MALABAR DENTAL COLLEGE AND RESEARCH CENTRE

DEPARTMENT OF PUBLIC HEALTH DENTISTRY

SEMINARS

SUBMITTED BY:
S ABHIRAMI
FINAL YEAR PART 1
REG NO: 180020601

1
 INDEX

SEMINAR 1: ACCREDITED SOCIAL HEALTH ACTIVIST

SEMINAR 2: MEDICAL JURISPRUDENCE: CONSENT

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 ACKNOWLEDGEMENT

This is to express my sincere gratitude to all those without whose valuable help, this seminar
could not have been materialized.

I would like to express my sincere gratitude to Dr Abdul Saheer, Reader and Head of
Department of Public Health Dentistry, for his generosity and willingness to share his valuable
time and feedback.

I extend my heartfelt gratitude to Dr. Manna S Mathai Lecturer & Dr Anjana Vipal, Lecturer,
for the constant support and encouragement throughout the academic year.

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 MALABAR DENTAL COLLEGE AND RESEARCH CENTRE

DEPARTMENT OF PUBLIC HEALTH DENTISTRY

SEMINAR TOPIC: ACCREDITED SOCIAL

HEALTH ACTIVIST

SUBMITTED BY:
LEYA JOY K J
FINAL YEAR PART 1
REG NO :180020583

SIGNATURE OF SIGNATURE OF
INTERNAL EXAMINER EXTERNAL
EXAMINER

4
 CERTIFICATE

This is to certify that the seminar entitled ACCREDITED SOCIAL HEALTH ACTIVIST’
‘is a bonafide record done by Ms. LEYA JOY K J, of BDS course during the year 2021-
2022as a part of seminar presentation in the Department of Public Health Dentistry, Malabar
Dental College & Research Centre.

DATE:

STAFF:

UNIVERSITY REG NO.:

Reader & head

Department of Public Health Dentistry

5
 CONTENTS

1. INTRODUCTION
2. HEALTH CARE SECTORS IN INDIA
3. NATIONAL RURAL HEALTH MISSION
4. ACCREDITED SOCIAL HEALTH ACTIVIST
5. QUALIFIACATIONS OF ASHA
6. TRAINING PERIOD OF ASHA
7. DUTIES OF ASHA
8. CONCLUSION
9. REFERENCES

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 INTRODUCTION

● Health Systems are defined by WHO (2000) as comprising all the organizations, institutions
and resources that are devoted to producing health actions.
● A health action is defined as any sort of effort, whether in personal health care, public health
services or through inter-sectoral initiatives, whose primary purpose is to improve health.
● Health systems have been a vital and continuing responsibility to people and are crucial to the
healthy development of individuals, families and societies everywhere.

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 HEALTH CARE SECTORS IN INDIA

1. PUBLIC HEALTH SECTOR

A. Primary Health Care
i Village Level Workers
● Village Health Guide Schemes
● Local Dais
● Anganwadi Workers (ICDS Scheme)
● Accredited Social Health Activist (ASHA)
ii Sub Center Level
iii Primary Health Center Level
B. Hospitals/Health Centers
i Community Health Center Level
ii Rural Hospitals
iii District Hospitals/Health Centers
iv First Referral Units (FRUs)
C. Health Insurances Schemes
● Employees Sate Insurance
● Central Government Health Scheme
● Universal Health Insurance Schemes (UHIS)
D. Other Agencies
i Defense Medical Services
ii Indian Railway Medical Service
2. PRIVATE SECTOR
3. INDIGENOUS SYSTEMS OF MEDICINE
4. VOLUNTARY HEALTH AGENCIES
5. NATIONAL HEALTH PROGRAMS

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 NATIONAL RURAL HEALTH MISSION

National Rural Health Mission is a health program of the Government of India for
improving health care delivery across rural India. The mission, initially mooted for 7 years
(2005-2012), is run by the Ministry of Health.

The National Health Mission (NHM) encompasses its two Sub-Missions:

1. The National Rural Health Mission; and
2. The Newly Launched National Urban Health Mission.

The main components include:

● Health system strengthening in rural and urban areas;
● Reproductive- Maternal- neonatal- child and adolescent health (RMNCH+A);
● Communicable and non-communicable diseases.

