Guidelines on the Allocation and Utilization of Mobile Dental Vehicle (MDV)

December 6, 2018

DOH ADMINISTRATIVE ORDER NO. 2018-0027

 

 

I. RATIONALE:

Oral health is an essential component of general health, and is a major determinant of the quality of life. Unfortunately, oral disease continues to be a serious public health problem in the Philippines. The main oral health problems are dental caries (tooth decay) and periodontal disease (gun disease). The 2011 National Monitoring and Evaluation Dental Survey, showed that 87% of our people are suffering from tooth decay and 48% have gum disease. The combined ill effects of these two major diseases weaken bodily defense and serve as portal of entry to other more serious, potentially dangerous and opportunistic infections overlapping other diseases present. HTcADC

The Department of Health (DOH) envisions quality health care to be more accessible to the poor, GIDA, marginalized and vulnerable population by ensuring the availability of functional static and mobile health facilities, including mobile dental clinics. This will help in addressing the oral health care needs of all the Regional Offices, DOH hospitals, provinces, cities, municipalities, partners and other stakeholders in the country. Further, the DOH has committed to provide mobile dental vehicles, including equipment per province/city/municipality as an initial response to increase oral health care coverage nationwide and to improve oral health status towards promotion, prevention and control of oral diseases among all ages.

II. GENERAL OBJECTIVE:

To provide direction and guidelines on the proper allocation, utilization and maintenance of the Mobile Dental Vehicle (MDV) at the regional/DOH hospitals, provinces, cities, municipalities, partners and other stakeholders.

III. SPECIFIC OBJECTIVES:

With the MDV, the Regional Offices, DOH hospitals, provinces, cities, municipalities, partners and other stakeholders will be able to provide the following:

1. Conduct of oral health advocacy across All Life Stages.

2. Promote supervised tooth brushing drill at the communities, child development centers, schools and institutions. aScITE

3. Provide preventive oral health services.

4. Provide Basic Oral Health Care (BOHC) through:

4.1 Services and activities advancing oral health education and proper tooth brushing techniques.

4.2 Preventive oral health services pit and fissure sealants, atraumatic restorative treatment and application of fluoride varnish to the target population.

4.3 Curative oral health care such as restoration of savable teeth with glass ionomer filling materials and extraction/removal of unsavable teeth to control foci of infection, provision/prescription of medicines when necessary.

4.4 Health education on the harmful effects on the use of unprescribed prosthesis/products (Do-It-Yourself braces, dentures fabricated by unlicensed individual and other oral prosthesis/products purchased online); and

4.5 Risk behavioral education/counseling advice on ill effects of tobacco smoking, betel nut chewing, illicit drugs, alcohol, carbonated and high sugar as well as other sweetened beverages. HEITAD

5. Implementation of infection control practices.

IV. GENERAL GUIDELINES AND PROCEDURES:

This policy shall ensure that the recipient facility or organization shall undertake the following:

1. Use the MDV in the implementation of the Oral Health Program and other oral health related services aimed to improve access to such programs.

2. Use the MDV with available permanent dentist, dental hygienist, dental aide, trained driver, dental supplies, consumables and gasoline.

3. Ensure the rational use of the MDV within the region, province, city or municipality to maximize its benefit to the general public. aDSIHc

4. Ensure preventive maintenance of the MDV including equipment as well as its repair and shall provide safe and permanent parking area for the MDV. In case of theft or misuse of the aforesaid MDV, the recipient shall be responsible to replace all losses.

5. Ensure that the dental unit and chair, equipment, instruments and its accessories shall not be transferred/removed from the MDV.

6. The Regional Oral Health Program Coordinators and the Development Management Officers shall be responsible for monitoring and evaluating the rational use of the MDV at the provincial level.

7. The provincial/city supervising Dentist shall be responsible for monitoring and evaluation of the rational use of the MDV within their jurisdiction. ATICcS

8. The general services shall be responsible for MDV plan, budget, maintenance, comprehensive insurance, security and safety.

