This document summarizes the key issues around improving oral health for underserved populations in developing countries. It discusses how huge differences exist in oral health between urban/rural and rich/poor populations due to differences in socioeconomic status and access to care. While developing countries have many dental graduates and facilities, the high cost of private dental care means most of the poor population cannot afford basic services. Safety net programs aim to improve access for these underserved groups, but capacity is limited. The document examines dental safety nets in other countries and discusses policy options for expanding access to care for poor populations in developing nations.
11.[12 18]targeting poor health improving oral health for the poor and the un...Alexander Decker
This document summarizes a study on improving oral health for underserved populations in developing countries. It finds that huge differences exist in oral health between urban and rural populations, as well as between rich and poor urban residents, in developing nations. The poor and marginalized who form a majority have poor oral health and limited access to dental care due to high costs. Existing dental safety nets have very limited capacity compared to private dentistry. Safety nets aim to serve diverse underserved groups but are fragmented and face coordination challenges. Options to strengthen safety nets include increasing community clinics and training programs.
This document discusses dental public health in India and compares practices in other countries. It finds that in India, dental public health/community dentistry is often misunderstood and seen merely as a way to increase patient numbers rather than prevent disease. National oral health policies in India also remain unimplemented. By contrast, countries like the UK, Nordic nations, and the Netherlands integrate public dental health practitioners and preventive services into their universal healthcare systems. The document calls for India to better define the role of public dental health to improve oral health outcomes.
New Requirements And Challenges Joint Commission Cultural Competency Requir...mlw0624
The document discusses new requirements by the Joint Commission for hospitals to improve cultural competency and meet CLAS standards. It focuses on workforce and human resource issues, recommending that hospitals target diverse recruitment, provide cultural competency training to staff, and get staff input on improving care for diverse patients. Hospitals will be evaluated on these organizational supports and readiness factors during accreditation reviews starting in 2012.
2008 Pov Ill Book Challenges In Identifying Poor Oddar Meanchey Cambodiawvdamme
This document summarizes a study that assessed household eligibility for a Health Equity Fund (HEF) in Oddar Meanchey, Cambodia four years after an initial pre-identification process. The study evaluated three tools to assess HEF eligibility: 1) a scoring tool used in the original pre-identification, 2) interviewer assessments, and 3) a socioeconomic status index. The results showed high targeting errors across all three tools, suggesting that the original HEF eligibility granted through pre-identification four years prior did not accurately reflect households' current poverty status. Regular updates of pre-identification combined with post-identification are recommended to minimize targeting errors in the future.
This document discusses various mechanisms for paying for dental care, including private fee-for-service, post-payment plans, and private third party prepayment plans such as commercial insurance companies and non-profit plans like Delta Dental. It also covers prepaid group practice plans, capitation plans, salaries, and public programs like Medicare and Medicaid. Key aspects of reimbursement for dentists and advantages and disadvantages of different payment mechanisms are described.
Innovative social enterprise, rural health, India Infrastructure Report 2014Poonam Madan
It is a moot issue just how much time and resources can get used up by social entrepreneurs in seeking public partnerships to scale their work, while it would be in the interest of the nation for governments to examine, identify and work with them.
Introduction
The big business of health care is growing in a massive rate more now than ever according to The Center for Health Workforce Studies a non-profit organization located in Rensselaer, New York the organization report that, “While total U.S. employment dropped by over 2% between 2000 and 2010, health care employment grew by more than 25% during the same period. More than 13% of the U.S. labor force worked in the health sector or in a health occupation (19 million jobs out of 143 million jobs in U.S. labor force). The health care sector is projected to add over 4.2 million jobs between 2010 and 2020, with 63% of those in ambulatory settings (offices of health practitioners, home health, and other non-institutional settings” (2012, CHWS). Health care is booming in all areas of study and research from Holistic to Western Medicine which include purchasing and supply. Unfortunately this is based off the demand for more Physicians that are not available where there is a need. The health care industry believe it or not includes the food industry and health and fitness as well.
The matter of ethics within the health care industry always needs to be address along with the quality of care for patients. Within this working essay paper I will discuss the matter of; Care & Service Provider, Ethics (codes and values), Mal-Distribution Physician Labor Forces. Even though the health care industry is growing the mal-distribution of health care is still evident in some rural areas. This factor of not having proper care delivered to impoverish neighborhoods and communities is another issue that still plagues the United States. David Cutler the online journal reporter for PBS News Hour stated, “About 10, 15 percent. Just to give you one example, Duke University Hospital has 900 hospital beds and 1,300 billing clerks. The typical Canadian hospital has a handful of billing clerks. Single-payer systems have fewer administrative needs. That’s not to say they’re better, but that’s just on one dimension that they clearly cost less. What a lot of those people are doing in America is they are figuring out how to bill different insurers for different systems, figuring out how to collect money from people, all of that sort of stuff” (2013). The need for health care workers is great, but the balance is off regarding where the needs are not being meet.
11.[12 18]targeting poor health improving oral health for the poor and the un...Alexander Decker
This document summarizes a study on improving oral health for underserved populations in developing countries. It finds that huge differences exist in oral health between urban and rural populations, as well as between rich and poor urban residents, in developing nations. The poor and marginalized who form a majority have poor oral health and limited access to dental care due to high costs. Existing dental safety nets have very limited capacity compared to private dentistry. Safety nets aim to serve diverse underserved groups but are fragmented and face coordination challenges. Options to strengthen safety nets include increasing community clinics and training programs.
This document discusses dental public health in India and compares practices in other countries. It finds that in India, dental public health/community dentistry is often misunderstood and seen merely as a way to increase patient numbers rather than prevent disease. National oral health policies in India also remain unimplemented. By contrast, countries like the UK, Nordic nations, and the Netherlands integrate public dental health practitioners and preventive services into their universal healthcare systems. The document calls for India to better define the role of public dental health to improve oral health outcomes.