The NHM envisages achievement of universal access to equitable, affordable and quality
health care services that are accountable and responsive to people's needs

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 ACCREDITED SOCIAL HEALTH ACTIVIST
(ASHA)

One of the key components of the National Rural Health Mission is to provide every
village in the country with a trained female community health activist or Accredited
Social Health Activist (ASHA). Selected from the village itself and accountable to it, the
ASHA will be trained to work as an interface between the community and the public
health system.

QUALIFIACATIONS OF ASHA

● ASHA must primarily be a woman resident of the village.

● Preferably in the age group of 25 to 45 years.
● She should be a literate woman with formal education up to class 8. This may be relaxed
if no suitable person with this qualification is available.
● ASHA will be chosen through a rigorous process of selection involving various groups,
self-help groups, Anganwadi Institutions, The Block Nodal Officer, District Nodal
Officer, The Village Health Committee and the Gram Sabha

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 TRAINING PERIOD OF ASHA

● ASHA will have to undergo a series of training acquire the necessary knowledge, skills
and confidence for performing her spelled out roles.
● An ASHA will receive a total period of 23 days training in five episodes.
● However, ASHA training is a continuous one and she will develop the necessary skills
and expertise through continuous on the job training.
● After a period of 6 months of her functioning in the village she will be sensitized on
HIV/AIDS issues and referrals and also trained in new born care.

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 DUTIES OF ASHA
One Accredited Social Health Activist (ASHA) will cater to a village with a population
of 1000.
❖ Empowered with knowledge and a drug-kit to deliver first-contact healthcare, every
ASHA is expected to be a fountainhead of community participation in public health
programs in her village.
❖ ASHA will be the first port of call for any health-related demands of deprived sections of
the population, especially women and children, who find it difficult to access health
services.
❖ She would be a promoter of good health practices and will also provide a minimum
package of curative care as appropriate and feasible for that level and feasible for that
level and make timely referrals.
❖ ASHA will provide information to the community on determinants of health such as
nutrition, basic sanitation and hygiene practices, healthy living and working conditions,
information on existing health services and the need for timely utilization of health and
family welfare services.
❖ She will counsel women on birth preparedness, importance of safe delivery, breast
feeding and complementary feeding, immunization, contraception and prevention of
common infections including Reproductive Tract Infections/ Sexually Transmitted
Infections (RTIs/STIs) and care of the young child.
❖ ASHA will mobilize the community and facilitate them in accessing health and health
related services available at the Anganwadi/sub-Centre/primary health centers, such as
immunization, Ante Natal Check-up (ANC), Post Natal Check-up supplementary
nutrition, sanitation and other services being provided by the government.
❖ She will act as a depot holder for essential provisions being made available to all
habitations like Oral Rehydration Therapy (ORS), Iron Folic Acid Tablet (IFA),
Chloroquine, Disposable Delivery Kits (DDK), Oral Pills& Condoms, etc.
❖ She will be paid a fixed salary per month as well as performance-based incentives

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 CONCLUSION

ASHA workers were largely recruited as per present selection criteria with regard to
age, education, family status, income and residence.
The ASHA workers were found to be functional in some areas with scope for
improvement.
Motivating women to give birth in hospitals has reduced the complications to a great
extent
ASHA will mobilize the community and facilitate them in assessing in health and
health related services available at the anganwadi, subcenter, primary health centers
such as immunization, antenatal checkup, post-natal checkup etc.

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 REFERENCES
◾ Soben Peter: Health care sectors in India : Essentials of public health dentistry : 6th
edition : Arya (medi) publishing house .

◾ K.Park : chapter 7 :Health programmes in India :Textbook of Preventive and Social

Medicine:22 nd edition :M/s Banarsidas Bhanot publishers

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 MALABAR DENTAL COLLEGE AND RESEARCH CENTRE

DEPARTMENT OF PUBLIC HEALTH DENTISTRY

SEMINAR TOPIC: MEDICAL JURISPRUDENCE-CONSENT

SUBMITTED BY:
LEYA JOY K J
FINAL YEAR PART 1
REG NO :180020583

SIGNATURE OF SIGNATURE OF
INTERNALEXAMINER EXTERNAL
EXAMINER:

15
 CERTIFICATE

This is to certify that the seminar entitled ‘MEDICAL JURISPRUDENCE-CONSENT’ is a

bonafide record done by Ms. LEYA JOY K J, of BDS course during the year 2021-2022 as a
part of seminar presentation in the Department of Public Health Dentistry, Malabar Dental
College & Research Centre.

