national health mission mobile dental clinic project
TRANSCRIPT
1
NATIONAL HEALTH MISSION
MOBILE DENTAL CLINIC PROJECT
MONTHLY REPORT- JULY 2019
Maulana Azad Institute of Dental Sciences MAMC Complex, BSZ Marg, Delhi-‐110002
Email: [email protected]
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CONTENTS
1. PROGRAM INTRODUCTION 3
2. PROGRAM MPLEMENTATION 4-6
a. Mobile Dental Clinic Monthly Schedule
3. PROGRAM SERVICES & OUTCOMES 7- 24
a) Section I: OPD at Delhi Govt. Dispensaries
b) Section II: School Dental Health Program (NEEV)
c) Section III: ASHA Training Program
d) Section IV: Project AMMA: Geriatric Oral Health Program
e) Section V: Weekly Training of Mobile Dental Clinic Staff
f) Program Summary
g) Overall Patient Census
h) New Horizons
4. APPENDIX 25-26
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PROGRAM INTRODUCTION
The Mobile Dental Clinic Project is one of the landmark oral health care project rendering
preventive, promotive and curative services to the underserved thereby overcoming the
Accessibility, Affordability and Cultural Barriers by Maulana Azad Institute of Dental
Sciences under the umbrella of NHM/DSHM operational since May 2014.
More than 3000 people every month are benefitted by the program in different parts of
Delhi. The program has worked its way to integrate Dental health education with its treatment
services thereby fulfilling the primary purpose of creating awareness and promoting oral health.
Further, the program has attempted to integrate oral health into general health provide
comprehensive care to the masses especially target groups like children and geriatrics.
The Mobile Dental Clinic Project at MAIDS is operational in North East and North West
District of Delhi. All the six Mobile Dental Clinics cater to 9 Delhi Government Dispensaries
on rotational basis depending on their division of clusters:
• Cluster I [NORTH EAST]: Yamuna Vihar, Kanti Nagar, and Seelampur
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• Cluster II [East] Vasundhara Enclave, Mayur Vihar, Asha Kiran-Home for Mentally
Challenged Children, Rohini
• Cluster III [NORTH]: Timarpur
• Mobile Clinics are stationed for five days a week in each of the identified dispensaries on
rotational basis from 9:30 A.M. to 1:30 P.M
• Every 1st and 3rd Wednesday of the month Mobile Dental Clinic (MDC’s) will render are
to render care to the Asha Kiran- Home for Mentally Challenged
• Every Wednesday of the week is reserved for School Dental Health Programme for rendering
Dental Screening, Health Education Programs and Referral Services to the schools under
School Health Scheme, GNCT of Delhi by Information, Education and Communication
Mobile Vans (IEC Vans). Currently, two schools under school health scheme have already
been selected and the screening,treatment and health educational services are being
provided.
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PROGRAM IMPLEMENTATION
(MONTHLY SCHEDULE OF MOBILE DENTAL VANS)
AUGUST 2019
Kindly Note*:
- Every Wednesday is scheduled for Mobile Dental Clinics to render care to school children under School Health Scheme, GNCT Delhi.
- In case of breakdown of Mobile Vans, the respective DGD-CMO/MO will be given prior information.