New Requirements And Challenges Joint Commission Cultural Competency Requir...mlw0624
The document discusses new requirements by the Joint Commission for hospitals to improve cultural competency and meet CLAS standards. It focuses on workforce and human resource issues, recommending that hospitals target diverse recruitment, provide cultural competency training to staff, and get staff input on improving care for diverse patients. Hospitals will be evaluated on these organizational supports and readiness factors during accreditation reviews starting in 2012.
2008 Pov Ill Book Challenges In Identifying Poor Oddar Meanchey Cambodiawvdamme
This document summarizes a study that assessed household eligibility for a Health Equity Fund (HEF) in Oddar Meanchey, Cambodia four years after an initial pre-identification process. The study evaluated three tools to assess HEF eligibility: 1) a scoring tool used in the original pre-identification, 2) interviewer assessments, and 3) a socioeconomic status index. The results showed high targeting errors across all three tools, suggesting that the original HEF eligibility granted through pre-identification four years prior did not accurately reflect households' current poverty status. Regular updates of pre-identification combined with post-identification are recommended to minimize targeting errors in the future.
This document discusses various mechanisms for paying for dental care, including private fee-for-service, post-payment plans, and private third party prepayment plans such as commercial insurance companies and non-profit plans like Delta Dental. It also covers prepaid group practice plans, capitation plans, salaries, and public programs like Medicare and Medicaid. Key aspects of reimbursement for dentists and advantages and disadvantages of different payment mechanisms are described.
Innovative social enterprise, rural health, India Infrastructure Report 2014Poonam Madan
It is a moot issue just how much time and resources can get used up by social entrepreneurs in seeking public partnerships to scale their work, while it would be in the interest of the nation for governments to examine, identify and work with them.
Introduction
The big business of health care is growing in a massive rate more now than ever according to The Center for Health Workforce Studies a non-profit organization located in Rensselaer, New York the organization report that, “While total U.S. employment dropped by over 2% between 2000 and 2010, health care employment grew by more than 25% during the same period. More than 13% of the U.S. labor force worked in the health sector or in a health occupation (19 million jobs out of 143 million jobs in U.S. labor force). The health care sector is projected to add over 4.2 million jobs between 2010 and 2020, with 63% of those in ambulatory settings (offices of health practitioners, home health, and other non-institutional settings” (2012, CHWS). Health care is booming in all areas of study and research from Holistic to Western Medicine which include purchasing and supply. Unfortunately this is based off the demand for more Physicians that are not available where there is a need. The health care industry believe it or not includes the food industry and health and fitness as well.
The matter of ethics within the health care industry always needs to be address along with the quality of care for patients. Within this working essay paper I will discuss the matter of; Care & Service Provider, Ethics (codes and values), Mal-Distribution Physician Labor Forces. Even though the health care industry is growing the mal-distribution of health care is still evident in some rural areas. This factor of not having proper care delivered to impoverish neighborhoods and communities is another issue that still plagues the United States. David Cutler the online journal reporter for PBS News Hour stated, “About 10, 15 percent. Just to give you one example, Duke University Hospital has 900 hospital beds and 1,300 billing clerks. The typical Canadian hospital has a handful of billing clerks. Single-payer systems have fewer administrative needs. That’s not to say they’re better, but that’s just on one dimension that they clearly cost less. What a lot of those people are doing in America is they are figuring out how to bill different insurers for different systems, figuring out how to collect money from people, all of that sort of stuff” (2013). The need for health care workers is great, but the balance is off regarding where the needs are not being meet.
Federally Qualified Health Centers (FQHCs) provide critical primary care services to underserved communities but face funding challenges. They save billions for the healthcare system through reduced emergency room visits and hospitalizations. While the Affordable Care Act increased funding, cuts to Medicaid and state funding threaten their ability to meet growing demand. Private donations are needed to sustain FQHC programs and services that improve health outcomes and drive local economic growth through jobs and purchases.
The document provides information about health care facilities and programs in Iowa that aim to improve access to dental care. It discusses the types of health care facilities, the health center program, volunteer health care programs, and opportunities for dental providers to partner with public health programs. It also outlines shortage designations, state health workforce initiatives, and programs that can assist with job searches or provide scholarships and loan repayment. The overall aim is to describe Iowa's efforts to strengthen the dental workforce and increase access to dental services, especially for underserved populations.
The introduction of universal health coverage in Indonesia provides opportunities for investors to help develop the country's struggling healthcare system. Indonesia faces shortages of hospitals, beds, and medical professionals, especially in rural areas. The rising middle class is expected to drive demand for more affordable healthcare options. While challenges remain such as building new facilities and improving infrastructure, investors can play a role in areas like expanding healthcare access, finding innovative solutions to address costs, and providing management expertise.
This document discusses expanding access to mental health care through school-based health centers (SBHCs). It notes that while SBHCs have evolved since the 1900s to address various health needs, more is still needed to fill gaps in access to mental health care for children and teens. Key changes proposed include increasing and stabilizing funding for SBHCs from federal and state governments. This would allow for improved outreach, quality measures, and accountability. The impacts of these changes would be decreased health risks and costs to society by expanding access to mental health services for underserved youth populations.
The National Health Service Corps (NHSC) provides financial support like loan repayment and scholarships to health care providers in exchange for working in underserved areas. It supports over 8,000 providers across 10,000 sites. The NHSC falls under HRSA and aims to build healthy communities with limited access to care. It offers loan repayment up to $170,000 for 5 years of service as well as scholarships for students pursuing primary care careers.
This document summarizes a presentation on health financing strategies for achieving universal health coverage given by Sourav Goswami and moderated by Dr. Subodh Gupta at MGIMS, Sevagram on June 8th, 2017. The presentation discusses key aspects of health financing policy including universal health coverage goals of access, quality, and financial protection. It covers topics such as revenue raising, risk pooling, purchasing of health services, benefit package design, and principles of rationing health resources. Examples from countries like Moldova and Chile are provided. The current scenario of health financing in India is also summarized, highlighting high levels of out-of-pocket spending and a need to increase public financing to achieve equitable access to
This document provides an overview of healthcare financing in India. It begins with definitions of health care financing and outlines the key functions of accumulating, mobilizing, and allocating money for health needs. It then discusses the main mechanisms of healthcare financing globally and in India, including how money is raised through taxes, insurance contributions, and other means. It also addresses how funds are pooled and how health services are paid for. The document reviews India's current healthcare financing indicators and challenges, such as low public spending and high out-of-pocket costs. It concludes with initiatives by the Government of India and recommendations to improve healthcare financing in India.
