May 25, 1970

AGREEMENT BETWEEN THE REPUBLIC OF THE PHILIPPINES AND THE UNITED NATIONS CHILDREN'S FUND CONCERNING DENTAL HEALTH SERVICES.

Manila, May 25 and June 25, 1970.

Note: The Agreement entered into force, June 25, 1970.

Reference: This Agreement is also published in IX DFA TS No. 1, p. 63

25 May 1970

Sir:

This refers to continued UNICEF assistance during 1971 for the improvement of the dental services in the rural areas as originally described in the Plan of Operations for Assistance to the General Health Services Project, signed by the Government on 24 August 1967, by the World Health Organization on 6 July 1967, and by the United Nations Children's Fund on 30 June 1967; also the Exchange of Letters covering implementation in 1969 and forming Annex IV to the First Addendum to the Plan of Operations; and the Exchange of Letters covering implementation in 1970 and forming Annex IV to the Second Addendum to the Plan of Operations. This is a complementary project related to the Master Plan of Operations for General Health Services Development in the Philippines, signed on behalf of WHO on 20 November 1969 and on behalf of the Government on 20 January 1970 to which UNICEF is related by virtue of a Letter of Protocol signed by the UNICEF Resident Director on 2 January 1970 and confirmed by the Government on 12 February 1970.

1. The objectives of the plan, the role of the Government agencies involved, and the programme operation, implementation and evaluation are spelled out in detail in the plan of action referred to above and they remain unchanged.

2. The Bureau of Dental Health Services has, under its jurisdiction, 584 dentists and dental aides assigned to 292 rural health units. The location of the units and the staff by health region is given in the Exchange of Letters dated 21 June 1968 and remain unchanged. The plan is to eventually equip all of the 292 units; the present allocation brings the total number of sets of equipment supplied by UNICEF to 250 and, depending on the progress of the programme, it is anticipated that the request for the balance of 42 sets will be presented to the 1971 UNICEF Board, thus completing UNICEF assistance to this programme.

3. Under this Exchange of Letters, UNICEF will provide 50 sets of dental equipment, together with spare parts and replacement items, as recom¬mended by the WHO Short-Term Consultant, for use at rural health units, on the understanding that the Government will provide P 1,000 per unit for expendable items during 1971 for these new units, plus P50,000 for continuing expendables for the 200 units already provided under the three previous allocations. These funds are estimated to be sufficient, together with the budget from national and provincial sources, to meet the needs of the dentists and keep the units in full use. Sodium flouride tablets and stannous flouride powder are not requested under this allocation, pending utilization and evaluation of the supplies received by the Government during the first two years of operation. UNICEF will continue to provide simple educational materials for each of the 50 additional rural health units which will receive the new dental equipment. Stipends and honoraria will also be provided for the training of 150 dentists and supervisors. This will include the 50 dentists who will receive the new equipment, plus some of the backlog of dentists and supervisors who need to be trained within the total programme covering the 292 rural health units. Training will be undertaken in four-week seminars of 25 participants each, commencing in August 1970 and concluding by November 1971. This will leave a balance of 100 dentists and supervisors still to be trained under the 1971 allocation. Two utility vehicles are included; one for training, i.e. to be located at the Bureau headquarters training office in Manila and to be used for transporting trainees to demonstration clinics in the vicinity, e.g. San Jose City, Nueva Ecija, Cavite, and Bulacan; the other vehicle is for supervision of the cooperating dentists in Health Regions I, II, III, and IV, i.e. the land mass of Central Luzon.

The total UNICEF commitment amounts to $23,500 (Board document number E/ICEF/P/L 1361) during the period covered by this Exchange of Letters, i.e. mid 1970 through end 1971. The details are as follows:

a. 50 sets of manually operated dental equipment and supplies at $263.92 per set	$13,200
b. Spare parts and replacement items consisting of 2 electric engines and 11 foot engines, dental handpieces, portable dental chairs and tools as recommended by the WHO Short-Term Consultant	2,800
c. Dental health education materials consisting of 50 sets of charts, models and pamphlets	500
d. Stipends and honoraria for training of a total of 150 dentists, including regional and provincial supervisors, for 28 days at F5.00 per day and honoraria for consultants and lecturers at P 10.00 per hour for approximately 300 hours — P24,000, say	4,000
e. Two utility vehicles for training activities and supervision.	3,000
	_________
	$23,500
	========

4. The objectives and categories of the training remain as shown in paragraphs 4 and 5 of the previous Exchange of Letters dated 21 June 1968. It should, however, be clarified that while the dental unit and the dentist are assigned to a specific rural health unit, they are also made available for three or four months of the year to other rural health units or barrio stations in the vicinity. The equipment, including the chair, is portable in the sense that it can be moved by station wagon. This mobility means that the equipment is used in an area containing some 25,000-30,000 people, of which about 5,000 are expected to receive dental care each year.

5. The commitments of the Government for the calendar year 1971 will consist of the following:

a. Personnel Services (annual salaries):
8 regional supervising dentists	P 46,520
250 dentists I	984,000
250 dental aides	567,000
2 dental training officers	10,000
1 statistician	3,792
	__________
Total:	P1,611,312
	__________
b. Maintenance and other operating expenses:
8 regional supervising dentists	P 14,162
250 dentists I and 250 dental aides	291,576
	__________
Total	P 305,738
	__________
c. Dental expendables for the new 50 sets	P 50,000
d. Maitenance for the 200 sets	P 50,000
__________
GRAND TOTAL (Government Commitments):	P2,017,050
__________
__________

6. An evaluation of the programme took place in the second half of 1969, and the report of the WHO Consultant is awaited. It is understood that the recommendations included some changes concerning the type of supplies provided, the provision of a special tool kit and of spare parts and replacement items, and the establishment by the Government of a maintenance unit in the Bureau of Dental Health Services with trained mechanics. It was also recommended that the flouridation studies be completed and evaluated as quickly .as possible.

Depending upon the progress of the programme and the availability of funds, UNICEF will complete their assistance in 1972 with provision of 42 sets of equipment and training funds for 100 dentists and supervisors.

I should appreciate your confirmation of the above. The signing of nine copies of this Exchange of Letters will constitute an official agreement between the Government and UNICEF extending the Plan of Action through end 1971. Three copies of this Exchange of Letters are for use of your Government, the remaining six copies are to be returned to this Office for distribution.
 

	Very Truly yours,
	(Sgd). ANTONY E. MEAGER
	UNICEF Representatives

DONE in 9 copies in English.

CONCURRED ON BEHALF OF THE
GOVERNMENT OF THE PHILIPPINES:

(Sgd.) JOSE D. INGLES
Acting Secretary of Foreign Affairs.

Date: 26 June 1970