- Every 1st and 3th Wednesday of the month Mobile Dental Clinic (MDC – 1 & 2) respectively will render care to Asha Kiran-Home for Mentally Disabled
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PROGRAM SERVICES & OUTCOMES (As on 25.07.2019)
SECTION-I (VISIT TO DELHI GOVT. DISPENSARIES)
1. OPD/ Screening Services: Total Number of patients screened at dispensary– 3352
NEW OPD OLD OPD TOTAL OPD
2090 1262 3352
552
10
723 746
595
726
0
100
200
300
400
500
600
700
800
MDC1 MDC2 MDC3 MDC4 MDC5 MDC6
Total Screenings by each van
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2. Oral Disease Burden
Oral Diseases Dental Caries
Periodontal Disease
Malocclusion Pre- Malignant Lesions
Others
Total Patients Screened (n = 3352) 1459 1611 77 34 84
Percentage Burden 43.5% 48% 2% 1% 2.5%
Fig:2: Distribution of Dental Diseases
Table: Age wise Disease distribution
ORAL DISEASE 0-5 yrs 5-15 yrs 15-50 yrs >50 yrs
DENTAL CARIES 46 462 781 170
GINGIVITIS 0 262 645 191
PERIODONTITIS 0 06 121 386
44.00%
48%
2.00% 1% 2.50%
Prevalence of diseases
Dental Caries
Periodontol Diseases
Malocclusion
Premalignant
Flurosis and others
8
Fig. Age wise Disease distribution
Dental Treatment Services: Total Number of patients treated: 1213
Fig.3 Treatment services provided by Mobile Dental Vans
46
462
781
170
0
262
645
121
0 6
121
386
0
100
200
300
400
500
600
700
800
900
0-‐5years 6-‐15years 16-‐50years 51-‐70years
Age wise distribuFon of diseases
Carious
GingiviFs
PeriodonFFs
525
615
73
0
100
200
300
400
500
600
700
Oral Prophylaxis RestoraHon ExtracHon
Total Treatment
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Fig. 4 Dental Treatment Services Provided By Individual Vans
Referral to MAIDS: Total Number: 443
Fig.5 Referral to Tertiary care centre-MAIDS
0
50
100
150
200
250
300
MDC1 MDC2 MDC3 MDC4 MDC5 MDC6
190
5
223
264
182
145
106
3
163 174
115
184
9 0
29 19 24
39
Details of Treatment by each van
OP
Rest
Ext
305
8
415 457
321
368
0
50
100
150
200
250
300
350
400
450
500
MDC1 MDC2 MDC3 MDC4 MDC5 MDC6
Total Referral to MAIDS
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5.Dispensary-Wise Break Up of the Services:
Fig.6 Area wise Total OPD and Treatment Service
Dispensary Wise OPD=2738
AREA NUMBER OF DAYS TOTAL OPD TOTAL TREATMENT
Seelampur 21 509 251
Yamuna Vihar 19 754 317
Mayur Vihar 18 513 232
Kantinagar 18 611 234
Vasundhara Enclave 11 299 143
Timarpur 4 40 7
Asha Kiran 1 12 2
509
754
611
513
40 12
299 251
317
234 232
7 2
143
0
100
200
300
400
500
600
700
800
Seelampur Yamuna Vihar
KanHnagar Mayur Vihar Timarpur Asha Kiran Vasundara enclave
Total OPD and Treatment in each dispensary
OPD
Treatment
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6. Recall Appointment Services: Total Recall appointments: 1874
Fig.7 Recall Appointments
Fig.8 Details of recall appointments
305
8
415 457
321
368
0
50
100
150
200
250
300
350
400
450
500
MDC1 MDC2 MDC3 MDC4 MDC5 MDC6
Total Follow up by Each Van
0
50
100
150
200
250
300
MDC1 MDC2 MDC3 MDC4 MDC5 MDC6
190
5
223 264
182
145
106
3
163 174
115
184
9 0
29 19 24
39
Details of Follow up by each van
OP
Rest
Ext
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8. Health Education Services in the Community:
Fig.9 Total Number of times Health Educational Programs organised on Importance of Oral Health, Impact of Oral Health on General Healthand Tobacco Cessation –17 Sessions.
SECTION - II
SCHOOL DENTAL HEALTH SCHEME – NEEV
No. of School children Screened in July 2019: 614, Treated: 27
0
1
2
3
4
MDC1 MDC2 MDC3 MDC4 MDC5 MDC6
4
1
3 3
2
4
Health EducaFon Session
345
64
205
0 0 27
0
50
100
150
200
250
300
350
400
GGSSS Civil lines GGSSS Yamuna Vihar GGSSS Sonia Vihar
School Wise OPD and Treatment
OPD
Treatment
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SECTION - III
ASHA TRAINING One of the key strategies under the NRHM is having a community health worker who is
an Accredited Social Health Activist (ASHA) for every village with a population of 1000. The
ASHA workers should preferably be female, in the 25-45 years age group and have a
qualification of at least eighth class. With the introduction of ASHA workers under the NRHM from 2005 to 2006 in India,
utilization of healthcare services at the peripheral level has improved. Hence, ASHA’s being at
the grass root level workercan help in creating awareness in community on oral well-being and
mobilizing the community towards utilizing the oral health care services.ASHA’s with the basic
oral health educational trainings can acquire knowledge, skill and confidence for performing
roles in creating oral health awareness and aiding in making necessary referrals.
In this regard, the Mobile Dental Clinic Project has given the responsibility by DSHM to
conduct ASHA training Program on “Oral Health” during the regular Refresher Training
of ASHAs.
