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应对口腔健康不平等问题的卫生人力:行动机遇

Health workforce for oral health inequity: Opportunity for action.

作者信息

Gallagher Jennifer E, Mattos Savage Grazielle C, Crummey Sarah C, Sabbah Wael, Makino Yuka, Varenne Benoit

机构信息

Dental Public Health, Centre for Host Microbiome Interactions, King's College London, Faculty of Dentistry, Oral & Craniofacial Sciences, Denmark Hill Campus, London, United Kingdom.

Noncommunicable Diseases Management Team, WHO Regional Office for Africa, Cité Djoué, Brazzaville, Congo.

出版信息

PLoS One. 2024 Jun 13;19(6):e0292549. doi: 10.1371/journal.pone.0292549. eCollection 2024.

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.

摘要

在第75届世界卫生大会通过2022年全球口腔健康战略之后,口腔健康在全球议程上占据重要位置。鉴于口腔疾病的全球负担,为实现全民健康覆盖(UHC)而进行的劳动力发展对于在非传染性疾病议程范围内满足人群需求至关重要。本文旨在概述全球口腔健康劳动力(OHWF)与关键背景因素的关系。整合了来自国家卫生人力账户的数据以及对世界卫生组织(WHO)成员国的一项调查数据,同时纳入了国家层面的人口和收入状况数据。数据按照WHO对全球区域的分类以及世界银行确定的收入状况类别进行呈现。研究了关键OHWF类别的劳动力密度。使用多元回归对劳动力密度和背景影响进行建模。按国家收入状况研究了挑战和可能的解决方案。全球每10000人口中约有3.30名牙医,OHWF(牙医、牙科助理/治疗师和牙科修复技师)合计每10000人口中有5.31名。明显的区域不平等很明显,最显著的是在WHO欧洲区域和非洲区域之间;然而这两个区域都比其他区域更多地利用了技能组合。经区域调整后,“国家收入状况”和“人口城市化”是牙医劳动力密度的有力预测因素,对OHWF合计更是如此。劳动力分布不均(城乡)被认为是全球尤其是低收入国家的一个特殊劳动力挑战。加强口腔健康政策被认为对未来最为重要。牙医以及总体上OHWF的全球分布是不公平的,技能组合的使用多变且有限。需要有创造性的劳动力发展来实现全球口腔健康议程,并通过创新的护理模式努力实现公平,同时要有有效的治理和综合政策的支持。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c15b/11175420/bfbc1e9dd35c/pone.0292549.g001.jpg

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