9. The MDV shall be secured to avoid being tampered. The DOH LOGO should not be altered for any political agenda or commercial advertisement.

10. Provinces, cities and the municipalities shall submit and update on a monthly basis, a copy of the accomplishment report. Refer to Annex A.

The DOH, upon the recommendation of the Regional Offices, reserves the right to revoke the donation in case any of the aforesaid conditions are not faithfully complied with by the recipients. Moreover, the DOH shall issue a Notice of Revocation and has the right to withdraw or transfer the MDV from the recipient/s including all its accessories and equipment if any of the following grounds are present:

a. Three (3) consecutive monitoring findings of non-compliance to the guidelines shall be grounds for revocation.

b. Alteration and mutilation of MDV

c. Irrational use e.g., political campaigns and personal use

d. Abandoned MDV for six months

e. Absence of preventive maintenance plan

f. Absence of comprehensive updated MDV insurance

V. SPECIFIC GUIDELINES FOR ALLOCATION

Initially, two (2) MDVs per province (i.e., Provincial Health Office) and at least one (1) per city (i.e., City Health Office) were allocated based on the following criteria: (i) prevalence rates of dental caries, decayed, missing and filled teeth (DMFT), and periodontal diseases, (ii) presence of a Public Health Dentist, (iii) with recipients of DOH-Dentists Deployment Project (DDP) and (iv) areas that have poor access to oral health services. TIADCc

For 2019 onwards, the following shall be the additional criteria for allocation of MDVs:

1. Provinces: At least two (2) additional MDVs may be given depending on additional criteria such as population, land area, epidemiological data on oral health. This is subject to the capacity of the province to maintain the additional MDV/s. The MDVs that are given to the Provincial Health Offices (PHOs) shall cater to the different RHUs of all municipalities of each province to make the PhilHealth Oral Health Benefit Package available and accessible to all PhilHealth members.

2. Cities: At least one (1) additional MDV may be given depending on additional criteria such as population, land area, epidemiological data on oral health. This is subject to the capacity of the city to maintain the additional MDV. The MDVs that are given to the City Health Offices (CHOs) shall cater to the different Urban Health Centers (UHCs) to make the PhilHealth Oral Health Benefit Package available and accessible to all PhilHealth members.

3. Selected Municipalities: At least one (1) MDV may be given to selected municipalities depending on additional criteria such as population, geographical location and distance from the nearest City or Provincial Health Offices. The MDVs for the selected municipalities may be allocated to the nearest district hospital or DOH Regional Office/Hospital, if applicable, but shall be for the use of the said municipalities. The MDVs that are given to the selected Municipal Health Offices shall cater to the different Rural Health Units (RHUs) and Barangay Health Stations (BHS) to make the PhilHealth Oral Health Benefit Package available and accessible to all PhilHealth members.

4. Other Health Facilities and Partners: At least one (1) MDV may be given to other health facilities and partners such as Health Services Units or hospitals of the Philippine National Police (PNP) and Armed Forces of the Philippines (AFP); Hospitals of State Universities and Colleges (i.e., UP, WVSU); and DepEd Regional Offices (to address the high ratio of 1 Dentist to 70,000 students). This is depending upon the compliance to the requirements set in requesting for MDVs (Please see section VII of this Order). AIDSTE

5. DOH: At least one (1) MDV may be given to Central and Regional Offices including selected DOH hospitals with positions of a Public Health or hospital Dentist, depending upon the need and compliance to the requirements set in requesting for MDVs (Please see section VII of this Order).

VI. THE FOLLOWING ARE ROLES AND RESPONSIBILITIES OF AGENCIES/OFFICES INVOLVED:

1. DOH-Regional Offices:

1.1 Act as an advisory agency and provide technical assistance to recipients.

1.2 Conduct random monitoring on the use of the MDV.

1.3 Conduct oral health program activities as per request, and

1.4 Collect and consolidate monthly utilization report.

2. Provincial Health Offices:

2.1 Allocate sufficient budget as per attached project proposal and design for oral health program across "All Life Stages"; SDAaTC

2.2 Determine and approve requests from inviting agencies such as municipalities, other National Government Agencies (NGAs), Non-Government Organizations (NGOs), Private Organizations, etc; and

2.3 Assist the municipalities with or without MDV to extend oral health services and oral health promotion at the barangays/communities.