The document proposes introducing an electronically barcoded health-cum-insurance card for all eligible Indian citizens. The card would contain biometric and medical information to expedite healthcare services. It could reduce costs, prevent impersonation, and minimize paper usage. Similar programs have seen success in other regions. Implementing the plan would require strengthening rural healthcare, coordinating different government levels, and gaining public support over time. The card is envisioned as one part of improving primary healthcare access.
Oral disease burden amongst adults in indiaVini Mehta
This document discusses the oral disease burden in India. It provides definitions of oral health and major oral diseases like dental caries, periodontal diseases, and oral cancer. It summarizes findings from the National Oral Health Survey in India from 2002-2003 which found high prevalences of dental caries (affecting around 60% of the population) and periodontal diseases. Efforts to address the disease burden through programs like the National Oral Health Care Programme are discussed, as well as ongoing barriers.
This document summarizes a proposal to improve universal access to primary health care in India through better utilization of existing resources. The proposal suggests:
1) Utilizing both MBBS and AYUSH doctors by providing a mandatory internship program exposing them to rural health centers.
2) Providing a doctor at each sub-health center to improve quality at the first point of contact and reduce workload at primary health centers.
3) Addressing challenges like mentality shifts, proper implementation, and corruption.
Health Disparity Among People with Craniofacial Disabilities🌎 Cynthia Ⓥ Murphy ✌
Genetic circumstances typically cause craniofacial conditions, whereas a child is born with physical malformations to the head and body, resulting in the need for lifelong surgical procedures. These disabilities often cause chronic disease, hearing deficiencies, and severe speech impediments. Health disparity is a significant challenge that many face worldwide. This epidemic predominantly affects people with disabilities, including craniofacial conditions. Some of the common craniofacial disorders include Treacher Collins Syndrome, Nager Syndrome, Goldenhar Syndrome, Coffin-Lowry Syndrome, Craniosynostosis, Apert Syndrome, Cleft Lip and Palate, Pfeiffer Syndrome, Facial Infused Lipomatosis, Facial Palsy, among others (Bartzela, T. N., Carels, C., & Maltha, J. C., 2017).
This document summarizes an organization that provides business consulting services and has a presence in India, Dubai and 20 other countries. It has a team of over 35 employees and 15 freelancers with experience across industries like healthcare, energy and retail. The document then discusses the Indian healthcare sector and issues like low spending, shortage of facilities and professionals. It provides examples of public-private partnership models in healthcare and case studies of successful PPP projects in Indian states like Andhra Pradesh, Karnataka and Uttarakhand that improved access to services. Challenges in PPPs and recommendations for the road ahead are also highlighted.
Exploring the Potential Role Of Community Health Insurance Schemes In A Natio...David Lambert Tumwesigye
Exploring the Potential Role Of Community Health Insurance Schemes In A National Health Insurance Scheme-Presented to CHI practitioners of the Uganda Community Based Health Financing Association
The document summarizes the Indian healthcare landscape. It notes that India has a large population but low spending on healthcare per capita compared to other countries. Healthcare is provided through both public and private sectors. The burden of disease is shifting from communicable to non-communicable diseases. Government initiatives aim to increase access through programs and infrastructure growth, but challenges remain around access, costs and quality across the public and private sectors. The healthcare industry is seen as a major growth opportunity in India.
Healthcare Interpretation Network (HIN) Annual General Meeting - October 25, ...hintnet
The document summarizes the key points from an annual general meeting on healthcare interpretation. It discusses the importance of interpretation in enabling health equity and addressing barriers faced by immigrant populations and those with limited official language proficiency. It outlines social determinants of health and how language barriers can negatively impact access to care, health outcomes, and costs. Initiatives like Language Services Toronto and community organizations are highlighted as working to improve healthcare access and reduce inequities for diverse populations.
HFG Project Brief - Improving Health Finance and Governance Expands Access to...HFG Project
The USAID Health Finance and Governance Project works in over 25 countries to improve health systems financing and governance, expand access to essential services like maternal and child health care, and progress toward universal health coverage. In Burundi, the project strengthened the management and organizational capacity of the National HIV/AIDS Program. In Cote d'Ivoire, the project helped develop the country's first post-conflict strategic plan to address health workforce issues and better support HIV care. The project also piloted an integrated HIV service delivery model in Ukraine.
Disability is a complex, multidimensional issue defined by the interaction between impairments and environmental factors. In India, approximately 2.68 crore people or 2.21% of the population have a disability. Strengthening disability data is important for ensuring inclusive development and welfare initiatives for disabled people. Japanese Encephalitis is a major cause of disability in India, especially in Uttar Pradesh, where it has contributed to approximately 35-40 thousand cases over 30 years. Coordination between government schemes, NGO implementation, and legal protections is needed to promote the socio-economic development and safeguard the rights of disabled populations.
Since the 2000 US Surgeon General's report on oral health in the United States, important but insufficient results have been achieved in accessing and providing oral health care.
This policy paper proposes alternatives to improve India's oral health care system. The current system has high rates of oral diseases but lacks access in rural areas. Three alternatives are proposed: 1) Strengthen the dental workforce by training them to provide primary care in rural areas. 2) Develop epidemiological research to inform needs-based policies. 3) Maintain the status quo. The alternatives are evaluated based on improving health, cost-effectiveness, and cost of implementation. Strengthening the workforce and research score highest by improving health while research is most cost-effective.
This document discusses barriers to utilization of dental health care services. It defines key terms like need, health services, utilization, and barriers. It then describes factors that affect barriers to dental care utilization, like age, gender, race, income level, education level, geographic location, dental insurance status, and general health. Barriers are classified into availability, accessibility, affordability, acceptability, and accommodation based on a commonly used framework. The Indian scenario of dental care barriers is also mentioned.
