Department of Public Health Dentistry- Planning & Evaluation

EDITION OF : 18TH MAY 2021

DEPARTMENT OF PUBLIC HEALTH DENTISTRY INDIRA GANDHI INSTITUTE OF DENTAL SCIENCES, PONDICHERRY PLANNING & EVALUATION

SUBMITTED BY: M.VISHMA SAI 1704001016

FINAL YEAR, REGULAR BATCH

PLANNING AND EVALUATION Planning is a systematic approach to defining the problem , setting priorities ,developing specific goals and objectives and determining alternative strategies and methods of implementation.

To match limited resources with many problems, To eliminate wasteful expenditure or duplication of expenditure To develop the best course of action to accomplish a defined objective.

STEPS IN PLANNING 1. Identify the problem 2.

Determining priorities 3. Development of program goals , objectives and activities 4.

Resource identification 5. Identifying constraints 6. Identify alternative strategies 7. Develop implementation strategy 8. Implementation 9.

Monitoring 10. Evaluation CONCLUSION A plan can play vital role in helping to avoid mistakes or recognize hidden opportunities .

Planning helps in forecasting the future , making the future visible to some extent It bridges between where we are and where we want to go However planning is worthwhile only if changes is seen to be necessary and if the plans are capable of being implemented

CURRENT SCENARIO The prevalence of Dental Malocclusion in 12–15-year-old rural children in Pondicherry is 58%.

24% of the individuals were in great need of orthodontic management.

8% were in borderline.

26% were in little need.

22.86% of children felt selfconscious and feel tense about malocclusion.

INTRODUCTION Millions of individuals worldwide are suffering from oro- dental problems in spite of most of them being preventable. Malocclusion is one of them. Malocclusion is not a disease but a morphological variation which may or may not be associated with pathological conditions. Malocclusion is one of the most prevalent oral pathologies, next only to dental caries and periodontal disease and usually ranked third among worldwide public health dental disease priorities.

Developing countries like India are struggling to eradicate many medical and dental diseases. The main reason behind this is an inadequate implementation of preventive oral health care programs which need a sound base of epidemiological data. Epidemiological studies on occlusion and malocclusion not only help in orthodontic treatment planning and evaluation of dental health services but also offer a valid research tool for ascertaining the operation of distinct environmental and genetic factors in the etiology of malocclusion. Facial appearance has a longlasting implication on an individual. An unacceptable dental appearance has often been associated with a negative effect on self-image, career advancement and peergroup acceptance. In order to prevent a wide-spread impact on their psychological development, children having very severe or handicapping malocclusion should be identified and corrective measures should be instituted at the earliest. Early prevention and interception of a disease can reduce the burden of cost and more expensive treatment modalities on the nation.

Radha Krisna G et al. observed the prevalence of malocclusion in primary dentition in Chennai as 62.5% out of which 81% had Class I malocclusion, 15.3 % had Class II, only 3 % had Class III and 47.2% had crowding.

Joseph John in a similar study reported that 56.3% had no malocclusion, 25.1% had a definite malocclusion, 12.1% had a severe malocclusion and 6.2% had a handicapping malocclusion and concluded that the need to implement preventive and interceptive orthodontic care is of utmost importance to improve the aesthetic perception and social function.

PONDICHERRY An epidemiological study done in Pondicherry, revealed that about 58% of the population between the ages of 12 to 15 years of the rural households, suffered from Malocclusion.

Out of this 28% of the people were in great need of orthodontic management and about 22.86% of children felt self-conscious and tense about the malocclusion.

This discrepancy of 5.14% reveals that few people are comfortable about their disordered state of teeth, however majority of people were concerned about their malocclusion and how it affected their aesthetics.

This assignment aims to plan an awareness cum problem solving program for rural kids aged 12-15 years of age in Pondicherry.

IDENTIFYING THE PROBLEM Primary problem: Malocclusion in adolescents aged 12-15 years in the rural households of Pondicherry.

Secondary Problem: Lack of awareness of Growth and development, Growth spurts and prepubertal prevention of malocclusion.

Psychosocial impact of malocclusion.

DEMOGRAPHICS Site: Village Bahour – Pondicherry (Rural setting households) Total Population: 10,000 Adolescents: 40% of the total population (i.e 4000) Prevalence of malocclusion: Moderate - 58% of 4000 (i.e 2320) Water supply: Central well in the village Nearby Dental Health care service: Primary Health Centre + Dentist. (At a distance of 12kms, only basic oral health services present) The village has two schools from kindergarten to 12th standard.

There is one dental college at a distance of 4.5 km with community dentistry department.

