Document Type : Original Article
Authors
Health Human Resources Research Centre, School of Management and Medical Information Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
Abstract
Background: Each country’s health system is tasked with providing services to ensure the health of its population. Dental services are among these essential services. However, dental service utilization is unevenly distributed worldwide. This study’s findings will give health sector officials and policymakers valuable insights to enhance system performance.
Methods: This descriptive-analytical study, conducted in 2021, aimed to determine the distribution of dentists worldwide. The analysis utilized the Pareto curve, the dentist-to-population ratio (DPR), the Gini Coefficient (GC), and the Lorenz curve. The goal was to identify the countries with the highest number of dentists.
Results: There are over 2,500,000 dentists globally, averaging 3.6 dentists per 10,000 people. However, the ratios vary significantly, with about 6.8 per 10,000 in countries with very high Human Development Index (HDI) groups and 0.19 per 10,000 in low HDI groups. The data indicates that more than 80% of dentists work in countries with very high and high HDI.
Conclusion: This study suggests that job concentration is higher in areas with superior welfare and facilities, and dentistry is no exception. Therefore, creating better welfare in more disadvantaged areas, implementing mandatory government plans, and strategic government planning can help mitigate distribution inequality.
Highlights
Erfan Kharazmi (Google Scholar)
Shima Bordbar (Google Scholar)
Keywords
- Sanogo NA, Fantaye AW, Yaya S. Universal Health Coverage and Facilitation of Equitable Access to Care in Africa. Frontiers in Public Health. 2019;7. doi: 3389/fpubh.2019.00102 . PMID: 31080792; PMCID: PMC6497736.
- Suellen, Renata, Vaz J, Gonzaga T, Grazielle Christine Mattos-Savage, Gallagher JE, et al. The Influence of Dentists’ Profile and Health Work Management in the Performance of Brazilian Dental Teams. BioMed Research International. 2021; 2021:1–10.. 8843928. doi: 1155/2021/8843928 . PMID: 34778459; PMCID: PMC8580669.
- Bitton A, Ratcliffe HL, Veillard JH, Kress DH, Barkley S, Kimball M, et al. Primary Health Care as a Foundation for Strengthening Health Systems in Low- and Middle-Income Countries. Journal of General Internal Medicine. 2016; 32(5):566–71. doi: 1007/s11606-016-3898-5. PMID: 27943038; PMCID: PMC5400754.
- Davy C, Harfield S, McArthur A, Munn Z, Brown A. Access to primary health care services for Indigenous peoples: A framework synthesis. International Journal for Equity in Health. 2016; 15(1):1–9. doi: 10.1186/s12939-016-0450-5. PMID: 27716235; PMCID:
- El Tantawi M, Aly NM, Attia D, Abdelrahman H, Mehaina M. Dentist availability in Egypt: a 20-year study of supply, potential demand and economic factors. Eastern Mediterranean Health Journal. 2020; 26(9):1078–86. doi: 26719/emhj.20.008. PMID: 33047799.
- Pittman P, Chen C, Erikson C, Salsberg E, Luo Q, Vichare A, et al. Health Workforce for Health Equity. Medical Care. 2021; 59(Suppl 5):S405–8. doi: 1097/MLR.0000000000001609. PMID: 34524235; PMCID: PMC8428843.
- Albejaidi, F. and K.S. Nair, Building the health workforce: Saudi Arabia's challenges in achieving Vision 2030. Int J Health Plann Manage, 2019. 34(4): p. e1405-e1416. doi: 1002/hpm.2861. PMID: 31402508.
- Bourgeault I, Simkin S, Chamberland-Rowe C. Poor health workforce planning is costly, risky and inequitable. Canadian Medical Association Journal. 2019; 191(42):E1147–8. doi: 1503/cmaj.191241. PMID: 31636162; PMCID: PMC6805167.
- Abdullah, M.A., et al., The health workforce crisis in Pakistan: a critical review and the way forward. World Health Popul, 2014. 15(3): p. 4-12. PMID: 25576749.
- Aluttis C, Bishaw T, Frank MW. The workforce for health in a globalized context--global shortages and international migration. Glob Health Action. 2014 Feb 13;7:23611. doi: 10.3402/gha.v7.23611. PMID: 24560265; PMCID: PMC3926986.
- Aluttis C, Bishaw T, Frank MW. The workforce for health in a globalized context – global shortages and international migration. Global Health Action. 2014; 7(1):23611. doi: 3402/gha.v7.23611. PMID: 24560265; PMCID: PMC3926986.
- Emamgholipour Sefiddashti S, Arab M, Ghazanfari S, Kazemi Z, Rezaei S, Kazemi Karyani A. Trends of geographic inequalities in the distribution of human resources in healthcare system: the case of Iran. Electronic physician. 2016; 8(7):2607–13. doi: 19082/2607. PMID: 27648186; PMCID: PMC5014498.
- Stephens, M.B., J.P. Wiedemer, and G.M. Kushner, Dental Problems in Primary Care. Am Fam Physician, 2018. 98(11): p. 654-660. PMID:
- Fiorillo L. Oral Health: The First Step to Well-Being. Medicina. 2019; 55(10):676. doi: 3390/medicina55100676. PMID: 31591341; PMCID: PMC6843908.