Federally Qualified Health Centers (FQHCs) provide critical primary care services to underserved communities but face funding challenges. They save billions for the healthcare system through reduced emergency room visits and hospitalizations. While the Affordable Care Act increased funding, cuts to Medicaid and state funding threaten their ability to meet growing demand. Private donations are needed to sustain FQHC programs and services that improve health outcomes and drive local economic growth through jobs and purchases.
The document provides information about health care facilities and programs in Iowa that aim to improve access to dental care. It discusses the types of health care facilities, the health center program, volunteer health care programs, and opportunities for dental providers to partner with public health programs. It also outlines shortage designations, state health workforce initiatives, and programs that can assist with job searches or provide scholarships and loan repayment. The overall aim is to describe Iowa's efforts to strengthen the dental workforce and increase access to dental services, especially for underserved populations.
The introduction of universal health coverage in Indonesia provides opportunities for investors to help develop the country's struggling healthcare system. Indonesia faces shortages of hospitals, beds, and medical professionals, especially in rural areas. The rising middle class is expected to drive demand for more affordable healthcare options. While challenges remain such as building new facilities and improving infrastructure, investors can play a role in areas like expanding healthcare access, finding innovative solutions to address costs, and providing management expertise.
This document discusses expanding access to mental health care through school-based health centers (SBHCs). It notes that while SBHCs have evolved since the 1900s to address various health needs, more is still needed to fill gaps in access to mental health care for children and teens. Key changes proposed include increasing and stabilizing funding for SBHCs from federal and state governments. This would allow for improved outreach, quality measures, and accountability. The impacts of these changes would be decreased health risks and costs to society by expanding access to mental health services for underserved youth populations.
The National Health Service Corps (NHSC) provides financial support like loan repayment and scholarships to health care providers in exchange for working in underserved areas. It supports over 8,000 providers across 10,000 sites. The NHSC falls under HRSA and aims to build healthy communities with limited access to care. It offers loan repayment up to $170,000 for 5 years of service as well as scholarships for students pursuing primary care careers.
This document summarizes a presentation on health financing strategies for achieving universal health coverage given by Sourav Goswami and moderated by Dr. Subodh Gupta at MGIMS, Sevagram on June 8th, 2017. The presentation discusses key aspects of health financing policy including universal health coverage goals of access, quality, and financial protection. It covers topics such as revenue raising, risk pooling, purchasing of health services, benefit package design, and principles of rationing health resources. Examples from countries like Moldova and Chile are provided. The current scenario of health financing in India is also summarized, highlighting high levels of out-of-pocket spending and a need to increase public financing to achieve equitable access to
This document provides an overview of healthcare financing in India. It begins with definitions of health care financing and outlines the key functions of accumulating, mobilizing, and allocating money for health needs. It then discusses the main mechanisms of healthcare financing globally and in India, including how money is raised through taxes, insurance contributions, and other means. It also addresses how funds are pooled and how health services are paid for. The document reviews India's current healthcare financing indicators and challenges, such as low public spending and high out-of-pocket costs. It concludes with initiatives by the Government of India and recommendations to improve healthcare financing in India.
The document proposes introducing an electronically barcoded health-cum-insurance card for all eligible Indian citizens. The card would contain biometric and medical information to expedite healthcare services. It could reduce costs, prevent impersonation, and minimize paper usage. Similar programs have seen success in other regions. Implementing the plan would require strengthening rural healthcare, coordinating different government levels, and gaining public support over time. The card is envisioned as one part of improving primary healthcare access.
Oral disease burden amongst adults in indiaVini Mehta
This document discusses the oral disease burden in India. It provides definitions of oral health and major oral diseases like dental caries, periodontal diseases, and oral cancer. It summarizes findings from the National Oral Health Survey in India from 2002-2003 which found high prevalences of dental caries (affecting around 60% of the population) and periodontal diseases. Efforts to address the disease burden through programs like the National Oral Health Care Programme are discussed, as well as ongoing barriers.
This document summarizes a proposal to improve universal access to primary health care in India through better utilization of existing resources. The proposal suggests:
1) Utilizing both MBBS and AYUSH doctors by providing a mandatory internship program exposing them to rural health centers.
2) Providing a doctor at each sub-health center to improve quality at the first point of contact and reduce workload at primary health centers.
3) Addressing challenges like mentality shifts, proper implementation, and corruption.
Health Disparity Among People with Craniofacial Disabilities🌎 Cynthia Ⓥ Murphy ✌
Genetic circumstances typically cause craniofacial conditions, whereas a child is born with physical malformations to the head and body, resulting in the need for lifelong surgical procedures. These disabilities often cause chronic disease, hearing deficiencies, and severe speech impediments. Health disparity is a significant challenge that many face worldwide. This epidemic predominantly affects people with disabilities, including craniofacial conditions. Some of the common craniofacial disorders include Treacher Collins Syndrome, Nager Syndrome, Goldenhar Syndrome, Coffin-Lowry Syndrome, Craniosynostosis, Apert Syndrome, Cleft Lip and Palate, Pfeiffer Syndrome, Facial Infused Lipomatosis, Facial Palsy, among others (Bartzela, T. N., Carels, C., & Maltha, J. C., 2017).
This document summarizes an organization that provides business consulting services and has a presence in India, Dubai and 20 other countries. It has a team of over 35 employees and 15 freelancers with experience across industries like healthcare, energy and retail. The document then discusses the Indian healthcare sector and issues like low spending, shortage of facilities and professionals. It provides examples of public-private partnership models in healthcare and case studies of successful PPP projects in Indian states like Andhra Pradesh, Karnataka and Uttarakhand that improved access to services. Challenges in PPPs and recommendations for the road ahead are also highlighted.
Exploring the Potential Role Of Community Health Insurance Schemes In A Natio...David Lambert Tumwesigye
Exploring the Potential Role Of Community Health Insurance Schemes In A National Health Insurance Scheme-Presented to CHI practitioners of the Uganda Community Based Health Financing Association
The document summarizes the Indian healthcare landscape. It notes that India has a large population but low spending on healthcare per capita compared to other countries. Healthcare is provided through both public and private sectors. The burden of disease is shifting from communicable to non-communicable diseases. Government initiatives aim to increase access through programs and infrastructure growth, but challenges remain around access, costs and quality across the public and private sectors. The healthcare industry is seen as a major growth opportunity in India.