Results: Out of the 2320 children, 24% of the individuals were in great need of orthodontic management. (~556) 8% were in borderline. (~185) 26% were in little need of treatment (~603) 22.86% of children felt self-conscious and feel tense about malocclusion. (~ 531)

PRIORITY DETERMINATION Out of 2320 children, 556 (24%) are in great need of orthodontic management making treatment and counselling regarding Malocclusion priority number 1 Assessment of psychosocial impact of malocclusion on adolescents using PIDAQ Awareness regarding Growth spurts, growth and development, Prevention of problems in developing occlusion by modifying growth and routine checkups and interception of establishing malocclusion at the earliest using myofunctional and removable appliances.

PIDAQ THE PSYCHOSOCIAL IMPACT OF DENTAL AESTHETICS QUESTIONNAIRE

GOALS &

OBJECTIVES

GOALS Establishment of aesthetically acceptable and functional occlusion in 24% of children on the top of priority list.

Psychological support to Children who felt selfconscious.

Prevention of problems in developing occlusion by modifying growth and routine checkups and interception of establishing malocclusion at the earliest using myo-functional and removable appliances and aesthetic management of 34% of children who are on the borderline and in little need of treatment.

Generating awareness regarding Growth and Development, Growth spurts and Orthodontic counselling on how malocclusion can be prevented.

The basic goal is to inculcate knowledge about malocclusion and reduce the evidence of malocclusion in the rural areas of Pondicherry

OBJECTIVES Achievement of functionally and aesthetically acceptable occlusion of 24% of the children by the end of next 5 years. (2026).

Orthodontic management and treatment of 8% of borderline children and 26% of people with little need of treatment by the end of next 10 years.

Generate awareness regarding Growth and Development, Growth spurts and Orthodontic counselling on how malocclusion can be prevented and create a positive dental approach by the end of next 12 years.

Pie chart 1 : Depicts the data provided to us initially .

PROGRAM ACTIVITIES

An established team of Public Health Dentists, Orthodontists, Dental hygienists, Clinical psychologists, Dental assistants would be allocated to visit the village and asses the conditions of the children.

Complete evaluation of Clinical history, Nutrition, Education, Growth assessment other needs required.

Regular visits to the village, Impression making, assessment of various treatment modalities depending upon the extent of malocclusion, fabrication of appliances.

Appointments to be given, Patients expected to report to the dental college if braces are required.

All of this is expected to be done by the end of May,2021.

Serial extraction if required.

Regular assessment of the dentition with the appliances.

Clinical counselling of the adolescents, Parents & Teachers regarding usage of appliances, functional use, maintenance of the device and how to maintain oral hygiene with the appliance in oral cavity.

Patient & Parent education with various educational aids

RESOURCE IDENTIFICATION

Possible Constraints At an early stage, you should find out how your resources may constrain the design. For example, limits may be set by availability of subjects, cost of treatment, availability of a chemical or bench space.

1

2 Negative attitude

Time consuming

4

3

Local authoritative permissions.

Lack of enough funding

6

5 Labor shortages

Psychology and changing patterns of modern family life.

Alternate Strategies Dental Health education provided by: Anganwadi worker Health educator ANMs Social workers

Dentist from nearby PHC

at individual and group level.

Mass media

IMPLEMENTATION

IMPLEMENTATION The Pilot Phase The Controlled Phase The Actualization Phase The Operational Phase

1. 10 school teachers, 5 from each school are recruited after providing training for 15 days in order to give dental health education to school children.

1. 1 school teacher is made responsible for every 250 children in providing health education and supervising proper usage of appliances.

1.

Health workers, ANMs and Anganwadi workers are utilized for providing health education to general population by training them to do so.

MONITORING It is the day today follow up of the activities during the implementation to ensure that they are proceeding as planned and are on schedule. It is a continuous process of observing, recording and reporting on the activities of the organization or project.

Allocation of one student intern, each day of the week, in the village for monitoring the status of the program and to report it daily to asses the progress.

MONITORING 1.Input Data 2. Process Data 3. Output Data

EVALUATION Criteria used in the evaluation of dental services (WHO-1972)

1.Effectiveness

2.Efficiency

4.Adequacy

3.Appropriateness

TYPES OF EVALUATION There are different types of evaluation depending on the object being evaluated and the purpose of the evaluation. The most important basic types of evaluation are: a. Formative evaluation

b. Summative evaluation

TYPES OF EVALUATION Formative evaluation: •It refers to the internal evaluation of a program. It is an examination of the activities of a program, as they are taking place. It is usually carried out to aid in the development of a program in its early phase.

•It is used primarily by the program developers as to whether they are workable or whether changes should be made to improve program activities Summative evaluation: •It judges the merit or worth of a program after it has been in operation. It is an attempt to determine whether a fully operational program is meeting the goals for which it was developed.

