Planning the Future Oral Health Workforce: A Rapid Review of Supply, Demand and Need Models, Data Sources and Skill Mix Considerations

Abstract

Over the last decade, there has been a renewed interest in oral health workforce planning. The purpose of this review is to examine oral health workforce planning models on supply, demand and needs, mainly in respect to their data sources, modelling technique and use of skill mix. A limited search was carried out on PubMed and Web of Science for published scientific articles on oral health workforce planning models between 2010 to 2020. No restrictions were placed on the type of modelling philosophy, and all studies including supply, demand or needs based models were included. Rapid review methods guided the review process. Twenty-three studies from 15 countries were included in the review. A majority were from high-income countries (n = 17). Dentists were the sole oral health workforce group modelled in 13 studies; only five studies included skill mix (allied dental personnel) considerations. The most common application of modelling was a workforce to population ratio or a needs-based demand weighted variant. Nearly all studies presented weaknesses in modelling process due to the limitations in data sources and/or non-availability of the necessary data to inform oral health workforce planning. Skill mix considerations in planning models were also limited to horizontal integration within oral health professionals. Planning for the future oral health workforce is heavily reliant on quality data being available for supply, demand and needs models. Integrated methodologies that expand skill mix considerations and account for uncertainty are essential for future planning exercises.

Health workforce for oral health inequity: Opportunity for action

“…For lower income countries, and the region of AFR which has the majority lower-income countries, it represents a particular challenge [ 41 ]. Inequitable distribution in relation to need [ 17 , 42 , 43 ], may be explained by a wide range of individual, organisational, political, economic and social contextually-specific factors [ 43 ]. This includes the recognition that the free-market business model of oral health care provision is predicated on demand for, and supply of, services [ 42 ], rather than workforce regulation and planning based on a fair distribution of the workforce according to the needs of the population [ 44 ], and guiding principles for universal health coverage [ 8 ].…”

“…Thus, these findings suggest that to achieve UHC, innovation on tackling the OHWF distribution to support rural areas is crucial [ 17 , 45 ] with the potential for models of care beyond the traditional focus of dentists with greater use of skill mix [ 17 , 23 , 24 , 46 ]. Examples include the use of dental therapists and dental health aids in Alaska [ 47 ] and Tanzania [ 48 ], and using community health workers in AFR [ 49 ].…”

“…The 2022 global strategy on oral health highlights the need for “innovative workforce models to respond to population needs”, and the importance of oral health being integrated into primary healthcare [PHC] [ 23 ], providing an important opportunity for change. Creating an NCD-ready workforce [ 54 ], will involve drawing on innovative training, utilising tools such as the global competency and outcomes framework in a context-specific manner [ 19 ], to identify, educate and train the most effective mix of staff, including community health workers, within available resources [ 17 ].…”

“…In support of building the global workforce for 2030, there has been progressive action to strengthen information systems [ 15 ], with increasing emphasis on the oral health workforce [ 16 , 17 ], to inform evidence-based national and international policies [ 2 , 3 , 11 , 12 , 16 , 17 ]. The National Health Workforce Accounts [NHWA] play an important role in building national capacity to strengthen and facilitate data sharing and use [ 18 ], including standardization of health workforce information systems for interoperability, that is the ability to exchange data within broader subnational or national health information systems, as well as within international information systems.…”

“…As member states take account of the new global strategy for oral health [ 1 ], there is an urgent need to consider OHWF patterns and trends, taking account of contextual factors, in support of planning [ 17 ] for UHC [ 5 ].…”