Geographic distribution indices of general practitioners, midwives, pediatricians, and gynecologists in the public sector of Iran

honarmand, r borgbar; Mozhdehifard, Mostafa; Kavosi, Zahra

doi:10.19082/4584

Cited by 13 publications

(17 citation statements)

References 18 publications

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“…In the study by Honarmand et al, the Gini coefficients of midwives in Iran were 0.18, 0.18, and 0.19 in 2010, 2011, and 2012, respectively, indicating that the trend of midwives' distribution was not significantly altered (30). The discrepancy between the Gini coefficients of distribution of Iranian midwives in the study by Tourani et al in 2015 and the study by the Honarmand et al in 2012 (0.40 and 0.19, respectively), as suggested about gynecologists, can be due to the sector the study was performed in (either public or private, or both).…”

Section: Discussionmentioning

confidence: 92%

“…One of the most important Millennium Development Goals is to create equity in access to health services, especially for vulnerable groups such as mothers and children (21,30). Since the first step for fair access to health services is the equal distribution of resources, monitoring the allocation of resources based on inequality indicators is essential (32).…”

Section: Discussionmentioning

confidence: 99%

“…The value of this index is between zero and one. Gini coefficients between 0.20 and 0.35 indicate relatively balanced distribution, 0.35 and 0.5 show relatively unequal distribution, and 0.5 and 0.70 indicate unequal distribution (30,31). The Gini index is computed through the Lorenz curve so that this coefficient is twice the zone between the Lorenz curve and the 45º line (perfect equality line) (1,32).…”

Section: Methodsmentioning

confidence: 99%

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Equality in the Distribution of Maternal and Child Care Providers in the Public Sector of Lorestan Province, Iran

et al. 2019

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Background: Equitable distribution of health services is the main goal of all countries, but this objective is more closely monitored and planned at the national level. Objectives: The purpose of this study was to investigate the distribution of care providers of mother and child as vulnerable groups at the provincial level in one of the provinces of Iran in 2011-2017. Methods: The Gini coefficient, dissimilarity index, and Gaswirth index were used to assess the distribution of maternal and child care specialists. The time trend of inequality was estimated using regression analysis. The calculations were performed using STATA-14 software. Results: The mean Gini coefficients of pediatricians, gynecologists, and midwives in the study period were 0.25, 0.32, and 0.36, respectively. The mean dissimilarity indices for the mentioned specialists in the study period were 15, 14.7, and 10.9, respectively. The mean Gaswirth indices were 0.99, 0.78, and 0.49, respectively. The results of the regression analysis showed that the effect of time on inequalities was not significant. Conclusions: The results of the study showed that there was some inequality in the distribution of human resources related to maternal and child health. Therefore, health policymakers are proposed to design and implement a sustainable policy for the fair distribution of these workforces at the provincial level. Equality of indicators at the national level does not necessarily imply equitable distribution at the county level. Therefore, it is proposed to measure and monitor the indicators at provincial/state levels, as well.

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Section: Discussionmentioning

confidence: 92%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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Equality in the Distribution of Maternal and Child Care Providers in the Public Sector of Lorestan Province, Iran

et al. 2019

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“…Theodorakis et al [16] measured the health inequalities in general practitioner distribution in Albania by plotting Lorenz curves and calculating Gini coefficients. Honarmand et al [17] calculated the Gini coefficient and Robin Hood index to investigate the equity in general practitioners, midwives, pediatricians, and gynecologists distribution in Iran. Wiseman [18] adopted Lorenz Curve/Gini Coefficient and Theil Index to explore the inequality in health manpower distribution in Fiji for doctors, nurses, and all health manpower (doctors, nurses, dentists and health support staff).…”

Section: Introductionmentioning

confidence: 99%

Spatio-temporal variations of licensed doctor distribution in China: measuring and mapping disparities