•Summative evaluation is aimed at program decision makers, who will decide as to a program’s continuation or termination and also at decision makers from other programs who might be considering adoption of the program.

TYPES OF EVALUATION

RELEVANCE EVALUATION : Relevance evaluation refers to activities designed to determine whether the program is needed or whether the program is targeting its efforts at the individuals in need.

Problems addressed by the program : 1. Functional and Aesthetic limitation of occlusion due to Malocclusion.

2. Psychosocial impact of malocclusion.

3. Limited knowledge of the public about Malocclusion, Growth and Development, Growth spurts, Etiology and development of Malocclusion

TYPES OF EVALUATION

Progress EVALUATION : Progress evaluation refers to efforts made to access the extent to which the programme implementation complies with the programme plan. This is also referred to as “process evaluation”. (formative evaluation). .

Are the required personnel, equipment, and financial resources in place at the times and locations necessary to meet program needs :

Yes. Do the program activities clearly conform to the original plan?

Yes.

TYPES OF EVALUATION

Effectiveness EVALUATION : Effectiveness evaluation refers to whether the program results meet predetermined objectives. Here the emphasis is on immediate outcomes of the program. .

Did the program meet its stated objectives?

Were the program providers satisfied with the effects of program activities?

Were the program beneficiaries satisfied with the effects of the program activities?

Is the problem reduced or eliminated as a result of the program?

TYPES OF EVALUATION

IMPAct EVALUATION : Impact evaluation refers to the long-term outcomes of the program. It determines whether the programmed intervention had any long-lasting effects on the ultimate problems that the program is intended to remedy.

TYPES OF EVALUATION

efficiency EVALUATION : Efficiency evaluations attempt to relate the results obtained from a specific program to the resources expended to maintain the program.

Efficiency evaluations are receiving increasingly greater attention as program must compete with the limited resources.

Do program benefits exceed the cost incurred?

Are program benefits more or less costly per unit of outcome when compared to other program designed to achieve the same objectives?

CONCLUSION PLANNING AND EVALUATION ARE THE BASIC NECESSITIES OF ANY PROGRAM TO SUCCEED. FAILING TO PLAN IS PLANNING FOR FAILURE.

REFRENCES SOBEN PETER (2018). ESSENTIALS OF PREVENTIVE AND COMMUNITY DENTISTRY. 6TH EDITION. HIREMATH S.S. (2014). TEXTBOOK OF PREVENTIVE AND COMMUNITY DENTISTRY, 5TH EDITION, K. PARK – PREVENTIVE AND SOCIAL MEDICINE 24TH EDITION .

A PROPOSED MODEL FOR INFANT AND CHILD ORAL HEALTH PROMOTION IN INDIA ASHWIN MURALIDHAR JAWDEKAR DEPARTMENT OF PEDIATRIC DENTISTRY, YMT DENTAL COLLEGE AND HOSPITAL, KHARGHAR, NAVI MUMBAI 410210, INDIA RECEIVED 30 MAY 2013; REVISED 8 SEPTEMBER 2013; ACCEPTED 8 SEPTEMBER 2013 AN OVERVIEW OF MALOCCLUSION IN INDIA, JOURNAL OF DENTAL HEALTH, ORAL DISORDERS & THERAPY 1 DEPARTMENT OF ORTHODONTICS, ARMY DENTAL CORPS, INDIA 2 DEPARTMENT OF ORTHODONTICS, ARMY DENTAL CENTRE, R & R HOSPITAL, INDIA *CORRESPONDING AUTHOR: SS AGARWAL, DEPARTMENT OF ORTHODONTICS, ARMY DENTAL CORPS, INDIA, TEL: 7086104044; EMAIL: RECEIVED: OCTOBER 29, 2015 | PUBLISHED: DECEMBER 21, 2015 EFFECT OF INCISOR POSITION ON THE SELF-PERCEIVED PSYCHOSOCIAL IMPACTS OF MALOCCLUSION AMONG CHINESE YOUNG ADULTS .

PLANNING AND EVALUATION OF A PROGRAM - DR DEEPTHI ATHULURU,DENTIST SCHOOL ORAL HEALTH PROGRAM MAINE CDC/DHHS - ORAL HEALTH PROGRAM -NICOLE M. BRETON RDH, BS 21ST SCHOOL DENTAL PROGRAMS AND COMMUNITY – DR. M. SENTHIL, DEPARTMENT OF PUBLIC HEALTH DENTISTRY INDIRA GANDHI INSTITUTE OF DENTAL SCIENCES. 9TH PLANNING EVALUATION – DR. M. SENTHIL, DEPARTMENT OF PUBLIC HEALTH DENTISTRY INDIRA GANDHI INSTITUTE OF DENTAL SCIENCES.