Shortage of paediatricians in China

Hu, Kejia; Sun, Zhenzhong; Rui, Yongjun; Mi, Jingyi; Ren, Ming-xi

doi:10.1016/s0140-6736(14)60482-7

Cited by 46 publications

(32 citation statements)

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“…One reason for this inequity may be the existence of a training capacity gap, with fewer avenues to train paediatricians or fewer opportunities for employment in areas with an already low workforce. Some high-income countries have already undertaken more detailed analysis of their paediatric workforce and used this to inform investment and education policy 14 20–24…”

Section: Discussionmentioning

confidence: 99%

Where are the paediatricians? An international survey to understand the global paediatric workforce

Harper

Nganga

Armstrong

et al. 2019

bmjpo

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ObjectiveOur primary objective was to examine the global paediatric workforce and to better understand geographic differences in the number of paediatricians globally. Secondary objectives were to describe paediatric workforce expectations, who provides children with preventative care and when children transition out of paediatric care.DesignSurvey of identified paediatric leaders in each country.SettingPaediatric association leaders worldwide.Main outcome measuresPaediatrician numbers, provision of primary care for children, age of transition to adult care.ResultsResponses were obtained from 121 countries (73% of countries approached). The number of paediatricians per 100 000 children ranged from a median of 0.5 (IQR 0.3–1.4) in low-income countries to 72 (IQR 4–118) in high-income countries. Africa and South-East Asia reported the lowest paediatrician density (median of 0.8 paediatricians per 100 000 children, IQR 0.4–2.6 and median of 4, IQR 3–9, respectively) and fewest paediatricians entering the workforce. 82% of countries reported transition to adult care by age 18% and 39% by age 15. Most countries (91%) but only 64% of low-income countries reported provision of paediatric preventative care (p<0.001, Cochran-Armitage trend test). Systems of primary care provision varied widely. A majority of countries (63%) anticipated increases in their paediatric workforce in the next decade.ConclusionsPaediatrician density mirrors known inequities in health provider distribution. Fewer paediatricians are entering the workforce in areas with already low paediatrician density, which may exacerbate disparities in child health outcomes. In some regions, children transition to adult care during adolescence, with implications for healthcare training and delivery. Paediatrician roles are heterogeneous worldwide, and country-specific strategies should be used to address inequity in child health provision.

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Section: Discussionmentioning

confidence: 99%

Where are the paediatricians? An international survey to understand the global paediatric workforce

Harper

Nganga

Armstrong

et al. 2019

bmjpo

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“…91 Lower incomes, highly pressured working conditions, and demanding parents all contribute to the unpopularity of paediatrics as a specialty. 92 So any increase in birth rate resulting from the two-child policy will exacerbate pressures on an already stressed system.…”

Section: The Potential Effects Of the Universal Two-child Policymentioning

confidence: 99%

The effects of China's universal two-child policy

2016

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In October, 2015, China’s one-child policy was replaced by a universal two-child policy. The effects of the new policy are inevitably speculative, but predictions can be made based on recent trends. The population increase will be relatively small, peaking at 1·45 billion in 2029 (compared with a peak of 1·4 billion in 2023 if the one-child policy continued). The new policy will allow almost all Chinese people to have their preferred number of children. The benefits of the new policy include: a large reduction in abortions of unapproved pregnancies, virtual elimination of the problem of unregistered children, and a more normal sex ratio. All of these effects should improve health outcomes. Effects of the new policy on the shrinking workforce and rapid population ageing will not be evident for two decades. In the meantime, more sound policy actions are needed to meet the social, health, and care needs of the elderly population.

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“…According to the Pediatric Society of the Chinese Medical Doctor Association (PS-CMDA), although children account for 20% of the total population in China, there are only 68 specialized hospitals for children with a total of ∼258 000 beds, representing only 6.4% of all hospital beds. 1,2 Compared with the huge demand for hospital care, pediatric medical resources are limited. In particular, almost all of the large pediatric hospitals are in big cities.…”

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confidence: 99%

Chinese Pediatricians Face a Crisis: Should They Stay or Leave?

Zhang

2014

Pediatrics

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Shortage of paediatricians in China

Cited by 46 publications

References 1 publication

Where are the paediatricians? An international survey to understand the global paediatric workforce

Where are the paediatricians? An international survey to understand the global paediatric workforce

The effects of China's universal two-child policy

Chinese Pediatricians Face a Crisis: Should They Stay or Leave?

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