Healthcare Interpretation Network (HIN) Annual General Meeting - October 25, ...hintnet
The document summarizes the key points from an annual general meeting on healthcare interpretation. It discusses the importance of interpretation in enabling health equity and addressing barriers faced by immigrant populations and those with limited official language proficiency. It outlines social determinants of health and how language barriers can negatively impact access to care, health outcomes, and costs. Initiatives like Language Services Toronto and community organizations are highlighted as working to improve healthcare access and reduce inequities for diverse populations.
HFG Project Brief - Improving Health Finance and Governance Expands Access to...HFG Project
The USAID Health Finance and Governance Project works in over 25 countries to improve health systems financing and governance, expand access to essential services like maternal and child health care, and progress toward universal health coverage. In Burundi, the project strengthened the management and organizational capacity of the National HIV/AIDS Program. In Cote d'Ivoire, the project helped develop the country's first post-conflict strategic plan to address health workforce issues and better support HIV care. The project also piloted an integrated HIV service delivery model in Ukraine.
Disability is a complex, multidimensional issue defined by the interaction between impairments and environmental factors. In India, approximately 2.68 crore people or 2.21% of the population have a disability. Strengthening disability data is important for ensuring inclusive development and welfare initiatives for disabled people. Japanese Encephalitis is a major cause of disability in India, especially in Uttar Pradesh, where it has contributed to approximately 35-40 thousand cases over 30 years. Coordination between government schemes, NGO implementation, and legal protections is needed to promote the socio-economic development and safeguard the rights of disabled populations.
Since the 2000 US Surgeon General's report on oral health in the United States, important but insufficient results have been achieved in accessing and providing oral health care.
This policy paper proposes alternatives to improve India's oral health care system. The current system has high rates of oral diseases but lacks access in rural areas. Three alternatives are proposed: 1) Strengthen the dental workforce by training them to provide primary care in rural areas. 2) Develop epidemiological research to inform needs-based policies. 3) Maintain the status quo. The alternatives are evaluated based on improving health, cost-effectiveness, and cost of implementation. Strengthening the workforce and research score highest by improving health while research is most cost-effective.
This document discusses barriers to utilization of dental health care services. It defines key terms like need, health services, utilization, and barriers. It then describes factors that affect barriers to dental care utilization, like age, gender, race, income level, education level, geographic location, dental insurance status, and general health. Barriers are classified into availability, accessibility, affordability, acceptability, and accommodation based on a commonly used framework. The Indian scenario of dental care barriers is also mentioned.
The document discusses barriers to utilization of dental health care services. It defines key terms like need, health services, utilization, and barriers. It then describes various factors that can act as barriers, such as age, gender, race, education level, income level, dental insurance coverage, and geographic location. Barriers are also classified in different ways by various researchers, such as availability, accessibility, affordability, acceptability and accommodation of services. Common barriers include cost of treatment, fear or anxiety associated with dental procedures, lack of perceived need for care, and lack of access to dental services and insurance coverage.
Dental Health Care Services Discussion.docxstudywriters
This document discusses dental health care services and teledentistry. It describes how teledentistry uses technology and telecommunications to improve access to dental care, education, and awareness. Teledentistry has potential benefits like increasing access to specialists in remote/rural areas and reducing health disparities. The document also examines how states like Alaska are using teledentistry and mid-level dental providers to expand care.
This document discusses dental needs, demand, and manpower. It addresses:
1. The key questions around dental public health programs, including community dental needs, demand for treatment, available manpower, and how prevention can reduce need.
2. Factors that affect dental needs like age, sex, income level, and geographic region.
3. Factors that drive demand for dental care, including population growth, education levels, and income.
4. Considerations around dental manpower supply, distribution, productivity, and utilization.
5. How dental care can be organized efficiently using different levels of personnel, including dentists, dental assistants, hygienists, and new auxiliary types for underserved areas
The document discusses universalizing access to quality primary healthcare in India. It identifies economic barriers and the high cost of treatment as leading causes for poor primary healthcare access. It proposes several solutions such as promoting generic medicines, implementing national health insurance, and increasing the number of medical professionals in rural areas. The proposed solutions aim to make healthcare more affordable and accessible to all citizens of India.
This document provides an overview of oral healthcare delivery in India. It discusses the high burden of oral diseases in India such as oral cancer, periodontal disease, dental caries, and edentulism. It also notes the shortage of dental professionals in India, with a ratio of 1 dentist per 5,015 people. The document outlines India's health system administration and the different levels of oral healthcare delivery. It discusses India's National Oral Health Programme and strategies to improve oral health for children. Barriers to oral healthcare delivery in India include the shortage of dental professionals and resources in rural areas as well as insufficient public funding. The document also discusses the potential role of dental insurance, tele dentistry, and other reforms to expand
Improving Oral Health Access Migrant and Seasonal WorkersMPCA
Migrant farmworkers face significant barriers to accessing oral healthcare. Dental disease is one of the top 5 health problems for farmworkers aged 5-29. The main barriers include lack of insurance, inability to afford care, and lack of providers accepting Medicaid. Several organizations in Michigan provide dental services to migrant farmworkers, but they can only serve about 15-20% of this population due to limited resources. Expanding access will require innovative models of care delivery and increasing funding for preventive oral health programs.
Improving Oral Health Access Migrant and Seasonal WorkersMPCA
Migrant farmworkers face significant barriers to accessing oral healthcare. Dental disease is one of the top 5 health problems for farmworkers aged 5-29. The main barriers include lack of insurance, inability to afford care, and lack of providers accepting Medicaid. Several organizations in Michigan provide dental services to migrant farmworkers, but they can only serve about 15-20% of this population due to limited resources. Expanding access will require innovative models of care delivery and increasing funding for preventive oral health programs.
