BackgroundSingapore’s population, as that of many other countries, is aging; this is likely to lead to an increase in eye diseases and the demand for eye care. Since ophthalmologist training is long and expensive, early planning is essential. This paper forecasts workforce and training requirements for Singapore up to the year 2040 under several plausible future scenarios.MethodsThe Singapore Eye Care Workforce Model was created as a continuous time compartment model with explicit workforce stocks using system dynamics. The model has three modules: prevalence of eye disease, demand, and workforce requirements. The model is used to simulate the prevalence of eye diseases, patient visits, and workforce requirements for the public sector under different scenarios in order to determine training requirements.ResultsFour scenarios were constructed. Under the baseline business-as-usual scenario, the required number of ophthalmologists is projected to increase by 117% from 2015 to 2040.Under the current policy scenario (assuming an increase of service uptake due to increased awareness, availability, and accessibility of eye care services), the increase will be 175%, while under the new model of care scenario (considering the additional effect of providing some services by non-ophthalmologists) the increase will only be 150%. The moderated workload scenario (assuming in addition a reduction of the clinical workload) projects an increase in the required number of ophthalmologists of 192% by 2040.Considering the uncertainties in the projected demand for eye care services, under the business-as-usual scenario, a residency intake of 8–22 residents per year is required, 17–21 under the current policy scenario, 14–18 under the new model of care scenario, and, under the moderated workload scenario, an intake of 18–23 residents per year is required.ConclusionsThe results show that under all scenarios considered, Singapore’s aging and growing population will result in an almost doubling of the number of Singaporeans with eye conditions, a significant increase in public sector eye care demand and, consequently, a greater requirement for ophthalmologists.Electronic supplementary materialThe online version of this article (doi:10.1186/s12960-015-0085-4) contains supplementary material, which is available to authorized users.
Acknowledgements:We thank Tony Roach, Manager at Vinnies Men's Crisis Centre, for his support of the FSRC. We also thank Laalithya Konduru for her instrumental work conceptualising, setting up, liaising with partners, and running the FSRC, without which this project would not have been possible. We also thank the patients, community general practitioners and medical student volunteers who made the FSRC pilot possible.
Introduction:There is little data on offer and uptake of pre-exposure prophylaxis (PrEP) for HIV prevention on the ground. Objective:The aim of this study was to assess the offer and uptake rates of PrEP in a metropolitan sexual health centre, among individuals at high risk for HIV infection. This can improve service delivery and uptake of HIV prevention. Methods: A retrospective review was conducted among clients with a positive diagnosis of rectal gonorrhoea, rectal chlamydia, or infectious syphilis between 1 July to 31 December 2018, to ascertain what percentage were offered PrEP, and of those, what percentage took up PrEP.Results: Of72 eligible males, 50 (69.4%) were offered PrEP. Of these, 29 (58%) took up PrEP, while 21 (42%) did not. Those who declined often wanted time to consider, did not make an appointment, or declined due to side effects. Conclusion:There is an acceptable PrEP offer rate which can be increased by training and enhanced documentation. More than half of eligible clients offered PrEP took it up, which is essential for HIV prevention. Patient education on PrEP and text reminders may increase PrEP uptake.
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