the seminar focuses on national health policy and how we can implement these policies to promote oral health.

1. Presented By:
Dr. Rohma Yusuf
Mds
1

2. Contents
• INTRODUCTION
• HISTORY
• BASIC CONSIDERATIONS
• HIGHLIGHTS OF NHP 1983 & 2002
• POLICY PRESCRIPTION (2002)
• NHP- 2017
2

3. • NATIONAL ORAL HEALTH POLICY
• NEED FOR ORAL HEALTH POLICY
• TEN POINT RESOLUTION
• KARNATAKA STATE HEALTH POLICY
• PLAN OF EXTENDING MINIMUM ORAL HEALTH CARE
• RECENT AFFAIR
• CHALLENGES
• CONCLUSION
• REFERENCES
3

4. INTRODUCTION
• In recent times, economists at the World Bank and the
International Monetary Fund (IMF) have tentatively
suggested that within a year or two, India’s economy
might be growing more quickly than that of China.
• In spite of its tremendous potential, manpower
resource and growing economy, India stands behind
in terms of education, standard of living and in
particular health.
4

5. • Oral diseases remained still a public health problem for
developed countries and a burden for developing
countries like India especially among the rural
population.
• India is predominantly rural covering about 69% of the
population.
• Prevalence of oral diseases is very high in India with
dental caries and periodontal diseases as the 2 most
common oral diseases.
5

6. • Every country develops its own health policy aimed
at defined goals.
• National health programs are launched by the
government of India for control/ eradication of
communicable disease, environmental sanitation,
nutrition, population control and rural health.
6

7. • Government of India (GoI) put a step forward to
enhance the healthcare system by introducing
National Health Policy (1983) which was reformed to
lay down a new policy structure for the speedy
achievement of the public health goals in 2002.
7

8. HISTORY
8

9. • Health planning in India can be seen as pre and
post independence.
Health planning in india-
pre- independence
Health planning in india-
post independence
9

10. • The most comprehensive health policy was prepared in
India on the eve of Independence in 1946.
• This was the ‘Health Survey and Development
Committee Report’ popularly referred to as the Bhore
Committee.
• This Committee prepared a detailed plan of a National
Health Service for the country, which would provide a
universal coverage to the entire population free of charges
through comprehensive state run salaried health service.
10

11. HEALTH PLANNING IN INDIA- POST
INDEPENDENCE
• National health committees
• Planning Commission
• Five year plans
• National Health Policy
11

12. • In the Five Year Plans, the health sector constituted
schemes that had targets to be fulfilled.
• During the first two Five Year Plans the basic structural
framework of the public health care delivery system
remained unchanged.
• To evaluate the progress made in the first two plans and
to draw up recommendations for the future path of
development of health services the Mudaliar Committee
was set up.
12

13. • 1950s and 1960s - focus of the health sector was to
manage epidemics.
• Mass campaigns - eradicate various diseases.
• Separate countrywide campaigns with a techno-
centric approach were launched against:-
▫ Malaria
▫ Smallpox
▫ Tuberculosis
▫ Leprosy
▫ Filaria
▫ Cholera.
• In India until 1983 there was no formal health policy
statement.
13

14. BASIC CONSIDERATION
• HEALTH
Health is a state of complete physical, mental and
social well-being and not merely the absence of
disease or infirmity.
14

15. • ORAL HEALTH
The World Health Organization defines oral health as a
“state of being free from chronic mouth and facial
pain, oral and throat cancer, oral sores, birth defects
such as cleft lip and palate, periodontal (gum)
disease, tooth decay and tooth loss, and other diseases
and disorders that affect the oral cavity”.
15

16. • POLICY
Course or principle of action adopted by the Government.
• HEALTH POLICY
Is an statement of an authority adopted by the
Government or public in order to improve the health
services.
• NATIONAL HEALTH POLICY
It is an expression of goals for improving the health, the
priorities among these goals, and the main directions for
attaining them for a nation.
16

