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A strife of interests: A qualitative study on the challenges facing oral health workforce policy and planning

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  • Balasubramanian, Madhan
  • Brennan, David S.
  • Short, Stephanie D
  • Gallagher, Jennifer E

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.

Suggested Citation

  • Balasubramanian, Madhan & Brennan, David S. & Short, Stephanie D & Gallagher, Jennifer E, 2019. "A strife of interests: A qualitative study on the challenges facing oral health workforce policy and planning," Health Policy, Elsevier, vol. 123(11), pages 1068-1075.
    • Handle: RePEc:eee:hepoli:v:123:y:2019:i:11:p:1068-1075
    DOI: 10.1016/j.healthpol.2019.07.010
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    References listed on IDEAS

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    1. Kuhlmann, Ellen & Larsen, Christa, 2015. "Why we need multi-level health workforce governance: Case studies from nursing and medicine in Germany," Health Policy, Elsevier, vol. 119(12), pages 1636-1644.
    2. Ruggeri, Matteo & Drago, Carlo & Moramarco, Vincenzo & Coretti, Silvia & Köppen, Julia & Islam, Muhammad Kamrul & Gibson, Jonathan & Busse, Reinhard & van Exel, Job & Sutton, Matthew & Askildsen, Jan , 2018. "New professional roles and patient satisfaction: Evidence from a European survey along three clinical pathways," Health Policy, Elsevier, vol. 122(10), pages 1078-1084.
    3. Adams, Tracey, 1999. "Dentistry and medical dominance," Social Science & Medicine, Elsevier, vol. 48(3), pages 407-420, February.
    4. Gallagher, Jennifer E. & Eaton, Kenneth A., 2015. "Health workforce governance and oral health: Diversity and challenges in Europe," Health Policy, Elsevier, vol. 119(12), pages 1565-1575.
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    Cited by:

    1. Madhan Balasubramanian & Aliya Hasan & Suruchi Ganbavale & Anfal Alolayah & Jennifer Gallagher, 2021. "Planning the Future Oral Health Workforce: A Rapid Review of Supply, Demand and Need Models, Data Sources and Skill Mix Considerations," IJERPH, MDPI, vol. 18(6), pages 1-33, March.

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