AIMS OF THE INITIATIVE:
1. Create awareness about the “Oral health and Pregnancy” by educating the Community
Stakeholders like ASHA and ANM’s at community grass root level.
2. Evaluate Knowledge, Attitude and Practice of ASHA and ANM Workers in relation to
“Oral Health and Pregnancy” so that proper interventions can be undertaken to improve
their knowledge in any deficient field of Oral Health.
3. Collection of baseline data to help the program managers in formalizing an effective and
efficient “ASHA and ANM Oral Health Training Module” focusing on the areas in
which a knowledge-practice gap is identified.
4. Assess the Post Training knowledge gained through a pre-validated questionnaire
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DETAILS OF ASHA TRAINING SCHEDULE FOR JULY 2019:
The schedule of the ASHA Training Programs organised in the month of July 2019 is:
• A two hour Health Educational Session was conducted using a Power-point
presentation on “ASHA - A STEP TOWARDS INTEGRATING ORAL HEALTH
WITH GENERAL HEALTH” was conducted.
• Prior to this a Pre Training Knowledge, Attitude and Practices assessment regarding oral
health was conducted through a 21 item pre-validated questionnaire.
• Following the Training Session a Post training assessment of Knowledge, Attitude and
Practices was again conducted to assess the level of knowledge gained.
S.
No.
Name of the
Dispensary Date Session Conducted
Number of ASHA
and ANM Trained
1. DGD Batla House 22/07/19 Dr. Swati 25
2. DGD Nabi Karim 25/07/19
Dr. Swati 27
3. DGD Tank Road Dr. Shekhar 30
4. DGD Burari 26/07/19 Dr. Swati 41
5. MCW Jaitpur 27/07/19
Dr. Shekhar 30
6. Dujana House Dr. Swati 30
TOTAL ASHAs TRAINED IN JULY 2019 183
15
ASHA training at DGD, Burari
ASHA Training at MCW Jaitpur, Tughlakabad
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SECTION – IV: Project “AMMA”
Comprehensive Oral Healthcare Program for the Elderly
Maulana Azad Institute of Dental Sciences, Delhi was entrusted to operate and meet the
desired objectives of improving access and utilisation of dental care with the Mobile Dental
Clinic Project under DSHM/ NHM. One of the primary objectives of the Project is to provide
services to the various special groups considering the high disease burden in them. The
Project is already catering to special groups like School children, Maternal and child
population through ASHA workers, Asha Kiran-home for mentally challenged etc.
According to Population Census 2011 there are nearly 104 million elderly persons
(aged 60 years or above) in India; 53 million females and 51 million males.5.9% of the
population of Delhi comprises of citizens aged 60+.The projections indicate that the
number of 60+ in India will increase to 14.3 crore in 2021 and 17.3 crore in 2026.
Continuous increase in life expectancy means that more people are now living longer.
There are only few Government initiatives operational for the geriatric population.
Integrated Program for Senior Citizens-A central Govt. Scheme(revised on 01/04/2018) is being
implemented to improve the quality of life of the Senior Citizens by providing basic amenities
like shelter, food, medical care and entertainment opportunities and by encouraging productive
and active ageing through providing support for capacity building of State/ UT Governments.
Further, there is also the provision of old age homes under Department of Social security in
GNCTD along with Geriatric Program under Department. of Health & Family Welfare
GNCTD.
Studies in health seeking behavior in old age have shown that Oral health is not separate
from general health, but maintaining oral health is definitely difficult and different in old age.
The OPD records of the patients reporting to the Mobile Dental Clinics reveal that almost
39% of the patients diagnosed with dental caries and 33% of the patients suffering from
gingival/periodontal diseases belong to geriatric population clearly indicating high burden
of oral diseases amongst this special group. Almost 14 % of the geriatric population suffer
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from edentulousness. This not only affects their general health but also affects the quality
of life in general.
At present oral healthcare is not included in any of the above mentioned
Government projects going for Geriatric population. Hence, providing primary oral health
care to the geriatric population especially for the people who remain underserved is vital
for a country like India which has a significant proportion of elderly population. A
considerable number of senior citizens have limited knowledge of the cause and prevention
of oral disease as well.
Keeping in view of the above facts; the Mobile Dental Clinic Project has initiated a
newer horizon for Geriatric Oral Health Care: Project “AMMA” :Comprehensive Oral
Healthcare Program for the Elderly. The program has been initiated with collaboration
with Department of Social Security which supervises old age homes (Dept. Of Social
Welfare)under GNCTD for further coordination and organizing various activities. Mr.