17. NATIONAL HEALTH POLICY- 1983
• India had its first national health policy in 1983 i.e.
36 years after independence.
• In the circumstances then prevailing, this policy
provided the initiatives like:
a. Comprehensive health care linking with extension
and health education.
b. Intermediation by health volunteers.
c. Decentralisation to reduce burden of high level
referral system.
d. To make government facility limited to eligible poor,
by private investment for patients who can pay.
17

18. • The noteworthy initiatives under that policy were:-
• A phased, time-based bound program for setting up a
well dispersed network of comprehensive primary
health care services, linked with extension and health
education, designed in the context of the ground
reality that elementary health problems can be
resolved by the people
themselves.
18

19. • Government initiatives in the public health sector
have recorded some noteworthy successes over time.
• Smallpox and Guinea Worm Disease have been
eradicated from the country.
• Polio is on the verge of being eradicated.
• Leprosy, Kala Azar, and Filariasis can be expected to
be eliminated in the future.
19

20. • There has been a substantial drop in the Total Fertility
Rate and Infant Mortality Rate.
• The success of the initiatives taken in the public
health field are reflected in the progressive
improvement of many demographic /
epidemiological/ infrastructural indicators over time.
20

21. Comments
• It does not speak about social injustice- an essential
prerequisite for Health for All.
• No definite program – to promote community
participation in health.
• No mention - health budget
• Does not emphasis on: –
Accident Prevention,
 Geriatric Care
 Non- Communicable Disease Like Obesity,
Coronary Heart Disease
 Disease Related To Use Of Tobacco, Alcohol, Drugs,
Etc.
21

22. NHP- 2002
• A revised health policy for achieving better health
care and unmet goals has been brought out by
government of India- National Health Policy 2002.
• According to this revised policy, government and
health professionals are obligated to render good
health care to the society.
• Optimizing the use of health service to a large group
rather than a small group is a foreseen event by the
NHP 2002.
22

23. Objectives
• Achieving an acceptable standard of good health of
Indian Population.
• Decentralizing public health system by upgrading
infrastructure in existing institutions.
• Ensuring a more equitable access to health service
across the social and geographical expanse of India.
23

24. • Enhancing the contribution of private sector in
providing health service for people who can afford to
pay.
• Emphasizing rational use of drugs.
• Increasing access to tried systems of Traditional
Medicine.
24

25. Policy prescription
25

26. 26

27. • 1. Financial Resources:
• The Central Government will play a key role in
augmenting public health investments.
• Taking into account the gap in health care facilities, it
is planned, under the policy to increase health sector
expenditure to 6 percent of GDP, with 2 percent of
GDP being contributed as public health investment,
by the year 2010.
27

28. • 2. Equity:
• To meet the objective of reducing various types of
inequities and imbalances – inter-regional, across the
rural – urban divide and between economic classes.
• The Policy projects that the increase aggregate
outlays for the primary health sector will be utilized
for strengthening existing facilities and opening
additional public health service outlets, consistent
with the norms for such facilities.
28

29. • 3. Delivery Of National Public Health Programme:
• This policy is a key role for the Central Government
in designing national programmes with the active
participation of the State Governments.
• Vertical programmes for control of major diseases like
TB, Malaria, HIV/AIDS, and Universal Immunization
Programmes, would need to be continued till
moderate levels of prevalence are reached.
29

30. • 4. State Of Public Health Infrastructure:
• The Policy envisages restarting of the Primary Health
System by providing some essential drugs under
Central Government funding through the
decentralized health system.
• Policy recognizes - frequent in-service training of
public health medical personnel, at the level of
medical officers as well as paramedics.
30

31. • 5. Extending Public Health Services:
• The policy envisages the need for expanding the pool of
medical practitioners to include practitioners of Indian
Systems of Medicine and Homoeopathy.
• These extended areas of functioning of different
categories of medical manpower can be permitted, after
adequate training.
• State Governments could also rigorously enforce a
mandatory two-year rural posting before the awarding of
the graduate degree.
31

32. • 6.Role Of Local Self Government Institutions:
• The Policy urges all State Governments to consider
decentralizing the implementation of the programmes
to local self- government Institutions by 2005.
• To achieve this, financial incentives will be provided
by the Central Government.
32