3. Local Government Units:

3.1 Allocate sufficient budget as per attached project proposal and design for oral health program across "All Life Stages";

3.2 Implement efficient public health programs focusing on strengthening promotive and preventive oral health activities;

3.3 Determine and approve requests from inviting agencies such as municipalities, National Government Agencies (NGAs), Non-Government Organizations (NGOs), Private Organizations, etc; and

3.4 Assist the municipalities with or without MDV to extend oral health services at the barangays/communities.

4. Role of Requesting/inviting agencies/host organizations:

4.1 Provide gasoline or fuel for the MDV. acEHCD

4.2 Ensure security and safety of the oral health team and other health workers.

4.3 Ensure convenient venue for participants.

4.4 Provide dental supplies and materials.

4.5 Provide meals for the oral health team, in cases of GIDA areas, they should be responsible for the accommodation of the team.

4.6 Inform the recipient Local Government Unit (LGU) and the general public regarding the schedule of the conduct of the activity and services to be provided.

4.7 In case of negligence on the part of the requesting/inviting agencies/host organization, (e.g., the MDV does not function after its use) the requesting/inviting/host organization will be responsible for repair of the MDV.

4.8 In case of loss of equipment and other accessories, the requesting/inviting agencies/host organization will replace the same; and

4.9 Return the MDV in functioning clean condition and ensure all instruments used have been sterilized and ready for use for the next activity. SDHTEC

5. Function and Duties of the Dental Team

The Dental Team of Regional Offices, DOH Hospitals, Provinces, Cities, Municipalities, Partners and other stakeholders shall have the following functions and duties:

a. Responsible for coordination of activities as advised by the point person which includes proper scheduling of the visit; and

b. Responsible for proper endorsement/instruction to the Oral Health Team point person. A checklist will be provided before and after each use of the MDV including the equipment and its accessories. HSAcaE

c. Ensure strict compliance in accomplishing the Oral Health Form 1 for every patient. Such form must be completely and properly filled up.

d. The team shall secure approved and signed travel order and trip ticket seven (7) days prior to the conduct of the activity.

e. The Dental Hygienist (or Dental Aide) shall be responsible for checking and maintaining records and hand instruments in order and in good working condition likewise observe standard sterilization process of the latter.

f. The assigned Driver shall:

i. Ensure the MDV is functional and in good working condition by keeping the water reservoir full and draining the water tank after every use.

ii. Ensure that the battery is always charged after use and that the belt and lights (warning and information lamps included) are fully functional;

iii. Always check the power inverter component, inverter operation interchange, water pump switch, and emergency switch;

iv. Always drain the Air compressor to avoid water moisture; and

v. Take charge of the entire MDV, change oil, clutch & break fluid, repair and safety of the MDV all the time. HESIcT

VII. PROCEDURE FOR REQUESTING THE SERVICE OF THE MDV AT THE RECIPIENT.

1. Submit a letter of request addressed to the head of office, indicating the date, time of usage and to be submitted fourteen (14) working days prior to the intended use of the MDV.

2. Approval of the request shall be based on the following:

2.1 availability of the assigned driver; and

2.2 oral health team including the driver have been properly oriented on the management of the dental unit.

3. If the oral health team from the recipient is inadequate to address the delivery of service of the expected number of participants, the requesting agency or organization shall provide augmentation of human resource health for the timely, accession and efficient delivery of oral health services.

VIII. EFFECTIVITY

This Order shall take effect immediately. caITAC

(SGD.) FRANCISCO T. DUQUE III, MD, MScSecretary of Health