Rashtriya swasthya bima yojna health insurance for the poor - a brief analys...iaemedu
This document provides an overview of the Rashtriya Swasthya Bima Yojna (RSBY) health insurance scheme in India, which aims to provide health insurance coverage to below poverty line families. It discusses the challenges of access to healthcare in India, including high out-of-pocket costs that push many into poverty each year. Previous government-run health insurance schemes had low enrollment and claims ratios. The document examines the implementation of RSBY in Kerala state through interviews with hospitals and insurers, finding some of the same challenges reported elsewhere, such as with enrollment and fraud. Further research is needed to improve the effectiveness of the program.
1. The document outlines a proposed plan for a Rural Dental Center Project by Dr. Amit Saini's organization, Global Oral Health Foundation Society.
2. The plan is to establish a dental center in a village that would serve 25-30 surrounding villages, providing affordable dental care through a dentist and staff. Outreach camps would increase oral health awareness.
3. Corporate sponsors are proposed to provide equipment, medicines, and other supplies to ensure the center is properly equipped while keeping costs low for patients. Transparency measures like audits and cameras would ensure accountability.
This document summarizes a needs assessment project conducted in Cortland County, NY to evaluate dental health education needs. Survey results showed that some children were not receiving regular dental care or only going to the dentist during emergencies. Many adults supported community water fluoridation, a cost-effective way to prevent cavities. The purpose of the project was to identify gaps in dental health knowledge and guide future education efforts. Results will help the Cavity Free Cortland coalition expand outreach and tailor messages based on the community's needs.
This document discusses dental needs, demand for dental care, and dental manpower. It addresses the following questions: 1) What are a community's dental needs? 2) How large is the demand for treatment? 3) What manpower is available? 4) How can prevention reduce needs? Dental needs vary based on factors like development level, age, sex, income, and race. Demand depends on automatic factors like population size, education levels, and income as well as dentists' education efforts. Dental manpower supply and distribution must meet the needs and demands of the population.
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11.targeting poor health improving oral health for the poor and the underserved
1. International Affairs and Global Strategy www.iiste.org
ISSN 2224-574X (Paper) ISSN 2224-8951 (Online)
Vol 3, 2012
Targeting poor health: Improving oral health for the poor and
the underserved
Abhinav Singh* ,Bharathi Purohit
Peoples College of Dental Sciences, Department of Public Health Dentistry, Peoples University, Bhopal,
India
* E-mail of the corresponding author: drabhinav.singh@gmail.com
Abstract
Huge differences exist in health status including oral health between urban and rural population in
developing countries. Differences also exist in health status between the urban rich and the urban poor.
Poor and marginalized population form majority of the population in developing countries. This undeserved
population typically defined by their low incomes has poor oral health status and most of the times are
unable to afford basic and emergency health care services. Significant disparities remain in both the rates of
dental disease and access to dental care among subgroups of the population, especially for children and
adults who live below the poverty threshold.
Keywords: oral health disparities, dental safety net, developing countries, marginalized population
1. Introduction
Oral health is a critical but overlooked component of overall health and well-being among children and
adults. Dental caries (tooth decay) is the most common preventable chronic childhood disease. Dental
disease restricts activities in school, work, and home and often significantly diminishes the quality of life
for many children and adults, especially those who are low-income or uninsured. There is increasing
evidence of associations between oral infections and other diseases, such as pre-term, low birthweight
babies, heart disease, lung disease, diabetes and stroke among adults (National Institute of Dental and
Craniofacial Research, 2000)
Huge differences exist in health status including oral health between urban and rural population in
developing countries. Differences also exist in health status between the urban rich and the urban poor. The
finding has been mainly attributed to differences in socio economic status and limited paying capacity
across populations, specifically in developing countries. Although there have been impressive advances in
both dental technology and in the scientific understanding of oral diseases, significant disparities remain in
both the rates of dental disease and access to dental care among subgroups of the population, especially for
children and adults who live below the poverty threshold.
2. State of Affairs: India
Private fee for service is the only mechanism of payment for dental care in most of the developing countries
including India. The major disadvantage of fee for service is that many patients are unable to receive any
care. Developing countries have a high unequal income distribution and in a market based delivery system
socio economic factors play a major role in use of health care services.
India has 289 dental colleges with around 25,000 graduates each year (Sivapathasundharam, 2007).
Dental manpower though available yet the utilization of oral health care services is low. The reason for the
low utilization of health care services being the high cost involved thereby widening the oral health
differences across the social economic classes.
Poor and marginalized population form majority of the population in developing countries. This
undeserved population typically defined by their low incomes has poor oral health status and most of the
times are unable to afford basic and emergency health care services. Many developing countries including
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India have neither an oral health policy nor a planned oral health care delivery system. Oral health policy
was drafted by Dental Council of India (DCI) way back in 1985. National oral health policy (1985)
recommends dentists to be appointed at primary and community health centres. Till date the policy has not
be implemented. (National oral health policy, 1985)
3. Dental Safety Net
Dental safety net providers are public and private non-profit organizations that provide comprehensive oral
health care to children, adults and the elderly. The dental “safety net” is variously defined as the facilities,
providers, and payment programs that support dental care specifically for “underserved populations.”
(Kwon, 2009) These various definitions distinguish the “safety net” from the delivery of dental care by
dentists in private practice. The safety net portion of care delivery in India that exclusively focuses on
caring for the underserved has very limited capacity compared to the cumulative capacity of private
dentistry. As a result, most care received by the underserved is today provided by private dentists.
Although a variety of social and demographic characteristics correlate with use of dental services,
underserved populations are typically defined by their low incomes (Guay, 2004). Bailit et al. (2006) in
America characterized the dentally underserved as individuals with incomes less than twice the federal
poverty level (82 million Americans or 27 percent of the US population) because these individuals utilize
dental services at about half the rate of higher-income groups and are described as “unable to purchase
private sector care”.
“Effective demand” for dental care by the underserved, defined as having both motive and financial
means to obtain care, has been considered to be modest. (Guay, 2004) In addition to those disadvantaged by
income, the underserved also includes those whose age, physical, health, behavioral, social, language, or
geographical conditions render them vulnerable and limit their access to, or acceptance by majority of the
dentists in private practice (Edelstein, 2005). In short, the dental safety net is the composite of all places,
providers, and programs that deliver dental services to people disenfranchised from the predominant private
dental delivery system.
