A strife of interests: A qualitative study on the challenges facing oral health workforce policy and planning |
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| Institution: | 1. The University of Sydney, Faculty of Health Sciences, Sydney, Australia; The University of Sydney School of Dentistry, Sydney, Australia; Western Sydney Local Health District, New South Wales Health, Australia;2. Australian Research Centre for Population Oral Health, Adelaide Dental School, The University of Adelaide, Australia;3. The University of Sydney, Faculty of Health Sciences, Sydney Australia; Sydney Asia Pacific Migration Centre, Faculty of Arts and Social Sciences, Sydney, Australia;4. Faculty of Dentistry, Oral and Craniofacial Sciences, Kings College London, London, United Kingdom;1. IMEHPS.research, Vienna, Austria;2. Clinical Division of Social Psychiatry, Medical University of Vienna, Vienna, Austria;3. dwh Simulation Services, Vienna, Austria;4. SINTEF Digital, Health Research, Trondheim, Norway;5. National School of Public Health, Management and Professional Development (SNSPMPDS), Bucharest, Romania;6. National Institute for Health and Welfare (THL), Mental Health Unit, Helsinki, Finland;7. Department of Neurosciences, Biomedicine and Movement Sciences, Section of Psychiatry, University of Verona, Verona, Italy;8. Research Centre of the Slovenian Academy of Sciences and Arts (ZRC SAZU), Ljubljana, Slovenia;1. Health Economics Research Unit, University of Aberdeen, United Kingdom;2. University of Melbourne, United Kingdom;1. National Centre for Classification in Health, University of Sydney, Australia;2. Australian Institute of Health Innovation, Macquarie University, Australia;3. Independent Consultant, Australia;4. Population Wellbeing and Environment Research Lab., University of Wollongong, Australia;5. Royal North Shore Hospital, Sydney, Australia;6. Centre for Health Service Development, University of Wollongong, Australia;7. Independent Hospital Pricing Authority, Australia;1. Department of Patient and Care, Clinical Epidemiology and Medical Technology Assessment (KEMTA), Maastricht University Medical Center, The Netherlands;2. Care and Public Health Research Institute (CAPHRI), Maastricht University, The Netherlands;3. National Healthcare Institute Netherlands (Zorginstituut Nederland), The Netherlands;4. Clinical Trial Center Maastricht, The Netherlands;5. Panaxea b.v., Amsterdam, The Netherlands;6. Department of Family Medicine, Vrije Universiteit Brussels, Brussels, Belgium |
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| Abstract: | Oral health workforce policy has often lacked systematic connections with broader health policy, and system-based reforms that would enable more effective responses to future needs of the population. The aim of the study was to better understand challenges facing oral health workforce policy and planning and identify potential solutions. In-depth interviews of 23 senior oral health leaders and/or health policy experts from 15 countries were conducted in 2016-17. Grounded theory principles using the Straussian school of thought guided the qualitative analysis. The findings identified: (i) narrow approach towards dental education, (ii) imbalances in skills, jobs and competencies, and (iii) geographic maldistribution as major challenges. An overarching theme -“strife of interests” - shed light on the tension between the profession's interest, and the needs of the population. A key aspect was the clash for power, dominance and authority within the oral health workforce and across health professions. This study argues that appreciating the history of health professions and recognising the centrality of the strife of interests is necessary in developing policies that both address professional sensitivities and are in line with the needs of the population. Integration and closer collaboration of oral health professionals with the mainstream medical and health professions has emerged as the key issue, but the solutions will be diverse and dependent on country- or context-specific scenarios. |
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| Keywords: | Health workforce Medical-dental divide Interprofessional colloboration Integrated care Health professions |
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