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UNI Program - Monterrey

Dr. Atanasio Carrillo Montemayor, Dean, Nuevo Leon Autonomous University, Dental School, Monterrey, Mexico
Background Information

The dental program began in 1976, as part of the Guadalupe Health Program. Eleven primary care dental units were installed in the community of Guadalupe, Nuevo Leon. The objective of this program was to improve the population's level of oral health. This improvement was to be accomplished through a multidisciplinary, inter-institutional program based on academic teaching, clinical services, and community diagnosis and planning. With this program, students were given alternatives to clinical practice and did not need to look for patients to reach academic objectives.

In 1986, in order to provide more holistic care, a secondary ambulatory care program was created. This program provided endodontics, periodontics, pediatric dentistry, orthodontics, and maxillofacial surgery in Guadalupe's Module of Nuevo Leon Autonomous University (UANL) and in the Nuevo Leon Health State Secretary (SESNL).

With the introduction of secondary care, a registration of diagnoses through consultation was initiated. Through this process data was collected by diagnosis and cause of morbidity, which provided a means for evaluation of the dental program's decision-making regarding teaching and clinical services.

General Information

UNI Program-Leon is being implemented in the state of Nuevo Leon, Mexico. The state is situated in the northeast part of the country. Nuevo Leon shares one border with the USA, while its western border lies 200 kilometers from the Gulf of Mexico. Its area is 64,081 km2, with a population density of 49.5 inhabitants/km2.

The state is comprised of 51 cities, 9 of which are in the metropolitan zone. One of these 9 cities is Monterrey, the state capital.

The total population of the state is 3,170,000, of which 2,635,000 (83%) reside in the metropolitan area.

The UNI Program serves the cities of Guadalupe and Apodaca, within the metropolitan area. The populations of Guadalupe and Apodaca are 616,000 and 174,000 respectively. The combined population of the two cities (790,000) represents 30% of the total population of the metropolitan area and 25% of the state's total population.

Sixty-five percent of the population are covered by the Social Security institutions, the Mexican Institute of Social Security (IMSS) being the most important of them. Thirty percent have no access to public health services nor can they afford private care. They are called "the open populations" and they receive care from the federal services (Health Secretary, SSA) and state services (Family Integral Development System, DIF). Only five percent of the population have access to private health services.

The participating institutions and staff for the UNI Project are:

· Educational Institutions

Nuevo Leon Autonomous University - Schools of Medicine, Nursing, Dentistry, Clinical Biology, Pharmacy, and Nutrition.

Staff: professionals: 163; students - 6899

· Health Services Agencies

- Mexican Institute of Social Security (IMSS)

- Nuevo Leon State Health Secretary (SESNL)

- Municipal government

Staff: professionals: 490

Health Care Units: Primary care level: 34; Secondary care level: 2; Tertiary care level: 2

Financial Resources: Combined UANL and W.K. Kellogg funds totaled $4,706,504 (US dollars) over four years

Dental Component of UNI Project

On January 1992, the UNI Project began a new academic initiative that combined health professions education with community involvement. The mission of the Program was to facilitate changes in its three main components: community, health services and university. The dental component started its activities in part in February 1993, with additional dental units added to the service. This allowed the following to take place:

1. More student learning opportunities in the community, through the existing courses: Child Clinic, Integral Clinic, Orthodontia II, Supervised Pre-professional Practices, Preventive I, and Preventive II.

2. The incorporation of six other disciplines in community-based teaching: Social Dentistry, Introduction to Dental Sciences I, II, Integral Seminar, Dental Deontology.

Thus far, sixteen dental units have been set up, including four X-ray machines. Twelve of the units are in municipalities of Guadalupe (four in the Vicente Guerreiro University Clinic, eight in the Guadalupe Dental Module). The other four units are in Apodaca municipality, in the Pueblo Nuevo University clinic. Presently, there is a total of seventy dental units available at both care levels.

Implementation of the UNI Program will continue in September, beginning with education in the waiting rooms to promote self-care practices. Clinical teaching will be accomplished by using a video camera placed inside the mouth, which permits patients to see their particular oral health conditions firsthand.

In addition, a communications system will be established for a referral network encompassing the three levels of care. A continuing education program featuring up-to-date training with modern methodology will be developed. A teaching center with audiovisual and computing equipment will also be constructed and will include facilities for self-paced learning. Multiprofessional work based on problem-solving and scientific research will also be integral parts of student training.

The following picture portrays the organization of services by care levels and the corresponding distribution of students and teachers.

The pie charts (page 23) depict the distribution of service activities and consultations by care level and specialty.


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