4. Composition Of Safety Nets—Whom Do They Serve and How Are They Organized?
Health care safety nets serve a diverse patient population, including inner city and rural poor, the homeless,
low-income migrant workers, the uninsured and underinsured. Many of these patients are also chronically
ill and require coordinated disease management. Safety nets usually are community-based and are
influenced in large part by economic and other characteristics of their local communities. Some safety net
providers are run by hospitals or community groups, others by physicians or local governments. Some rely
on donations of time and effort by physicians, nurses and other providers, while others rely on discounted
payment for caregivers. Some are a mixture of both. In sum, they are organized according to their particular
patient population and financing. The local variations in financing, patient mix and workforce may result in
a poorly coordinated and fragmented system of safety nets.
Thus, while safety nets provide essential health services to individuals who otherwise would lack
access to care, this patchwork system also results in common problems such as restricted access to specialty
services, disruption in care, and long waiting periods for patients. Despite these strains, the same
fragmented local forces that create a patchwork system also open up opportunities for innovation that are
highly attuned to a specific community’s need. A closer look at different safety nets across nations reveals
some examples that provide adequate and coordinated care. In this case, adequacy means that the provider
actively screens and enrolls eligible patients, assigns them to a primary care medical home, and provides a
reasonably comprehensive range of services, including essential medications, specialist referrals, chronic
disease management and hospitalizations. Through such coordination of care, these adequate safety nets
can also rein in health care costs.
Hospital emergency departments have a number of sites in underserved areas to potentially meet
demand for health services, yet they rarely are responsive to dental needs, are not designed to provide
comprehensive dental care, and have none or insufficiently trained personnel to deal with even acute dental
problems. Policies therefore could be developed to establish at least a minimum standard of emergency
dental care in these sites. Safety net providers could also benefit from health information technology,
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enhanced cultural appropriateness, expanded dental workforce size, and increased delegation through allied
dental professionals (Byck et al, 2002; Okunseri et al, 2008)
A study was conducted to shed more light on the effectiveness of waivers and exemptions as safety
nets in the public health sector in Kenya. Findings indicate that, for the selected facilities, waivers and
exemptions have not been fully effective in protecting the poor against the negative effects of fees on their
demand for health services, due to: (i) limited volume of waivers granted and waivers provided; (ii) limited
awareness among the targeted; (iii) varied assessment procedures, with some procedures unable to
accurately identify the targeted; (iv) lack of support from facility staff due to revenue loss, given that user
fee revenues have become an important source of finance for non-wage recurrent expenditure; and (v) lack
of enforcement of guidelines on waivers and exemptions by Ministry of Health, resulting in health facility
managers exercising discretion on the implementation. In an effort to increase effectiveness of the system,
the study recommends the following: (i) publicising the waivers and exemptions programme; (ii) enforcing
issued guidelines on waivers and exemptions; (iii) increasing targeting efficiency through improved
assessment and approval mechanisms; (iv) providing incentives to facility staff to support the safety nets; (v)
use of needs criteria by the Ministry of Health when allocating resources to facilities. There was no mention
of inclusion of oral health care services in the safety nets. (Eberhardt et al, 2001)
5. Rural Safety Nets
Rural and urban areas differ in many ways, including demography, environment, economy, social structure,
and availability of resources The differences in these characteristics significantly affect the structure,
capacity, and functioning of the rural health care safety net. Rural populations, on average, tend to be older
than those in urban areas and suffer from greater levels of poverty and unemployment and lower levels of
income. Rural residents are more likely to engage in risky health behaviors than urban residents. Rates of
smoking, alcohol consumption, and obesity are higher in rural areas. Chronic illnesses and associated
limitations in activity are more prevalent, and mortality rates for chronic conditions such as chronic
obstructive pulmonary disease are higher in rural areas. (Safety Nets in Kenya's Public Health Sector, 2003)
Rural residents are more likely than urban residents to describe their overall health as fair to poor. Urban
and rural hospitals differ considerably in regard to the safety net and their financial vulnerability. The
ability of rural hospitals to cost shift indigent care to their paying customers is significantly reduced by the
nature of their revenue mix. While urban hospitals also face a large proportion of publicly funded patients,
they typically have the availability of clinicians-in-training to deliver care. Although 70% of Indian
population resides in rural areas yet there is no provision of dental care through primary health centers.
What is worse is that oral health has not been included in public health policies noticeably there is no space
for dental safety net in public health policies.