33. • 7. Norms For Healthcare Personnel:
• Minimal norms for the deployment of doctors and
nurses in medical institutions need to be introduced
urgently under the provisions of the Indian Medical
Council Act and Indian Nursing Council Act.
• These norms can be progressively reviewed and
made more stringent as the medical institutions
improve their capacity for meeting better normative
standards.
33

34. • 8. Education Of Healthcare Professionals:
• This policy envisages the setting up of a Medical
Grants Commission for funding new Government
Medical and Dental Colleges in different parts of the
country.
• Upgradation of the infrastructure of the existing
Government Medical and Dental Colleges to ensure
an improved standard of medical education.
34

35. • policy identifies a significant need to Modify the existing
curriculum
• The Policy also recommends a periodic skill updating of
working health professionals through a system of
continuing medical education.
• The Policy emphasises the need to expose medical
students, through the undergraduate syllabus, to the
emerging concerns for geriatric disorders, as also to the
cutting edge disciplines of contemporary medical
research.
35

36. • 9. Need For Specialists In Public Health And Family
Medicine:
• To alleviate the acute shortage of medical personnel
with specialization implementation of mandatory
norms to raise the proportion of postgraduate seats in
these discipline in medical training institutions, to
reach a stage wherein 1/4th of the seats are for these
disciplines.
36

37. • Specialization in Public health may be encouraged
not only for medical doctors, but also for non-
medical graduates from the allied fields of public
health engineering, microbiology and other natural
sciences.
• 10. Nursing Personnel:
• The policy emphasizes the need for an improvement
in the ratio of nurses, doctors/beds.
37

38. • 11. Use Of Generic Drugs And Vaccines:
• There is a need for basic treatment regimens, on a
limited number of essential drugs.
• Cost-effective.
• Prohibit the use of proprietary drugs, except in
special circumstances.
• Not less than 50% of the requirement of vaccines/sera
be sourced from public sector institutions.
38

39. • 12. Urban Health:
• Setting - organized urban primary health care
structure.
• Adoption - population norms for its infrastructure.
• Funding will be by the local, State and Central
Governments.
• Establishment of fully-equipped ‘hubspoke’ trauma
care networks in large urban agglomerations to
reduce accident mortality.
39

40. • 13. Mental Health:
• A network of decentralised mental health services for
more common disorders.
• Upgrading of the physical infrastructure of mental
health institutions at Central Government expense.
40

41. • 14. Information, Education And Communication
(IEC):
• Information to those population groups which cannot
be effectively approached by using only the mass
media.
• The focus on the inter-personal communication of
information and by folk and other traditional media to
bring about behavioural change.
• The community leaders- particularly religious
leaders, are effective in imparting knowledge for
behavioural change.
41

42. • School health programs are the most cost-effective
intervention - improves the level of awareness of
future generation.
42

43. • 15. Health Research:
• Domestic medical research would be focused on new
therapeutic drugs and vaccines for TB and Malaria,
also on the sub-types of HIV/AIDS prevalent in the
country.
• Increase in Government-funded health research
 to a level of 1% of the total health spending by 2005
and
 up to 2 % by 2010.
43

44. • Emphasis on time-bound applied research for
developing operational applications.
• This would ensure the cost-effective of existing /
future therapeutic drugs/vaccines for the general
population.
44

45. • 16. Role Of Private Sector:
• This Policy welcomes the participation of the private
sector in all areas of health activities.
• Setting up of private insurance instruments for
increasing the scope of the coverage of the secondary
and tertiary sector under private health insurance
packages.
45

46. • Applications of tele-medicine in the health care
sector.
• A legislation for regulating minimum infrastructure
and quality standards in clinical establishment of
medical institutions by 2003.
46

47. • 17. Role Of Civil Society:
• Contribution of NGOs and other institutions of the
civil society in making available health services to
the community.
• The disease control programmes should have a
definite portion of budget.
47

48. • 18. National Disease Surveillance Network:
• Integrated disease control network from the lowest
public health administration to the Central
Government, by 2005.
• Installation of data-base handling hardware
• In-house training for data collection.
48