DATE:
STAFF:
UNIVERSITY REG NO.:

Reader& Head
Department of Public Health Dentistry

16
 CONTENTS

1. INTRODUCTION
2. TYPES OF CONSENT
3. SITUATIONS WHERE CONSENT MAY NOT BE OBTAINED
4. SITUATIONS REQUIRING EXTRA CAUTION

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 INTRODUCTION
🞆 “When two or more persons agree upon the same thing in the same sense they are said
to consent”.

🞆 This is the definition of consent given as per the section 13 of the Indian contract act
1872.

Who can give consent:

🞆 For the purpose of clinical examination, diagnosis and treatment, consent can be given
by any person who is conscious, mentally sound and is of and above 12 years of age
as provided under sections 88 and 90 of Indian penal code 1860.

🞆 Doctors are reminded that consent is taken under section 13 0f Indian contract act
1872.

🞆 Consent should be obtained, specially written consent from parents / guardian of a

patient who is below 18 years so that validity of the contract is not challengeable

When consent is not valid:

🞆 Consent given under fear, fraud or misrepresentation of facts or by a person who is

ignorant of the implications of the consent or who is under 12 years of age is invalid
(IPC sec 90).

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 TYPES OF CONSENT
• IMPLIED CONSENT (TACTIC CONSENT)
• EXPRESS CONSENT
• INFORMED CONSENT
• PROXY CONSENT (SUBSTITUTE CONSENT)

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IMPLIED CONSENT (TACIT CONSENT)

🞆 Most common

🞆 The fact that a patient comes to a doctor for an ailment implies that he is agreeable to
medical examination in the general sense.

🞆 This does not imply consent to procedures more complex than inspection, palpation,
percussion, auscultation and routine sonography.

🞆 For other examinations, notably withdrawal of blood for diagnostic purpose, express
consent (oral or written) should be obtained

🞆 For more complicated diagnostic procedures, e.g.: radiology, C T scan etc. express
written consent should be obtained.

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 EXPRESS CONSENT
🞆 Anything other than the implied consent is express consent.

🞆 This may be either oral or written

🞆 Express oral consent is obtained for relatively minor examinations or therapeutic

procedures, preferably in the presence of a disinterested third party.

🞆 Express written consent is so obtained for all major diagnostic procedures, general
anesthesia and for surgical operations.

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 INFORMED CONSENT
🞆 The concept of informed consent has come to the fore in recent years.

🞆 All information must be explained in comprehensible non-medical terms preferably in

local language about the:

⮚ Diagnosis

⮚ Nature of treatment

⮚ Risks involved

⮚ Prospects of success

⮚ Prognosis, if the procedure is not performed.

⮚ Alternative methods f treatment.

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 PROXY CONSENT
All the above types of consent can take the shape of proxy consent.

Parent for child, close relative of mentally unsound / unconscious patients etc.

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SITUATIONS WHERE CONSENT MAY NOT BE OBTAINED
Medical emergencies

Immigrants

In case of person suffering from notifiable disease.

Members of armed force

Handlers of food and dairymen.

New admissions to prisons

In case of a person where a court may order for psychiatric examination or treatment.

Under section 53 (1) of the code of criminal procedure, a person can be examined at
the request of the police, by the use of force.

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 SITUATIONS REQUIRING EXTRA CAUTION

Retention of objects in operation sites

Accident and emergency departments.

Amputation of wrong limb, digit or operation of wrong eye / tooth.

anesthesia

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 CONCLUSION

Consent is a very important in all aspects of medical science.

A patient’s consent is of legal importance

The hospitals and clinics should practice to get a proper consent from all patients or
their bystanders before any procedures.

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 REFERENCES
◾ SOBEN PETER: Medical Jurisprudence, Essentials of Public Health Dentistry : 6th
edition: Arya (Medi) publishing house .
◾ S.S HIREMATH : consumer protection act p.no:245 :dental public health :3 rd
edition:Elsevier.

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