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Gallagher JE, Mattos Savage GC, Crummey SC, Sabbah W, Makino Y, Varenne B. Health workforce for oral health inequity: Opportunity for action. PLoS One 2024; 19:e0292549. [PMID: 38870162 PMCID: PMC11175420 DOI: 10.1371/journal.pone.0292549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Accepted: 09/24/2023] [Indexed: 06/15/2024] Open
Abstract
Oral health is high on the global agenda following the adoption of the 2022 global strategy on oral health at the 75th World Health Assembly. Given the global burden of oral disease, workforce development to achieve universal health coverage [UHC] is crucial to respond to population needs within the non-communicable disease agenda. The aim of this paper is to present an overview of the oral health workforce [OHWF] globally in relation to key contextual factors. Data from the National Health Workforce Accounts and a survey of World Health Organization [WHO] member states were integrated for analysis, together with country-level data on population and income status. Data are presented using the WHO categorisation of global regions and income status categories established by the World Bank. Workforce densities for key OHWF categories were examined. Multiple regression was used to model workforce density and contextual influences. Challenges and possible solutions were examined by country income status. There are approximately 3.30 dentists per 10,000 population globally, and a combined OHWF [dentists, dental assistants/therapists and dental prosthetic technicians] of 5.31 per 10,000. Marked regional inequalities are evident, most notably between WHO European and African regions; yet both make greater use of skill mix than other regions. When adjusted by region, 'country income status' and 'population urbanization' are strong predictors of the workforce density of dentists and even more so for the combined OHWF. Maldistribution of the workforce [urban/rural] was considered a particular workforce challenge globally and especially for lower-income countries. Strengthening oral health policy was considered most important for the future. The global distribution of dentists, and the OHWF generally, is inequitable, with variable and limited use of skill mix. Creative workforce development is required to achieve the global oral health agenda and work towards equity using innovative models of care, supported by effective governance and integrated policies.
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Affiliation(s)
- Jennifer E. Gallagher
- Dental Public Health, Centre for Host Microbiome Interactions, King’s College London, Faculty of Dentistry, Oral & Craniofacial Sciences, Denmark Hill Campus, London, United Kingdom
| | - Grazielle C. Mattos Savage
- Dental Public Health, Centre for Host Microbiome Interactions, King’s College London, Faculty of Dentistry, Oral & Craniofacial Sciences, Denmark Hill Campus, London, United Kingdom
| | - Sarah C. Crummey
- Dental Public Health, Centre for Host Microbiome Interactions, King’s College London, Faculty of Dentistry, Oral & Craniofacial Sciences, Denmark Hill Campus, London, United Kingdom
| | - Wael Sabbah
- Dental Public Health, Centre for Host Microbiome Interactions, King’s College London, Faculty of Dentistry, Oral & Craniofacial Sciences, Denmark Hill Campus, London, United Kingdom
| | - Yuka Makino
- Noncommunicable Diseases Management Team, WHO Regional Office for Africa, Cité Djoué, Brazzaville, Congo
| | - Benoit Varenne
- WHO Oral Health Programme, Noncommunicable Diseases Department | Division of Universal Health Coverage & Communicable and Noncommunicable Diseases, World Health Organization, Geneva, Switzerland
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Gallagher Mbe JE. A sustainable oral health workforce: time to act. Br Dent J 2024; 236:855-856. [PMID: 38877227 DOI: 10.1038/s41415-024-7535-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/16/2024]
Affiliation(s)
- Jennifer E Gallagher Mbe
- Ambassador, International, Engagement & Service King´s College London; Newland-Pedley Professor of Oral Health Strategy/Honorary Consultant in Dental Public Health, Faculty of Dentistry, Oral & Craniofacial Sciences, King´s College London, Bessemer Rd, London, SE5 9RS, UK.