Zhu

Hsieh

Mao

2020

BMC Health Serv Res

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Background: The licensed doctor misdistribution is one of the major challenges faced by China. However, this subject remains underexplored as spatial distribution characteristics (such as spatial clustering patterns) have not been fully mapped out by existing studies. To fill the void, this study aims to explore the spatio-temporal dynamics and spatial clustering patterns of different subtypes of licensed doctors (i.e., clinicians, traditional Chinese medicine doctors, dentists, public health doctors, general practitioners) in China. Methods: Data on the licensed doctor quantity and population during 2012-2016 was obtained from the National Health (and Family Planning) Yearbook. Functional boxplots were used to visualize and compare the temporal trends of densities of different subtypes of licensed doctors. This study adopted two complementary spatial statistics (space-time scan statistics and Moran's I statistics) to explore the spatio-temporal dynamics and spatial clustering patterns of licensed doctor distribution in China. The former was used to explore the spatial variations in the temporal trends of licensed doctor density during 2012-2016, and the latter was adopted to explore the spatial changing patterns of licensed doctor distribution during the research period. Results: The results show that the densities of almost all subtypes of licensed doctors displayed upward trends during 2012-2016, though some provincial units were left behind. Besides, spatial distribution characteristics varied across different subtypes of licensed doctors, with the low-low cluster area of general practitioners being the largest. Conclusions: The misdistribution of licensed doctors is a global problem and China is no exception. In order to achieve a balanced distribution of licensed doctors, the government is suggested to introduce a series of measures, such as deliberative policy design and effective human resource management initiatives to educate, recruit, and retain licensed doctors and prevent a brain drain of licensed doctors from disadvantaged units.

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“…(8) Health in general and oral health in particular are affected by characteristics of health equity, such as access and distribution, and the disparities and access problems have forced many countries to improve their policies, especially the distribution of human resources. (9,10) So in Iran the oral health office in ministry of health in 2014 decided to implement the national program to improve oral and dental health equality in 6-14 year-old students in all over the country. (11,12) One of the objectives of this program was to ensure fairness in the provision of preventive services to students and the fair distribution of dental care providers throughout the programme.…”

mentioning

confidence: 99%

Inequality Assessment of Oral Health Workforce’s Distribution in Iran’s National Oral Health Promotion Program

Mozhdehifard¹,

Shabaninejad²

2019

jemds

Self Cite

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BACKGROUND Oral health is a major factor in public health. Children aged 6-12 years are the most important target group for oral and dental hygiene programs due to the high prevalence of dental caries, development of permanent teeth, and formation of lifestyles in this period and schools are the easiest and most cost-effective way to reach them. The latest national oral health promotion (NOHP) program in Iran was implemented in 2016-2017 to provide preventive and treatment services such as fluoride varnish treatment (FVT) to 7-14-year-old children. The purpose of this study was to evaluate the status of oral health promotion services and inequality assessment of total inequality in oral health workforce distribution in Iran based on distribution indices. METHODS The data about the number of oral health related workforce and also primary students (6-12 years) in NOHP program was obtained from the report of oral health office in Iranian Ministry of health. The geographic unit of analysis was 50 medical universities in all provinces of Iran. The human resource per target population ratio was used as oral health workers accessibility. The Gini coefficient and Robin Hood index was used to assess inequality. Number of dentists, dental therapists and oral hygienists in medical universities per 100,000 primary students was calculated. FVT coverage reported by each medical university was considered as NOHP program outcome. RESULTS In terms of human resources to student's ratio, the results showed that North Khorasan and Tehran centers respectively had the highest (8.94) and lowest (0.03) ratio of health workers, and Ardabil had the highest ratio (0.79) of oral hygienists. Kerman had the highest (0.73) and Iranshahr had the lowest (0.07) ratio of dentists. The Gini coefficient was 0.28 for dentists and 0.76 for oral hygienists. CONCLUSIONS Although the coverage of programs for oral and dental health promotion among students in Iran seems adequate, unfair distribution of human resources and the lack of serious consideration for those involved in preventive care can negatively affect the quality of services. Fair distribution and adoption of corrective policies for redistribution of oral and dental care providers must be addressed more seriously by health policymakers in Iran.

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Geographic distribution indices of general practitioners, midwives, pediatricians, and gynecologists in the public sector of Iran

Cited by 13 publications

References 18 publications

Equality in the Distribution of Maternal and Child Care Providers in the Public Sector of Lorestan Province, Iran

Equality in the Distribution of Maternal and Child Care Providers in the Public Sector of Lorestan Province, Iran

Spatio-temporal variations of licensed doctor distribution in China: measuring and mapping disparities

Inequality Assessment of Oral Health Workforce’s Distribution in Iran’s National Oral Health Promotion Program

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