Willingness, self-efficacy, barriers, and facilitators to the provision of peer training on oral health education for nurses and community health workers in Nigeria

Abstract

Abstract Introduction In March 2024, Project OHE-NCHeW delivered oral health education training to 60 Primary health care workers across Lagos, Oyo, and Kano States in Nigeria. This follow-up study, conducted 6–8 months post-training, assessed participants’ willingness and self-efficacy to transfer knowledge and skills through peer-led trainings. Methods A cross-sectional survey was administered using a structured questionnaire. Cochran’s Q test assessed regional differences in barriers, facilitators, organizational factors, and post-training challenges, with Bonferroni-adjusted p values ( α = 0.01) and Cramer’s V for effect sizes. Binary logistic regression was used to examine the associations between region and key training outcomes, reporting odds ratios (ORs), 95% confidence intervals (CIs). Results Participants reported high perceived self-efficacy in oral health promotion: 93.3% (56/60) were “very confident” in training others and 95.0% (57/60) in promoting oral health. Facilitators included access to training materials (100.0%), and supportive work environments (86.7%). The barriers included a lack of resources (48.3%), and insufficient ongoing training (51.7%). Logistic regression indicated that participants in Lagos had significantly higher odds of reporting access to training resources (OR = 8.50, 95% CI: 3.27–24.70, p < 0.001, Cohen’s d = 1.43), time allocated for training (OR = 7.00, 95% CI: 1.71–28.67, p = 0.006, d = 0.77), and a supportive work environment (OR = 5.83, 95% CI: 1.56–21.82, p = 0.008, d = 0.72) compared with Kano, whereas the participants from Oyo had intermediate odds for these facilitators. Conclusion PHCWs demonstrated strong self-efficacy and readiness for peer-led oral health initiatives. Long-term sustainability requires institutional support, including leadership engagement, structured integration into routine systems, and mechanisms for ongoing training and supervision, particularly in resource-limited regions.