- Kiadaliri A, Hosseinpour R, Haghparast-Bidgoli H, Gerdtham UG. Pure and Social Disparities in Distribution of Dentists: A Cross-Sectional Province-Based Study in Iran. International Journal of Environmental Research and Public Health. 2013; 10(5):1882–94. doi: 3390/ijerph10051882. PMID: 23648443; PMCID: PMC3709354.
- Reda SF, Reda SM, Thomson WM, Schwendicke F. Inequality in Utilization of Dental Services: A Systematic Review and Meta-analysis. American Journal of Public Health. 2018; 108(2):e1–7. doi: 2105/AJPH.2017.304180. PMID: 29267052; PMCID: PMC5846590.
- Gallagher JE, Hutchinson L. Analysis of human resources for oral health globally: inequitable distribution. International Dental Journal. 2018; 68(3):183–9. 183-189. doi: 1111/idj.12349. PMID: 29297930; PMCID: PMC9378901.
- Brown MC. Using gini-style indices to evaluate the spatial patterns of health practitioners: Theoretical considerations and an application based on Alberta data. Social Science & Medicine. 1994; 38(9):1243–56. doi: 10.1016/0277-9536(94)90189-9.
- Anand S, Bärnighausen T. Human resources and health outcomes: cross-country econometric study. The Lancet. 2004; 364(9445):1603–9. doi: 1016/S0140-6736(04)17313-3. PMID: 15519630.
- Taylor DH, Ricketts TC, Kolimaga JT. Defining underservice and physician shortage areas in historical and future context. A Report to North Carolina Rural Health Research Program, University of North Carolina: USA, Carolina. Working Paper 1994 No.30: 31-39.
- Ahmad Kiadaliri A, Najafi B, Haghparast-Bidgoli H. Geographic distribution of need and access to health care in rural population: an ecological study in Iran. International Journal for Equity in Health. 2011;10(1):39. doi: 10.1186/1475-9276-10-39.
- Kandelman, D., Arpin, S., Baez, R.J., Baehni, P.C. and Petersen, P.E. (2012), Oral health care systems in developing and developed countries. Periodontology 2000, 60: 98-109. doi: 10.1111/j.1600-0757.2011.00427.x.
- Yousefi M, A Akbari Sari, Arab M, A Oliaeemanesh. Methods of Resource Allocation Based on Needs in Health Systems, and Exploring the Current Iranian Resource Allocation System. Hakim Research Journal. 2010; 13(2):80–90.
- Nahvi M, Ehsan Zarei, Marzban S, Nader Jahanmehr. Utilization of Dental Services and Its Out-of-Pocket Payments: A Study in Dental Clinics of Ramsar. 2017. doi: 22038/jmds.2017.8810.
- Mohammadzadeh Z, Jafarnejad F, Movahed T. Comparison of Oral Health -Related Quality of Life among Adult Referred to Public and Private Dental Clinics of Mashhad, Iran. Journal of Mashhad Dental School 2017; 41:239 -50.
- Takayoshi Hashimura, Tanimoto T, Morita T, Kami M. Distribution of dentists in the Greater Tokyo Area, Japan. International Dental Journal. 2019; 69(2):150–7. doi: 10.1111/idj.12446.
- Gächter M, Schwazer P, Theurl E, Winner H. Regional density of private dentists: empirical evidence from Austria. Community Dentistry and Oral Epidemiology. 2013; 42(1):20–9. doi: 10.1111/cdoe.12054.
- Gallagher JE, Manickam S, Wilson NH. Sultanate of Oman: building a dental workforce. Human Resources for Health. 2015; 13(1):1-0. doi: 10.1186/s12960-015-0037-z.
- Rezaei S, KaramiMatin B, Akbari Sari A. Inequality in the geographic distribution of health workers in the public health sector in Iran. Hakim 2015; 18 (3) :194-200
URL: http://hakim.tums.ac.ir/article-1-1553-en.html. - Yahyavidizaj J, Arab M, Emamgholipour S, Na’emani F. Distribution of dentists in public sector and household payments for dental services in Iran. Health Monitor Journal of the Iranian Institute for Health Sciences Research. 2020; 19(4):373–81. doi: 29252/payesh.19.4.373.
- World Health Organization. Country Cooperation Strategy at a glance—South Africa. 2018.
- Tiwari R, Bhayat A, Chikte U. Forecasting for the need of dentists and specialists in South Africa until 2030. Goli S, editor. PLOS ONE. 2021; 16(5):e0251238. doi: 10.1371/journal.pone.0251238.
- El Tantawi M, Aly NM, Attia D, Abdelrahman H, Mehaina M. Dentist availability in Egypt: a 20-year study of supply, potential demand and economic factors. Eastern Mediterranean Health Journal. 2020; 26(9):1078–86. doi: 26719/emhj.20.008 . PMID: 33047799.
- Ismail M. Regional disparities in the distribution of Sudan's health resources. Eastern Mediterranean Health Journal. 2020;26(9):1105-14.
- Waters KP, Zuber A, Simbini T, Bangani Z, Krishnamurthy RS. Zimbabwe’s Human Resources for Health Information System (ZHRIS)—an assessment in the context of establishing a global standard. International journal of medical informatics. 2017; 100:121-8. doi: 10.1016/j.ijmedinf.2017.01.011.
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