49. • 19. Health Statistics:
• National health accounts and accounting systems
would pave the way for decision-makers to focus on
relative priorities.
• Periodic updating of these baseline estimates through
representative sampling,
under an appropriate statistical
methodology.
49

50. • 20. Women’s Health:
• Women - under-privileged groups with low access to
health care.
• The expansion of primary health sector infrastructure
to facilitate the increased access of women to basic
health care.
50

51. • Highest priority of the Central Government to the
funding - programmes relating to woman’s health.
• The need to review the staffing norms of the public
health administration to meet the specific
requirements of women in a more comprehensive
manner.
51

52. • 21. Medical Ethics:
• A contemporary code of ethics be notified and
rigorously implemented by the Medical Council of
India.
52

53. • 21. Enforcement Of Quality Standards For Food And
Drugs:
• Food and drug administration will be progressively
strengthened, in terms of both laboratory facilities
and technical expertise.
• food standards will be close, if not equivalent, to
Codex specifications; and that drug standards will be
at par with the most rigorous ones adopted elsewhere.
53

54. • 23. Regulation Of Standards In Paramedical Discipline:
• Need for the establishment of professional councils
for paramedical disciplines to register practitioners,
maintain standards of training, and monitor
performance.
54

55. • 24. Enviromental And Occupational Health:
• The periodic screening of the health conditions of the
workers, particularly for high- risk health disorders
associated with their occupation.
• 25. Providing Medical Facilities To Users From
Overseas:
• The services to patients from overseas will be encouraged
by extending to their earnings in foreign exchange.
55

56. • 26. Impact Of Gobalization On Health Sector:
• The Policy takes into account the serious
apprehension, expressed by several health experts, as
a result of a sharp increase in the prices of drugs and
vaccines.
56

57. Goals to be achieved by 2015
57

58. 58

59. Achievements
• 2003 –
• Enactment of legislation for regulating minimum
standard in clinical Establishment / Medical
institution
• 2005-
• Eradication of Poliomyelitis is missed ,however there
is zero reporting of yaws since 2004.
59

60. • Leprosy has been declared eliminated according to
the criteria fixed by WHO. However, more efforts are
required.
• Integrated Disease Surveillance Project has been
launched but establishment of National Health
Accounts and Health Statistics is still lagging behind.
IDSP is also going at a slow pace.
60

61. • Spending of state Sector Health has not much
increased as planned from 5.5% to7.7% of budget.
• Budget for medical research is not much increased as
1% of the total health budget for Medical Research
has been targeted.
• Decentralization of implementation of public health
Programs:
• National Rural Health Mission has been launched in
this direction.
• 2007-
• Achieve of REDUCTION of HIV/AIDS
61

62. 62

63. NATIONAL HEALTH POLICY- 2017
• It was approved on 15th march 2017.
• The policy is patient centric and quality driven.
• It addresses health security and make in India for
drugs and devices.
63

64. 64

65. Objective
To achieve highest possible level of good health and
well being, through preventive and promotive health
care.
To achieve universal access to good quality health
services without anyone having to face financial
hardship as a consequence.
65

66. Policy proposes free drugs, diagnostics and emergency
care services in all public hospitals.
It envisages strategic purchase of secondary and tertiary
care services to supplement and fill the critical gaps in
health system.
Policy proposes raising public health expenditure to 2.5%
of the GDP in a time bound manner
Policy provides assures package of comprehensive PHC
through health and wellness centres.
66

67. • Assigning of specific quantitative targets aimed at
reducing the disease prevalence/incidence, health
system performance.
• Strengthens the health surveillance system and
establishing registries for diseases of public health
importance by 2020.
• Primary aim of the policy is to inform, clarify,
strengthen and prioritize the role of government in
shaping the health system in all its dimensions.
67

68. • Principles of policy:
1. Professionalism
2. Integrity and ethics
3. Respect for the dignity and personhood of all people.
4. Equity
5. Affordability
6. Universality
7. Patient centered and quality of care
8. Accountability and pluralism
68

