QUALITY OF DENTAL SERVICES In The Philippines MANUEL F. CALONGE, DDM, DDPH Chief Health Program Officer Department of Health Philippines

Current Oral Health Status of the Filipinos

Prevalence of the Two Most Common Oral Diseases, Philippines 1987 -2011

Prevalence of Dental Caries by Age and Gender, Philippines, 2011

Average Decayed, Missing, Filled Teeth (XDMFT) in the Philippines by Age Group, 2011

Average Decayed, Missing, Filled Teeth (XDMFT) in the Philippines by Age Group, 1987 – 2011 Mean DMFT Decreasing

Average DMFT 12 Years Old, ASEAN Nations

Quality of Dental Services in the Philippines

Psychosocial Survey, DOH, 2011 Only 45.3% of the Filipinos consult a dentist at least once a year. Majority (67%) do not consult a dentist even if needed and this is primarily due to financial problem (63%) There is preference for public health personnel (60%) over private practitioners (29%) as providers of dental services. Trust and confidence in the dentist’s ability to deliver health services and prescribe medicine is high (92%).

Some Major Factors affecting Quality Dental Care in the Philippines Clinical Practice Guidelines were not being followed in some dental procedures (use of x-ray during tooth extraction, hospital charting ) Illegal practice (ortho, prostho) Poor infection control practices Unmaintained/incomplete dental facilities High costs of dental care Proliferation of the selling of do-it-yourself (DIY) dental products/supplies/ appliances (dental brackets/ retainers) Availability of dental manpower in rural and far-flung communities

Efforts to Improve Quality of Dental Services in the country

Present Oral Health Care Delivery System in the Philippines Department of Health – Formulates national policies and guidelines, conducts health promotion, advocacy, research, provides technical assistance to stakeholders Government Hospitals– under the supervision of the DOH, provide hospital dental care to in-patient and out-patient (promotive, preventive, curative and rehabilitative care) Local Government Units– Province/city/municipality/barangay – implement Comprehensive Oral Health Program/Provide Basic Oral Health Care Department of Education – formulates/develops and implements school oral health programs and projects for school children ages 6 to 12 years old ( EHCS, Healthy Smile, etc) Armed Forces of the Philippines/Philippine National Police – provides oral care to the members of the military and their dependents (Promotive, preventive, curative) Occupational Dental Health Services – companies provides emergency, preventive and curative oral services to their employees and dependents (free or through salary deduction) Private School Dental Services – provides limited oral services to their students- dental fees are incorporated in the students tuition fees

Current Initiatives to Improve Quality of Dental Services in the Philippines Support the statement of WHO policy paper on Mercury in Health Care and UNEP regarding the use of amalgam-The DOH issued an Administrative Order in 2008 for the Gradual Phase-out of Mercury in the Philippines Health Care Facilities and Institutions Policy of Infection Control for Dental Health Services in the Philippines (1998)- standardized the measures in the prevention of cross infection in the dental clinic Philippine Dental Health Law, 2007 – only trained and licensed dentists can manipulate the oral cavity Regulating the Dental Prosthetic Laboratories Philippine Dental Association Memo to all members: “No extaction policy during outreach missions” to prevent cross infection and post-operative infection

The Philippines Health Goal To address inequity in health care specifically to the poorest of the poor families in the Philippines Our government’s health agenda is very mindful of the plight of the poorest of the poor families in the Philippines as they continue to suffer from morbidity to mortality unless the health system can sustain equitable and accessible health care services. Kalusugan Pangkalahatan (KP) or Universal Health Care has been launched to address these challenges. Through attainment of Universal Health Care or Kalusugan Pangkalahatan (KP)

Universal Health Care Universal Health Care (UHC) is the DOH health agenda to ensure that Filipinos, particularly the poor, are: Able to avail of quality health goods and services at affordable cost when enrolled in the National Health Insurance Program; and Cared for in modern health care facilities and by competent and caring health providers at all levels. Prevented from falling ill when there is improved access to preventive and promotive health goods and services to improve health outcomes and attain health-related MDGs; Universal Health Care is the Aquino administration’s health agenda to ensure that all Filipinos, beginning with the poor, are 1) Able to use quality health services at affordable cost, by being enrolled in the National Health Insurance Program; 2) Cared for in modern health care facilities; and 3) Prevented from falling ill by using public health services to improve health outcomes and attain health-related Millennium Development Goals (MDGs).   Given limited resources, UHC implementation will initially focus on the poor and the informal sector (Q1 and Q2) (Phase 1) and progressively include health benefits of all sectors (Q3, Q4 and Q5) (Phase 2), especially the formal sector and the non-poor informal sector.

STAKEHOLDERS’ SUMMIT ON THE ORAL HEALTH OF FILIPINOS, July, 2014

Vision for the oral health of Filipinos in the next 3 years Financing National Health Insurance Program (PhilHealth) to cover dental health packages Outpatient dental care to be covered by dental insurance Governance In 4 years, proper information campaign, sufficient financial support from the government, restoration of a Dental Health Service in the DOH

Vision for the oral health of Filipinos in the next 3 years Equity and Access All dentists think of equity and quality of health/care Affordable oral health care for the less fortunate in the hospital All Filipinos with access to free oral health care Coalition A WHO Collaboration Center be established in the Philippines Everyone and every agency working together Interdisciplinary oral health teams

Vision for the oral health of Filipinos in the next 3 years Oral diseases The poor and senior citizens with healthy teeth DMFT reduced by 50% Prevalence of dental caries reduced by at least 40% Training and Education Schools playing a bigger role in caries prevention Dental curriculum re-oriented from treatment to prevention

Vision for the oral health of Filipinos in the next 3 years Health workforce Oral health given priority with adequate and competent health work force Information The Collaboration Center providing data on oral health

Thank You and Good Day!