|Year : 2017 | Volume
| Issue : 3 | Page : 72-73
Workforce planning and distribution for universal oral health coverage: An Indian perspective
Department of Public Health Dentistry, Dr. D.Y. Patil Dental College and Hospital, Dr. D.Y. Patil Vidyapeeth, Pune, Maharashtra, India
|Date of Web Publication||11-Jan-2018|
Department of Public Health Dentistry, Dr. D.Y. Patil Dental College and Hospital, Pune - 411 018, Maharashtra
Source of Support: None, Conflict of Interest: None
On the global picture India is a fast growing nation with an equally growing population. The dental workforce has grown in the absence of any specific design or policy planning, resulting in an oversupply of dentists in urban areas. The inverse ratio of dentist to population is a major setback especially in the rural areas. Proper distribution of available manpower is the need of the hour. The challenges are many, but they can be overcome with strong consensus and implementation through upstream approaches.
Keywords: Dental workforce, manpower planning, oral health coverage
|How to cite this article:|
Mehta V. Workforce planning and distribution for universal oral health coverage: An Indian perspective. J Dent Res Rev 2017;4:72-3
|How to cite this URL:|
Mehta V. Workforce planning and distribution for universal oral health coverage: An Indian perspective. J Dent Res Rev [serial online] 2017 [cited 2021 Oct 22];4:72-3. Available from: https://www.jdrr.org/text.asp?2017/4/3/72/223053
| Introduction|| |
On the global picture, India is a fast-growing nation with an equally growing population. About 68% of India's population resides in villages that lack basic general health infrastructure. Furthermore, there exists a pervasive trend within the health-care industry wherein oral healthcare is isolated, and it is not seen as a priority by the government, policymakers, and importantly, by the communities itself. Lack of dental infrastructure, workforce, and uneven distribution is an addition to this adversity.
Currently, there are 310 dental colleges with around 270 private and 40 government colleges along with over 117,825 registered dentists working in India. A gradual increase in the number of dental graduates should be beneficial for an overall oral health of the country, but the reality is grim. Although India has a dentist to population ratio of 1:10271, budding dentists find it difficult to survive. The dental workforce has grown in the absence of any specific design or policy planning, resulting in an oversupply of dentists in urban areas. Deficient workforce planning and projection is the result of mushrooming of dental colleges, geographical imbalances, the skewed dentist-population ratio, lopsided specialist training, the lack of dental auxiliaries, inadequate workforce in rural areas, immigration and migration of the dental workforce, and changing disease patterns. The work interests of dentists are associated with their unwillingness to work in rural areas due to socioeconomic, geographical factors, and lack of government jobs.
This situation has a direct impact on oral health delivery in the nation. The inverse ratio of dentist to population is a major setback, especially in the rural areas. This is one of the reasons for the alarming increase in number of quacks in these areas who provide services at minimal charges. The unethical and unhygienic practice of the quacks has increased the oral health problems rather than minimizing it. Continuation of the current situation will lead to wastage of highly trained dental workforce and create a threat to the professional integrity of the dentists. Accessible, affordable, available, and appropriate oral healthcare, in the form of a tailor-made oral health package, is vital for every community.
All these reasons together have created a vacuum in the universal oral health coverage in the country. Proper distribution of available workforce is the need of the hour. The challenges are many, but they can be overcome with strong consensus and implementation through upstream approaches. Beginning from the basic foundation, that is, the compulsory rotatory internship period, we can lobby with the government to impose a mandatory rural posting of dental interns for 1 year. This will provide oral healthcare to the last man in the remotest village. Community health leaders such as ASHAs and Anganwadi workers help bridge the gap between the health system and the community. They have been successful in mitigating several health issues and thus can be utilized for providing basic oral health care. There is a need to include compulsory oral health-care provisions at primary health centers and community health centers. The gap between preventive (primary) and tertiary oral care levels needs to be bridged.
The ideal goal of community-based oral health coverage is to place health in the hands of the community. People are more likely to use and respond positively to health services if they have been involved in making decisions about how these services are delivered, thus helping to make these services sustainable. One way to overcome the challenge of needs assessment is to empower communities to conduct their own assessments. This requires little training and continuous support. Community-based diagnosis is also advantageous in a populous country like India, where such humongous endeavors require massive resources.
If need-based workforce estimation is to be considered for the Indian scenario, the question here is who is going to pay for the dental care for underserved populations. Under the corporate social responsibilities, the private business firms and multinational companies can perform their discretionary responsibility of philanthropy toward the oral health coverage of the fellow countrymen. Dental colleges are another important channel for involving communities. Often, their work takes a top-down approach to conduct free oral health check-up and treatment camps can be a means to deliver this duty.
One of the strategies to improve oral health is through encouraging public–private partnership (PPP). PPP can play a pivotal role with each sector contributing significantly to improve oral health outcomes. One of the major advantages of encouraging PPP is that when public and private sectors come together, they overcome each other's weaknesses and work like a potent bullet to slay oral problems. It increases the public expenditure on health aspects and reduces regional imbalances in health, pooling resources, optimization of health workforce, community participation, and ownership. It brings convergence of private sector interests and public sector goals. It intends to optimally utilize and enable increased access to vast rural poor and focus on marginalized segments such as slum dwellers.
Oral health problems are a perennial global problem, which means a mouthful of silver for the patients and a pocketful of gold for the dentists. This wrongly conceived notion may be one of the reasons why people tend to put dental health on the backburner. To change this notion, this redefined PPP, if introduced, can play a magnanimous catalytic role in achieving excellence in oral health. Public and private insurance companies can spread their span of activities to benefit the poorer sections covering wide varieties of oral problems with minimal interest.
There is vocal support for incorporating universal oral healthcare, but the government and the private sector need to work together to assure comprehensive dental care services, especially for the most vulnerable who bear the double burden of restricted access and unaffordable treatments and greater need. Dynamic models and the sociodental approach can be useful for determining the needs of various population groups. Thus, workforce planning should be a continuous process and not sporadic and requires continuous monitoring and evaluation.
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.
| References|| |
Singh S, Badaya S. Health care in rural India: A lack between need and feed. South Asian J Cancer 2014;3:143-4.
] [Full text]
Vundavalli S. Dental manpower planning in India: Current scenario and future projections for the year 2020. Int Dent J 2014;64:62-7.
Tandon S. Challenges to the oral health workforce in India. J Dent Educ 2004;68:28-33.
Rifkin SB. Lessons from community participation in health programmes: A review of the post alma-ata experience. Int Health 2009;1:31-6.
Bailey W. Public-private partnership: Complementary efforts to improve oral health. J Calif Dent Assoc 2014;42:249-52.