69. • Policy affirms commitment to pre-emptive care to
achieve optimum levels of child and adolscent health.
• Policy envisages school health programmes as a
major focus area.
• To leverage the pluralistic health care, policy
recommends mainstreaming different health systems
like AYUSH.
• Policy proposes establishment of national digital
health authority to regulate, develop, and deploy
digital health.
69

70. NATIONAL ORAL HEALTH POLICY
70

71. • In 1984, national workshops were organized in
Bombay on oral health targets for India and in the
year 1986, ORAL HEALTH POLICY was
conscripted by Indian Dental Association (IDA).
• However, to reduce the morbidity of the oral-related
diseases, no much work has been done till date.
71

72. • Based on the recommendation of Indian Dental
Association, 2 more national workshops were organized,
one at Delhi in 1991 and the other at Mysore after 3
years.
• Through the input of these 2 workshops National Oral
Health Policy has been developed by Dental Council of
India (DCI).
72

73. • There has been a significant changes in the
determinant factors relating to health sector
necessitating a revision of policy in 2002, But;
• Oral health still did not find its place due to:
Lack of awareness in the masses about the
prevalence and severity of dental diseases.
Oral disease are not life threatening or severely
debilitating.
The fact that oral diseases are almost preventable
by simple and low cost means and is not in the
knowledge of authorities responsible for
formulating the national health policy.
73

74. • 8th October 1985 a committee headed by Dr. Mrs.
Amrit Tewari submitted a draft plan of “National
Oral Health Policy for INDIA” to the MOH union
government India.
74

75. NEED FOR ORAL HEALTH POLICY
75

76. 1.INCREASING PREVALENCE AND SEVERITY
OF DENTAL DISEASES:
• Dental caries has been increasing both in prevalence
and severity over the last three decades.
• In 1940-1950, prevalence reported has been 40-50%
with an average DMFT of 1.5
76

77. • In 1980-1990, prevalence reported has been increased to
80% with an average DMFT of 5 in urban and 4 in rural
areas.
• Periodontal disease prevalence has been in the range of
90-100% in various age groups.
• The above facts have been stressed by a number of
national level workshops.
77

78. 2.DENTIST POPULATION RATIO:
There were only 35,000 dentists serving the entire
population of 90 crores in 1990’s.
90% of them were in cities, only 10% in rural areas with a
population of over 75%.
 The current dentist–population
ratio is reported to be 1:8,000 in
urban and 1:50,000 in rural areas.
https://medical.prepladder.com/dental/721-the-imbalance-of-dentist-patient-
population-ratio.Published: Wednesday, 31 May 2017 17:50
78

79. 3.CRIPPLING NATURE OF ORAL DISEASE:
 85% of children and 95- 100% of adults were suffering
from periodontal disease.
 80-85% of children were suffering from dental caries.
 The pus oozing pocket of periodontal disease of adults
act as a focus of infection for other vital organs of body.
79

80.  The dental caries with its crippling effect can lead to
more malnutrition as the young adults would not be
able to chew any coarse food.
 35% of all body cancers are oral cancer, most of
them are preventable.
 35% of children suffer from malaligned teeth and
jaws affecting proper function.
80

81. 4.IMPELLING ECONOMIC REASONS FOR EARLY
RECOGNITION AND PREVENTION OF ORAL
DIEASES:
 Dental caries is an expensive disease which causes
economic losses both to the individual and to the country.
 India spends approximately 1 to 1.5 % of total national
budget on health and as there is no specific allocation for
oral health budget.
81

82.  Water fluoridation, one of the preventive measures
for dental caries was recommended in the 12th 5-year
plan without any proposed strategies for its
implementation.
82

83. 5.PREVENTION OF ORAL DISEASES --- THE ONLY
ALTERNATIVE:
 The upward trend of dental caries could be effectively
checked by the implementation of organized oral health
preventive programmes at the community level.
 The methods used for primary prevention of dental
caries also achieves primary prevention of periodontal
disease and oral cancer.
83

84. A TEN POINT RESOLUTION
• The core committee appointed by Ministry of Health
and Family Welfare (Central Council of Health &
Family Welfare), accepted national oral health policy
as a component of NHP and moved a 10 point
resolution in its fourth conference in the year 1995.
84

