Exploratory scoping of the literature on factors that influence oral health workforce planning and management in developing countries

Abstract

Exploratory scoping of the literature on factors that influence oral health workforce planning and management in developing countries Abstract: Objectives: The purpose of this study was to scope the literature that exists about factors influencing oral health workforce planning and management in developing countries (DCs). Methods: The Arksey and O'Malley method for conducting a scoping review was used. A replicable search strategy was applied, using three databases. Factors influencing oral health workforce planning and management in DCs identified in the eligible articles were charted. Findings: Four thousand citations were identified; 41 papers were included for review. Most included papers were situational analyses. Factors identified were as follows: lack of data, focus on the restorative rather than preventive care in practitioner education, recent increase in number of dental schools (mostly private) and dentistry students, privatization of dental care services which has little impact on care maldistribution, and debates about skill mix and scope of practice. Oral health workforce management in the eligible studies has a bias towards dentist-led systems. Due to a lack of countryspecific oral health related data in developing or least developed countries (LDCs), oral health workforce planning often relies on data and modelling from other countries. Discussion and conclusion: Approaches to oral health workforce management and planning in developing or LDCs are often characterized by approaches to increase numbers of dentists, thus not ameliorating maldistribution of service accessibility. Governments appear to be reducing support for public and preventative oral healthcare, favouring growth in privatized dental services. Changes to professional education are necessary to trigger a paradigm shift to the preventive approach and to improve relationships between different oral healthcare provider roles. This needs to be premised on greater appreciation of preventive care in health systems and funding models.

A global perspective on implant education: Cluster analysis of the “first dental implant experience” of dentists from 84 nationalities

“…10 resent not only a younger demographic in terms of regional dental manpower in Asia 21,22,51 and a somewhat later growth in popularity of implant dentistry, but also reflect regional differences in common "practice models" in terms of public versus private health care 52 and number of dentistry programmes. 53 Most developing nations such as China, India and Malaysia house large populations and have seen a relative upsurge in the number of dental training programmes in the last 1-2 decades. 54 Correspondingly, these data seem to suggest that at a global scale, the younger implant practitioner demographic maybe skewed towards Asia, South America and Africa, which is not surprising.…”

“…The Cluster 4‐YPG‐U or the “young post‐graduate in University or public hospital settings” showed a relative over‐representation of location in Asia. This trend may represent not only a younger demographic in terms of regional dental manpower in Asia and a somewhat later growth in popularity of implant dentistry, but also reflect regional differences in common “practice models” in terms of public versus private health care and number of dentistry programmes . Most developing nations such as China, India and Malaysia house large populations and have seen a relative upsurge in the number of dental training programmes in the last 1‐2 decades .…”

Policymaking Challenges in the Oral Health in a Low-income Developing Country:A Qualitative Approach

“…It was found that the policy of increasing the number of dental colleges and training of dental specialists did not lead to improvement of oral health state. It is also emphasized that increasing the number of dentistry colleges in developing countries, not only causes high costs for health care system, but also makes serious concern to decrease the quality of services and education [20] Another evidence also suggests that in developing countries the policy of increasing and training intermediate forces can provide better results and help improve the oral health state of the community [18], so that this policy can reduce caries, increase and improve restoration and reduce dental emergencies, especially in children.…”

Fortitude and resilience in service of the population: a case study of dental professionals striving for health in Sierra Leone

“…41 Workforce considerations must take account of population needs, together with a range of other factors in an integrated as well as a flexible approach. 42,43 However, a critical barrier especially for LICs, has been the dearth of evidence or an understanding of local issues. 43 Future planning needs to build on the realty that exists and learn from those who deliver care on the ground.…”

“…42,43 However, a critical barrier especially for LICs, has been the dearth of evidence or an understanding of local issues. 43 Future planning needs to build on the realty that exists and learn from those who deliver care on the ground.…”