Fieldwork on dental care in Hargeisa, Somaliland

Abdelrahman is a master student in International Community Health at the University of Oslo. For his thesis on oral health, he combined WHO structured interviewer-administered questionnaire with clinical examinations for the first time in Somaliland and Somalia.

An important part is the opportunity to travel for fieldwork during your master¡¯s degree in International Community Health. This gave Abdelrahman the opportunity to support community-based health promotion and disease prevention research globally, and to gain the skills and knowledge required to conduct his own research.

¨C Prior to Abdelrahman¡¯s data collection for his master thesis, no comprehensive survey was conducted on the oral health status of Somali population, he explains. 
In order to assess the dental health status, he researched related risk factors of 12-year-old children, the impact on quality of life, and finally evaluated the level of intervention required.

Collaboration in the field

According to Abdelrahman, his three years of teaching experience at Amoud Dental College in Somaliland enabled him to establish relationships with local professional dentists who played a crucial role in assisting him with data collection. They were later divided into two teams. One for clinical examination and the other for interviewer-administered questionnaire.

The collaboration enabled the local research assistants to get the knowledge and experience required for conducting further oral health surveys in the years ahead, consistent with the guidelines of the global code of conduct for research in resource-poor settings. 

Challenges and how to overcome them

Abdelrahman experienced some methodological challenges during his fieldwork. He found that cooperation with public schools was much better than with private ones. Due to the refusal of four of the selected private schools to participate in the survey, Abdelrahman had to conduct an additional sampling using the non-public school list to replace them, he explains. Another challenge he had to deal with was the absence of birth date records. 

¨C The birth date records were unavailable in most of the selected schools and a significant number of students started primary school late, particularly in rural areas, he says. The team members visited all school classes up to grade six in each selected school to compile a comprehensive list of twelve-year-old students who met the inclusion criteria, from which participants were randomly selected for the study.

There was also the issue of lacking appropriate spaces within the schools. To handle this, they scheduled the data collection on different days, and they divided participants into small groups in order not to disrupt the discipline in the school. 

Recruitment of participants and data collection

To ensure an ethical and comprehensive study, he first needed approval from the Ministry of Health, the Ministry of Education and the administrators of the selected schools. 

¨C  The selected students got an informed translated consent letter, he explains.
The technical part, comprising sampling, conducting a pilot study, and data collection including interviewer questionnaire and clinical examination, worked well. 

¨C In addition, the logistics such as sterilization of diagnostic instruments and comfortable transportation for the team were properly arranged, Abdelrahman explains.
At the end of examination, Abdelrahman and his assistants informed participants about their oral health status, and gave instructions on how to maintain good oral hygiene. In addition, they contacted their parents in case an urgent or immediate dental intervention was required for their child.

Additional skills and competencies gained 

Research based fieldwork has given Abdelrahman valuable skills and competencies in overcoming unexpected challenges underway. According to Abdelrahman the fieldwork has given him experience with: 

1. Obtaining ethical approval from relevant authorities and institutions in addition to informed consent from participants.
2. Project management: including recruiting participants as well as recruiting research assistants and necessary logistics like equipment and transportation.
3. Data Collection: using various methods, such as surveys, interviews, clinical examinations, laboratory tests, or reviewing existing records and databases. 

To finish things off he lists his thoughts on why fieldwork abroad is such a valuable experience:

• You gain key skills in terms of teamwork, project planning and project management.
• It helps you make the method section of the thesis vivid and appealing.
• It defines the actual limitations and strengths of the research.
• It can provide novel and valuable data that can be published in a prestigious journal.
• And finally: It can help you secure the best grade for your master's degree.

During his project period, Abdelrahman was a part of an experienced research and supervision team.