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Dasson Bajaj P, Shenoy R, Davda LS, Mala K, Bajaj G, Rao A, K S A, Pai M, Jodalli P, B R A. A scoping review exploring oral health inequalities in India: a call for action to reform policy, practice and research. Int J Equity Health 2023; 22:242. [PMID: 37990194 PMCID: PMC10664303 DOI: 10.1186/s12939-023-02056-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Accepted: 11/12/2023] [Indexed: 11/23/2023] Open
Abstract
INTRODUCTION Reduction in health inequalities and providing universal access to health care have been identified as two important global milestones by the World Health Organization for countries to achieve by 2030. Therefore, recognizing the magnitude of oral health inequalities in India has become a pressing priority to improve access to dental care within the country. This scoping review was conducted with the aim of reviewing, collating and analysing the current knowledge base on oral health inequalities in India. METHODOLOGY The scoping review followed Arksey and O'Malley's approach, and reporting was performed in accordance with the PRISMA-ScR guidelines. A systematic search was conducted on Scopus, PubMed, Web of Science, and EMBASE to identify literature addressing one or more dimensions of oral health inequalities in India, published in English between January 2002 and April 2022. The data were charted, and qualitative analysis was performed to derive themes, highlighting the key concepts emerging from this review. RESULTS In accordance with the eligibility criteria, a total of 71 articles retrieved through database search and backward citation search were included in this scoping review. The major themes ranged from individual to diverse sociodemographic factors acting as barriers to and facilitators of access to dental care. Deficiencies in human resources for oral health, along with a wide diversity in dental service provision and dental education were other major themes contributing to inequality. Subsequently, this has resulted in recommendations on restructuring the dental workforce and their development and modifications in oral health care policies and practices. The qualitative synthesis demonstrates the intertwined nature of the multiple factors that influence the goal of achieving an affordable, accessible, extensive and inclusive oral healthcare system in India. CONCLUSIONS This comprehensive review provides a broad perspective on oral health inequalities in India, providing valuable insights for both researchers and policymakers in this area and guiding their efforts towards achieving universal oral health coverage in the Indian context.
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Affiliation(s)
- Parul Dasson Bajaj
- Department of Public Health Dentistry, Manipal College of Dental Sciences Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka, 576104, India
| | - Ramya Shenoy
- Department of Public Health Dentistry, Manipal College of Dental Sciences Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka, 576104, India.
| | - Latha Sanjay Davda
- Civilian Dental Surgeon, UK and Adjunct Faculty, Manipal College of Dental Sciences Mangalore, Ministry of Defense, Manipal Academy of Higher Education, Manipal, Karnataka, 576104, India
| | - Kundabala Mala
- Department of Conservative Dentistry and Endodontics, Manipal College of Dental Sciences Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka, 576104, India
| | - Gagan Bajaj
- Department of Audiology and Speech Language Pathology, Kasturba Medical College Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka, 576104, India
| | - Ashwini Rao
- Department of Public Health Dentistry, Manipal College of Dental Sciences Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka, 576104, India
| | - Aparna K S
- Department of Public Health Dentistry, Manipal College of Dental Sciences Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka, 576104, India
| | - Mithun Pai
- Department of Public Health Dentistry, Manipal College of Dental Sciences Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka, 576104, India
| | - Praveen Jodalli
- Department of Public Health Dentistry, Manipal College of Dental Sciences Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka, 576104, India
| | - Avinash B R
- Department of Public Health Dentistry, Manipal College of Dental Sciences Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka, 576104, India
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Shevchenko OV. [The impact of primary prevention programs of dental diseases on the main trends in the development of dental services]. STOMATOLOGIIA 2023; 102:91-96. [PMID: 37144774 DOI: 10.17116/stomat202310202191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
Abstract
The vision of the global strategy on oral health is universal health coverage for oral health for all individuals and communities by 2030, enabling them to enjoy the highest attainable state of oral health and contributing to healthy and productive lives (WHO, 2022). To achieve this goal, it is necessary to ensure the development of the dental care system in Russia on the basis of primary prevention of dental diseases. OBJECTIVE Analysis of the methodology for the development, implementation and evaluation of programs for the primary prevention of dental diseases and their impact on the main trends in the development of dental services. MATERIAL AND METHODS The main research methods were search for publications, analysis and systematization of information on the methodology for developing, implementing and evaluating programs for the primary prevention of dental diseases. RESULTS Despite the single main goal of dental disease prevention programs, the analysis of the methodology of their construction and implementation must be carried out considering their impact on the main trends in the development of dental services. CONCLUSIONS The main directions of development of the methodology for the development, implementation, and evaluation of primary prevention programs of dental diseases should include the use of indicators of oral health recognized by the international community, which allow us to trace the degree of their influence on the development of the system of dental care.
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Affiliation(s)
- O V Shevchenko
- Central Research Institute of Dentistry and Maxillofacial Surgery, Moscow, Russia
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Balasubramanian M, Short S. The Future Health Workforce: Integrated Solutions and Models of Care. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:2849. [PMID: 33799573 PMCID: PMC8001327 DOI: 10.3390/ijerph18062849] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Accepted: 03/06/2021] [Indexed: 12/01/2022]
Abstract
The health workforce is a vital aspect of health systems, both essential in improving patient and population health outcomes and in addressing contemporary challenges such as universal health coverage (UHC) and sustainable development goals (SDGs) [...].
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