Rajeev Saxena, Additional Director, Department of Social Security has been immensely
supporting our initiative .We have received a list of old age homes and senior citizen
recreation centres under GNCTD and with Mr. Rajeev Saxena’s coordination the
activities are being organized.
The Project’s activities include:
a. Oral health Screening at Old Age Homes and Senior Citizen’s recreation centres
b. Primary and Preventive Oral Health Care Services.
c. Oral Health Promotion Activities like health education & Toothbrushing
demonstration.
d. Secondary care of treatment services feasible in Mobile Dental Vans like oral
prophylaxis and Restoration.
e. Referral to tertiary care centres for necessary and urgent oral care.
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Following activities under Project AMMA were conducted in July 2019:
S.No. Date Location Activities conducted
Details/No. of activities
conducted Conducted By
1. 11/07/2019 Sundar nagri (East District)
Health education session &
Demonstration of tooth brushing
01 1. Dr. Swati Jain(Consultant)
2. Dr. Srishti (PG student)
Dental screening 32
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SECTION – V:
Weekly Training Sessions of the Doctors & the Paramedical staff As an attempt to continue the services, weekly training sessions are conducted by
Dr.Nishtha Saini, Dental Surgeon and Training Incharge of Mobile Dental Clinic. For the month
of July 2019, following trainings were conducted:
S.
No Date Topic Led by
1. 13/07/19 Planning for Maintencance of Equipments in MDCP Dr. Annudeep
Bajaj
2. 06/07/19 Team Building exercise – Tallest Free Standing
Tower Dr. Nishtha
3. 13/07/19 Team Building exercise - Holding Paper
4. 20/07/19 Team Building exercise - Traffic Jam
5. 27/07/19 Biomedical Waste Management Dr. Jigyasa
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PROGRAM SUMMARY (As on 25th July 2019)
MDC 1 MDC2 MDC 3 MDC 4 MDC 5 MDC 6 Total
Total Patients Screened
552 10 723 746 595 726 3352
Dental Caries 228 7 369 406 157 292 1459
Periodontal Disease 205 6 325 383 353 339 1611
Malocclusion 8 4 15 32 10 8 77
Pre- Malignant Lesions 3 - 9 8 10 3 33
Others (Dental Fluorosis, Prosthetic Replacements, Tooth Fractures, Peri-apical
Pathologies, Hypoplasia, Wasting
diseases of teeth, Tooth Sensitivity)
22 2 12 11 20 7 84
Tobacco Usage 33 1 36 15 35 21 141
Total Patients Treated
272 0 271 158 242 270 1213
Oral Prophylaxis 131 0 138 42 117 97 525
Restoration 135 0 117 105 105 153 615
Extraction 6 0 16 11 20 20 73
Total Referrals 64 2 73 53 136 115 443
Total Recall Appointments**
305 8 415 457 321 368 1874
Total Working Days (19 Days – From
26.11.2017 to 25.12.2017)
19 1 21 21 19 18 99
TOTAL NO OF BENEFICIARIES
BY MDC 3352
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MAULANA AZAD INSTITUTE OF DENTAL SCIENCES NATIONAL HEALTH MISSION
MONTHLY REPORT (JULY- 2019)
S.No Work Done Total No. of
Patients
1. Total No .of Patients screened by vans 3352
2. Total No. of Dispensary OPD 2738
3. Total no. Of Patients screened with dental caries 1459
4. Total no. Of Patients screened with Periodontal Disease 1611 5. Total no. Of Patients screened with Malocclusion 77
6. Total no. Of Patients screened with Pre Malignant Lesion 33
7. Total no. Of Patients screened with Tobacco Usage 141 8. Total no. Of Patients screened with Dental Fluorosis,
Tooth Fractures, Wasting Diseases etc. 84
9. Total No. of Treatments 1213
10. Total No. of Oral Prophylaxis 525
11. Total No. of Restorations 615
12. Total No. of Extractions 73
13. Total No. of Oral Health Education Sessions Given 17
14. Total Monthly New O.P.D 2090
15. Total Monthly Old O.P.D 1262
16. Total No. Of Referrals 443
17. Total No. of Recall Appointments 1874
18. Total No. of ASHAs / Geriatric individuals benefitted 215
19. Total No. of beneficiaries 3567