6. The Informal Safety Net
Because rural communities have few or none formal dental safety net providers such as public hospital
outpatient departments, primary health centers (PHCs), and local health department’s vulnerable
populations in rural areas are often dependent on an informal safety net of providers who are not explicitly
dedicated to providing care to low-income population. These providers often include clinics, private
physicians, traditional healers and other providers who do not receive funding to serve vulnerable
populations, but do provide some access to care for these groups. Monitoring or even identifying the
components of this "informal" safety net is quite difficult and depends on providers' self-reports of the level
of care provided. (Taylor et al, 2003)
7. Dental safety Nets in Developed Countries
Before discussing the formation of dental safety nets in developing countries what is required is the
knowledge of how these programs have been running in developed countries. A Massachusetts analysis of
its community health center dentists reports that 132 (approximately 2 percent of state-licensed dentists) are
employed in health centers and that 40 percent of them hold limited licenses granted to graduates of foreign
dental schools. Most health center dental directors (87 percent) chose health center practice because they
“felt a mission to the dentally underserved population”. Compared to other Massachusetts dentists, they
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were disproportionately minority (36 percent African- American or Hispanic) and older (49 percent over
50), and earned less (83 percent earn less than $120,000). Among tomorrow’s dentists, the influence of
“care to underserved” in choosing a dental career varies considerably by race and ethnicity. Many more
black and Latino students who graduated in 2008 ranked care to the underserved as influential or very
influential in their career choice as did white students (80.9, 70.1, and 47.2 percent, respectively). These
minority students also expected to treat more underserved individuals in their future practices (36.8 percent
of black, 26.7 percent of Latino, and 6.5 percent of white students expect that 50 percent or more of their
future patients will be from underserved populations), but they comprise only 11 percent of the 2008
graduating classes. Underrepresented minority students’ anticipation of treating more underserved
individuals reflects existing practices of black and Latino dentists. (Brown et al, 2003)
Regarding dental school preparation to care for the underserved, one in six 2008 graduates (16.5
percent) reported being less than prepared to “care for a diverse society,” one in five (22.0 percent) to
“adapt treatment planning for low income individuals,” one in four (23.0 percent) to provide “oral health
care for rural areas,” and one in three (37.7 percent) to “care for the disabled.” The majority (70.5 percent)
agree that “access to care is a major problem in the United States,” and nearly the same numbers (69.5
percent) agree that “providing care to all segments of society is an ethical and professional obligation,” but
fewer students agree that “everyone is entitled to receive basic oral health care regardless of ability to pay”
(59.7 percent). Only one in 50 (1.7 percent) graduating students report a long-term plan to practice in a
“community clinic.”Among 2007 graduates, 1 year after graduation, 2.2 percent were employed by dental
safety net organizations. (Okwuje et al, 2009)
Bailit et al (2006) conducted a study to determine the size and characteristics of the dentally
underserved U.S. population, describe the capacity of the safety net system to treat the underserved, explore
policy options for expanding the system and discuss the policy implications of these findings. The
underserved population was consisting of 82 million people from low-income families. Only 27.8 percent
of this population visits a dentist each year. The primary components of the safety net are dental clinics in
community health centers, hospitals, public schools and dental schools. This system has the capacity to care
for about 7 to 8 million people annually. The politically feasible options for expanding the system include
increasing the number of community clinics and their efficiency, requiring dental school graduates to
receive one year of residency training, and requiring senior dental students and residents to work 60 days in
community clinics and practices. They concluded that the safety net system has limited capacity but could
be improved to care for another 2.5 million people. Even if it is expanded, however, the majority of
low-income patients would need to obtain care in private practices to reduce access disparities. The biggest
challenge is convincing the American people to provide the funds needed to care for the poor in safety net
clinics and private practices. (Balit et al, 2006)
Byck et al (2005) conducted a study to examine the role of community dental safety-net clinics in
providing dental care for these underserved populations. They administered a cross-sectional survey of all
identified safety-net dental clinics in Illinois. Seventy-one of 94 clinics responded (response rate, 76
percent), describing their history, operations, patients, staffing and dentist relationships. An in-depth
analysis of 57 clinics presents comparisons of three categories of clinics, sponsored by community health
8centers (23), local health departments (21) and private service agencies (13). Clinics were distributed
across the state; 80 percent were located in facilities with other health care providers, and all provided
dental care to low-income and other underserved groups. Clinics provided more than 3,100 annual dental
visits, operated with limited staffing and budgets, and had referral relationships with local dentists. Clinics
with full-time dentists or any dental hygienists had higher annual numbers of dental visits. These clinics
provide dental care to groups with traditional access barriers. Although they represent a small portion of all
dental care, their mission and role make them a key component of strategies to address the dental access
problem. Local and state dental practitioners seeking to expand dental access should consider these
community dental safety-net clinics as partners. Efforts to expand these clinics should include considering
optimizing staffing for better dental productivity. (Edelstein, 2009)
8. Policy alternatives
Addressing consequential oral health inequities and safety net inadequacies will require multifactorial
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5. International Affairs and Global Strategy www.iiste.org
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approaches and will therefore require the concerted and cooperative efforts of policymakers from across
domains of government, the health professions, education, research, social service, and the dental industry.
Without question, the single best approach is to dramatically reduce need and demand for conventional
dental treatment by preventing and managing disease, thereby attaining better health at lower costs. To
accomplish this, effective biological and behavioral interventions need to be further developed by scientists,
behaviorists, health educators, social workers, and health professionals; promoted by governmental
payment, workforce, and reporting policies; and institutionalized for the next generation of caregivers
through changes in curricula and experiential education.
The nation’s long-established and new dental schools need to view themselves as having a primary
responsibility to care of the underserved while balancing their educational and research missions. The new
dental schools need to explicitly reference responsibility to care for the underserved in their mission
statements and incorporate community-based learning as core elements of their curricular design. For
example, Western University of Health Sciences College of Dental Medicine, America describes its mission
as training dentists “who will fulfill their professional obligation to improve the oral health of all members
of society, especially those most in need”.
Because private practice dentists constitute the overwhelming majority of care delivery capacity in the
India, any attempt to reduce disparities must find ways to significantly increase private dentists’
participation. Short term, this can be accomplished through efforts ranging from providing outreach to
private practitioners, organizing care facilitation at the community level, contracting between health centers
and private dentists, instituting continuing education of dentists in care of special populations, and
developing local and state level care programs. Longer term, safety net improvements will require active
engagement of tomorrow’s dental professionals. This can result from changes in how students are selected,
trained, licensed, and recognized and rewarded.
We suggest that developing countries like India with sufficient dental manpower resources urgently
need to include dental safety net in public health services. This safety net should target population from low
socio economic status, children and other dependant groups. Dentists have to be employed by the state or
central governments from the available manpower resources. Allied dental health professionals also may
contribute meaningfully to the dental safety net. Basic and emergency oral health care services need to be
provided at these public health centers with provision of preventive care at the core. The next step will be
setting up of health centers where such care could be provided. These centers should be located preferably
within the reach of such population, specifically in rural areas.
9. Conclusion
Ultimate responsibility of the health of its citizen lies with the government. Oral health has not been
included in public health policies in India, a change that could have led to improvement in the differences
in health status of urban and rural population. The government specifically in developing countries needs to
focus on the health of its population irrespective of their ability to pay. Local efforts may also be needed
to engage more private practitioners in care of underserved. The formation and inclusion of dental safety
net in public health services may significantly reduce the oral health differences between the low and high
socio economic classes and thereby improve the oral health status of developing countries.
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