85. 1. There is an urgent need for an Oral health Policy for
the nation as an integral part of the National Oral
Health Care Programme Health Policy.
2. Special, well coordinated, National Oral Health Care
Programme be launched to provide Oral Health Care,
both in the rural as well as urban areas due to
deteriorating oral health conditions in the country as
revealed by various epidemiological studies.
85

86. • Also, it is important to launch preventive, curative
and educational oral health care programmes
integrated into the existing system utilizing the
existing health and educational infrastructure in the
rural, urban and deprived areas.
86

87. 3. A post of full time Dental Advisor at appropriate
level in the Dte. G.H.S. should be created as a first
step towards strengthening the technical wing of the
Dte.GHS in this regard.
4. Studies have revealed that dental diseases have been
increasing both in prevalence and severity over the
last few decades. There is an urgent need to prevent
the rising dental diseases in India.
87

88. 5. The Council, therefore, resolves that preventive and
promotive Oral Health Services be introduced from
the village level onwards and accordingly a pilot
project on Oral Health Care may be launched by the
Ministry of Health & Family Welfare during 1995-96
in five districts, one in each in five states.
6.warning on the wrappers and advertisement of
sweets, chocolates and other retentive sugar eatables
TOO MUCH EATING SWEETS MAY LEAD TO
DECAY OF TOOTH.
Similar measures are called for tobacco and pan
masala related products.
88

89. 7.National Training Centre to be established or the
existing centers be strengthened for training of
various categories of oral health care personnel.
8. All District Hospitals and Community Health
Centres have dental clinics. All Dental Colleges
should have courses on Dental
Hygienists and Dental Technicians.
89

90. 9. The Council further resolves that the Pilot Project
may be extended to all the States at the rate of one
District in every State.
10. The Council resolves that there is an urgent need to
have a National Oral Health Care Programme
Institute for Dental Research to guide oral health
research appropriate to the needs of the country.
90

91. KARNATAKA STATE HEALTH
POLICY- 2004
91

92. • Karnataka formally adopted an integrated health
policy combining health services, systems and social
determinants of health on 10th February, 2004.
92

93. KARNATAKA HEALTH POLICY GOALS
1. To provide integrated and comprehensive primary
health care.
2. To establish a credible and sustainable referral system.
3. To establish equity in delivery of quality health care.
4. To encourage greater public private partnership in
provision of quality health care.
5. in order to better serve the underserved areas.
93

94. 6. To address emerging issues in public health.
7. To strengthen health infrastructure.
8. To develop health human resources.
9. To improve the access to safe and quality drugs at
affordable prices.
10. To increase access to systems of alternative
medicine.
94

95. Dental Health / Oral Health:
• The awareness about dental health care is poor
especially in rural areas.
• The increased life expectancy of the population and
widespread prevalence of oral diseases warrants a
serious thought for immediate strengthening of the
existing oral health delivery system in the state.
95

96. The establishment of a three tier Oral Health Care
delivery system in Karnataka would be planned, namely:
96

97. • Other strategies include:
• Proper utilization of mass media for regular Oral
Health Education.
• Involvement of local non-governmental agencies in
programme operation for better implementation of
the programme.
• Programme for increasing awareness amongst
School teachers regarding Oral Health.
97

98. • Apart from the Government Dental College,
Bangalore, other good Dental Colleges in each
division would be identified so that such colleges,
dental association and other social organization adopt
some villages for comprehensive dental care delivery.
98

99. PLAN OF EXTENDING MINIMUM
ORAL HEALTH CARE TO THE
ENTIRE INDIAN POPULATION
99

100. Plan For Rural India.
PHASE I
▫ To provide primary prevention to the population
and handling of emergencies.
PHASE II
▫ Provision of at least one dentist at primary health
center with efficient equipment and the provision of
mobile dental clinics.
PHASE III
▫ Provision of oral health auxiliaries attached to the
dentist and in the periphery.
100

