Division of Health Systems and Public Health, Department of Global Health, Faculty of Health and Medical Sciences, Stellenbosch University, Cape Town, Western Cape, South Africa.
Department of Community Dentistry, University of Pretoria, Pretoria, Gauteng, South Africa.
PLoS One. 2021 May 17;16(5):e0251238. doi: 10.1371/journal.pone.0251238. eCollection 2021.
To manage the increasing burden of dental diseases, a robust health system is essential. In order to ensure the oral health system operates at an optimal level going into the future, a forecast of the national shortfall of dentists and dental specialists in South Africa (SA) was undertaken. There is currently a shortage of dentists and specialists in SA and given the huge burden of dental diseases, there is a dire need to increase the number of these health care workers. The aim was to determine the projected shortfall of dentists and specialists in each of the nine provinces in SA. The projected shortfall was calculated based on the SA Disability-Adjusted Life Years (DALYs) for each province. The estimate for the evaluation of the Global Burden of Disease (GBD) for SA was obtained from the Institute of Health Metrics and Evaluation (IHME) Global Burden of Disease website. For each province, age standardized DALYs were calculated with mid-year population estimates obtained from Statistics SA 2018. In order to reduce the existing human resources for health (HRH) inequity among the provinces of SA, three scenarios were created focussing on attaining horizontal equity. The best-case scenario estimates a shortfall of 430, 1252 and 1885 dentists and specialists in 2018, 2024 and 2030 respectively. In an optimistic scenario, the national shortfall was calculated at 733, 1540 and 2158 dentists and specialists for the years 2018, 2024 and 2030 respectively. In an aspirational scenario, shortfalls of 853 (2018), 1655 (2024) and 2267 (2030) dentists and specialists were forecasted. Access to oral health services should be ensured through the optimum supply of trained dentists and specialists and the delivery of appropriate oral health services. Thus, the roadmap provided for upscaling the oral health services recognizes the influence of both demand and supply factors on the pursuit of equity.
为了应对日益增长的口腔疾病负担，一个健全的医疗体系至关重要。为了确保南非的口腔卫生系统在未来能够保持最佳运行水平，对全国范围内的牙医和口腔专家短缺情况进行了预测。南非目前存在牙医和专家短缺的情况，鉴于口腔疾病的巨大负担，迫切需要增加这些卫生保健工作者的数量。目的是确定南非每个省份的牙医和专家预计短缺数量。根据每个省份的残疾调整生命年（DALY）来计算预计短缺数量。对南非全球疾病负担（GBD）评估的估计值是从健康计量与评估研究所（IHME）的全球疾病负担网站获得的。对于每个省份，使用南非统计局 2018 年提供的年中人口估计数计算了年龄标准化 DALY。为了减少南非各省份之间现有的卫生人力资源（HRH）不平等，创建了三个情景，重点关注实现横向公平。最佳情况下的估计值表明，2018 年、2024 年和 2030 年，分别短缺 430 名、1252 名和 1885 名牙医和专家。在乐观的情况下，全国范围内预计在 2018 年、2024 年和 2030 年分别短缺 733 名、1540 名和 2158 名牙医和专家。在理想的情况下，预计短缺 853 名（2018 年）、1655 名（2024 年）和 2267 名（2030 年）的牙医和专家。应该通过提供足够数量的经过培训的牙医和专家以及提供适当的口腔保健服务，来确保获得口腔健康服务。因此，扩大口腔卫生服务的路线图认识到需求和供应因素对追求公平的影响。
