addressing oral health workforce training in the pacific

Western Pacific Regional Office

Addressing Oral Health Workforce Training in the Pacific

Addressing Oral Health Workforce Training in the Pacific

Dr Rodel G Nodora

Technical Officer, HRH/POLHN

WHO/WPRO


Addressing Oral Health Workforce Training in the Pacific11-13 March 2014, Pohnpei, Federated States of Micronesia

Health Workers Save LivesHealth Workers Save Lives

The number of health professionals world-wide, and the quality and relevance of quality and relevance of

their educationtheir education, is insufficient to meet the current and future

health needs of local populations.

… a critical shortage was found in 57 countries.



HRH Action Framework WHO/WPROadapted from: Human Resources for Health Technical Framework: achieving a sustainable health workforce World

Health Report 2006

Critical Success FactorsResults-focused planning and practicesSystem-linked alignmentKnowledge-based decision-makingLearning-oriented perspectivesInnovative solutionsComprehensive and integrated approaches

BETTER HEALTH

OUTCOMES

Improved Health

Workforce Outcomes

Critical Success Factors Country-led initiativesGovernment-supported actionsMulti-sector engagementMulti-stakeholder involvementDonor alignmentGender sensitivity

EquityEffectiveness

EfficiencyAccessibility

Responsiveness

BETTER HEALTH

SERVICES

Preparation & Planning

Situ

atio

n A

na

lysi

s Imp

lem

en

tatio

n

Monitoring & Evaluation

Service DeliveryHealth Care Financing

Medical Products and Technologies

Health InformationGovernance

Policy

Leadership

Partnership Education

FinanceHumanResources for Health Systems

Country specific context Including labour market

HRH Vision 2020Population with access to adequate,

competent, productive and supported health workforce



Human Resources for Health (HRH) priority issues in the Pacific

Human Resources for Health (HRH) priority issues in the Pacific

● HRH policies, planning and systems– Management of HW performance

● Multisectoral engagement, financial constraints– Status of other health system components

● Mobility of HWs (internal, international)

● Access to education and training to address:Access to education and training to address:– Specific shortages; CPD requirements and how we “develop capacity”Specific shortages; CPD requirements and how we “develop capacity”

Recruitment, retention and an ageing workforce

● Health service needs of small populations dispersed through remote, rural and outer island settings

– Equity of distribution



Pacific Health Workforce Density (Doctors, Nurses and Midwives per 1,000 population)

Pacific Health Workforce Density (Doctors, Nurses and Midwives per 1,000 population)

2.3 / 1,000 (indicative minimum threshold;

WHO)



Transformative scale up of health professional educationTransformative scale up of health professional education

Source: Lancet 2010; 376: 1923-58



WHO’s Response to Oral HealthWHO’s Response to Oral Health

Oral diseases qualify as major public health problems – high prevalence and incidence in all regions of the world – the greatest burden of oral diseases is on the

disadvantaged and socially marginalized populations.

Traditional treatment of oral diseases is extremely costly in several countries and not feasible or possible to most low-income and middle-income countries.

The WHO Global Strategy for prevention and control of non-communicable diseases and the common risk factor approach is a strategy that is clearly linked to managing prevention and control of oral diseases.



Numbers/Quantity Challenge Numbers/Quantity Challenge

Number of Dentists in WPRORange: 1 in NRU and 149,000 in AUS



Number of Dentists in PICsNumber of Dentists in PICs

13 11 145

0

20

40

60

80

100

120

140

160

180



Nu

mb

er o

f D

enti

sts

in P

ICs

Nu

mb

er o

f D

enti

sts

in P

ICs

WPRO PICsNumber of Dentists

No./10 000 Year

American Samoa 13 3 2013Cook Islands 4 NA 2009Fiji 171 4 2009Kiribati 18 2 2008Marshall Islands 11 2 2008Federated States of Micronesia 14 4 2008Nauru 1 2 2009New Caledonia 89 NA 1995Niue 2 NA 2008Palau 5 3 2007Papua New Guinea 46 1 2008Samoa 17 NA 2008Solomon Islands 52 1 2008Tonga 11 NA 2009Tuvalu 2 2 2008



Quality (of oral health) workforce Quality (of oral health) workforce

Provide important and valuable services

Have specialist technical skills and/or knowledge

Require significant education and training

Often needs to work ‘face-to-face’ with patients

Can seldom be replaced with technology

And:

Generally, a large single cost in any health system



Approach for the Oral HWF Approach for the Oral HWF


through



BackgroundBackground

Intention of American Samoa’s oral health staff for dental assistants to be certified

Discussion with POLHN in early 2013 with Dr Stanley Gurr and Dr Talifa Talifa Jr.

POLHN Secretariat liaised with Penn Foster

WHO/POLHN covered the cost of tuition. Holds regular teleconferences with dental assistant learners and supervisors to monitor learner progress.

Face-to-face skills validation with PBDA and formal presentation of certificates.



Structure Structure

The diploma is self-paced and is expected to take 5 – 9 months to complete.

Penn Foster sends learning aids and course content to learners, additional resources are available online and exams are completed online.

POLHN included a face-to-face skills validation for program participants

Graduation ceremony for successful dental assistants



External AssessmentExternal Assessment

In collaboration with the Pacific Basin Dental Association (PBDA), an external assessor was engaged

– Dr Dustin Bantol from Marshall Islands

Practical examination and skills demonstration

To reinforce the learning of the dental assistants and to contextualize things into Pacific realities

An opportunity for the dental assistants to showcase their competencies on quality customer service and communication



AccreditationAccreditation

Accreditation is primarily a country specific consideration. Penn Foster has received accreditation in America as follows:

• State level: Penn Foster Career School is accredited for non-degree granting postsecondary programs by the Commission on Secondary Schools of the Middle States Association.

• National: Penn Foster Career School is accredited by the Accrediting Commission of the Distance Education and Training Council (DTEC).

• International: Penn Foster Career School has been approved as an Authorized Provider by the International Association for Continuing Education and Training.



POLHNPOLHN

The Pacific Open Learning Health Net (POLHN) is a partnership between Pacific Ministries of Health and WHO.

POLHN’s goals are: 1.Improve health professionals’ access to continuing professional development (CPD).2.Provide CPD for Pacific health professionals.3.Build capacity among local and regional academic institutions to develop and deliver online CPD.



Aims of POLHNAims of POLHN

Motivated and confident

health workers

Up-skilled and

competent

Technologically literate

Equipped with the knowledge to

respond to changing health needs

People Processes

Products Partners



Way Forward Way Forward

Design POLHN recommended courses per cadre guided by Career-Roles continuum

Develop more flexible courses that is practical and relevant to the contexts

– Examples:• certification of dental assistants• Post graduate NCD course

Advocate for accreditation from various health professional councils in the Pacific



Career Roles ContinuumCareer Roles Continuum

Technical/Clinical Roles

Management/Administrative Roles

Technical/Clinical Roles

C A R E E RC A R E E R



POLHN and training modesPOLHN and training modes

Formal

Informal

AccreditedNon-

Accredited



Example: CPD for Dental CadreExample: CPD for Dental Cadre



Example of Technical Course SkillsExample of Technical Course Skills



General Courses for Oral Health CadreGeneral Courses for Oral Health Cadre



This can be replicated in other cadres of the health sector.This can be replicated in other cadres of the health sector.



Learning Opportunities in WHOLearning Opportunities in WHO

Formal

Informal

AccreditedNon-

Accredited

addressing oral health workforce training in the pacific

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