101. PHASE I
To Provide Primary Prevention to the Population
and Handling of Emergencies
1) Preventive package.
2) Oral Health Education: children with specific ages,
expectant mothers ,adult community.
3) Plaque Control- Proper cleaning of the teeth to remove
dental plaque.
4) Use of Fluorides
5) Water Fluorination - Feasibility of water fluoridation in
India
6) Fluoride Mouth Rinses - weekly or fortnightly
7) Topical Application of Fluoride – every six months
8) Fluoride Tooth Paste - daily
9) Dietary Counseling.
101

102. TRAINING OF THE TRAINERS FOR TRAINING
THE HEALTH TEAM
Union Government with the help of the council can
identify a center which would have the capability of
training the existing health infrastructure
 i.e., Medical Doctors, Multipurpose workers,
Health guides.
The education material for the education of the
community by the health guides and multipurpose
workers, and school children in various age groups
by the school teachers have also to be prepared and
standardized.
102

103. Take the responsibility of training:
6 dentists from each State including 2 from each
dental college and 4 from each Union Territory.
These trained dentists should further be made
responsible to conduct training programmes for the
health staff at the PHCs in their states.
103

104. PHASE II
Provision of at least one Dentist at PHC with
Efficient Equipment by the year 1990
Mobile Dental Clinics
104

105. Phase III
Provision of Oral Health Auxiliaries Attached to the
Dentist and in the Periphery
105

106. Strategies Of Oral Health Care In Urban Areas
1. Involvement and reorientation of the dentists working
in urban areas.
2. Implementation of primary preventive package
through the school health schemes in the different
urban areas.
106

107. 3. Involvement, education and motivation of the teachers in
the various schools/colleges and other educational
institutions in the urban areas for the delivery of
primary preventive package to the school/college going
children and young adults.
4. Exploration and involvement of other voluntary (Rotary
club, Lion's club, YMCA, YWC etc.) and health
organization working in different urban areas in
achieving the oral health targets.
107

108. UTILIZATION OF THE MASS MEDIA
• With the help of the Ministry Of Mass
Communication some short- 2-3 minute films can be
made to be projected in television at peak hours and
also with clearly defined radio messages and flashes
108

109. REORIENTATION OF DENTAL EDUCATION
IN INDIA
• As already envisaged in the plan two teachers
(dentists) from each dental college
• One of the important components should be that out
of one year internship, six months be spent in the
rural areas.
109

110. INVOLVEMENT OF OTHER ALLIED
DEPARTMENTS
Education and social welfare
Include chapters giving adequate knowledge about
oral diseases and their prevention in the text books of
class 4th, 7th and 9th.
Ministry of finance and commerce
Tax provision
Removal of excise duty etc
110

111. SETTING UP OF APEX BODIES OF DENTAL
EDUCATION AND RESEARCH
• In the beginning at least one such institute of national
importance be set up for oral health where meaningful
research applicable to Indian conditions can be carried out
systematically;
1- There should be a statutory warning on the wrappers of
all sweets, chocolates and other retentive sugar eatables
"Eating sweets leads to decay of the teeth". For this
purpose appropriate Ministry to be contacted.
111

112. 2- Tooth brush and fluoride tooth paste and 2 mg
sodium fluoride tablets are the most essential
components in the prevention of dental caries and
periodontal diseases.
3- Dental treatment should be made available to low
income groups by rendering subsidized dental
services and providing dental insurance to workers.
112

113.  No sale tax or excise duty on equipment and materials
for dentists setting up private practice in rural areas.
The cost of dental treatment should be brought down
by reducing excise duty, custom duty and taxes and
categorizing all dental instruments and materials under
the category of 'Dentistry' (Ministry of Commerce
and Finance).
113

114.  A job of Additional Director General Health
Services (oral health) be created in the Directorate of
Health Services who should be responsible for
looking after the oral health of the country.
114

115. • After 3 years(1999), National Oral Health Care
Program (NOHCP), a project of Directorate General
Of Health Services (DGHS) and Ministry of Health
and Family Welfare was initiated and launched on a
pilot basis.
• Later the Department of Oral and Maxillofacial
Surgery, All India Institute of Medical Sciences
(AIIMS) was given the charge to execute it.
115

