach seems very promising, a comprehensive assessment of the project in terms of implementation, logistics, and outcomes is lacking. In a country as diverse as India, understanding and adapting to local contexts are important. To address this gap, a project aims to empower Anganwadi workers with comprehensive oral health training, with a specific focus on maternal and child oral health due to its significance in early childhood development. An implementation research project is planned to implement an oral health care program through Anganwadi workers, targeting pregnant women, young mothers, and children attending Anganwadi centers. Utilizing a training manual developed as part of the National Oral Health Program (NOHP), 100 Anganwadi workers will deliver oral health education to the beneficiaries (mothers and children). Training sessions for Anganwadi workers will be conducted by dentists affiliated with the district health services (DHS). The study aims to assess the coverage, acceptability, adoption, and fidelity of the oral health training program. Additionally, it will evaluate the improvement in knowledge regarding oral health among the beneficiaries. Employing a mixed-method approach, the evaluation will encompass surveys, in-depth interviews, and focus group discussions. The project is led by Amrita School of Dentistry and conducted through Amrita Urban Health Centre in Kerala, India, benefiting approximately 6,000 children and their mothers directly and around 20,000 family members indirectly.