116. • NOHCP, initiated as a “Pilot Project” in 5 states (Delhi,
Punjab, Maharashtra, Kerala, and North Eastern states),
in the process of achieving the goals of national oral
health policy.
• Single district from each above-mentioned were selected
to trial the strategies generated through 2 national and 4
regional workshops held in collaboration with AIIMS,
New Delhi, in different areas of the country.
116

117. • The strategies of this program include:
• Oral health education with information,
• Education and communication (IEC) materials by
involving health workers, School children, teachers and
mass media,
• Formulation of basic package on rural healthcare,
• Man-power and infrastructure development,
• Mobile dental clinic services for rural people,
• Public health as well as research monitoring.
117

118. 118

119. 119

120. • In 2006, a collaborative program between GoI and
WHO was held and this workshop suggested methods
to expand the role of dental work force in NRHMs.
• Apart from these, National Cancer Control Program,
National Tobacco Control Program, National Rural
Health Missions, and School Health Program are
giving negligible importance to oral health.
120

121. • Oral health policy - phase 1 was initiated with an
objective to provide free dentures to the needy senior
citizens of Karnataka who were below poverty line
and a draft was prepared proposing 5
recommendations.
• It was implemented in March 2014.
121

122. • In the 11th 5-year plan it was proposed to set up new
dental colleges in the underserved areas.
• Till today, there is no separate budget allocation for
oral health in national or in most of states’ health
budget.
• In the 12th 5-year plan no major discussion was
made on oral health except for that at present no more
dental colleges are required.
122

123. • Uttar Pradesh to become second state after
Karnataka to have state-specific health policy.
• The Uttar Pradesh government is in the process of
finalizing the state's first-ever state health policy and it is
likely to be notified after the Cabinet's approval in the
next three months; as said by Principal Secretary, Health,
Prashant Trivedi.
www.firstpost.com Published Date: Jan 23, 2018 08:49 AM | Updated Date: Jan 23, 2018
08:49 AM
123

124. The policy would be tailor-made for the state, as per
its requirements and available resources.
• This included:
▫ Raising a separate public health cadre, which was
separate from the clinical cadre,
▫ Associating nursing schools in all districts with
hospitals,
▫ Increasing the number of doctors, nurses, para-medical
staff both in number and also quality,
124

125. ▫ Introduction and promotion of tele-medicine,
▫ Establishing mobile medical units,
▫ Availability of generic drugs and
▫ Implementation of the existing policies.
125

126. CHALLENGES
1- Educating all including those in most deprived areas
with “facts of oral health” remained a challenge even
today.
2- Production of eligible dental healthcare planners
with necessary training is one of the challenges for
expanding oral healthcare.
126

127. 3- Absence of surveillance of oral healthcare services
which is helpful to direct planners;
4- Lack of dentists in the government decision-making
bodies,
5- Inability to generate manpower of good quality
according to the changing needs of the society.
127

128. • It is very much essential to provide the new dentists
with adequate, reputable, and good salaried job
opportunities devoid of rural-urban inequality which
appear to be the root of all issues the dental
profession is facing today in India.
128

129. • Barriers in rural health promotion include:
• Least priority to oral health by policy-makers,
• Possibility of neglected risk to human life because of oral
diseases,
• Inadequate information about burden of oro-dental problems,
• Expensiveness of oral treatments,
• Lack of awareness in dental graduates in their responsibilities
towards the society,
• Underutilization of internship program by dental colleges,
• Lack of resources to the fastest growing population,
• Overlooking of geriatric population.
129

130. CONCLUSION
• It is time that the responsibility of oral healthcare of
citizens are to be in the hands of governments. For
discharging their obligation of assuring healthy
smiles to their public, governments require a policy.
130

131. • All the queries in attaining oral health for all can be
answered by oral health policy. There is an urgent
need for implementation of the drafted oral health
policy with modification that suits the rapidly
changing oral health system of this country.
131

132. • Indian government needs to set up a committee by
involving dental professionals to plan to reduce the
oral disease burden of the country in a more
comprehensive and practical approach.
132

133. REFERENCES
133

134. 134