Transformative Education
for Health Professionals

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Tackle inequalities in distribution of dentists in Thailand

Dr Thunthita Wisaijohn

Dentists are important clinical staff of the health workforce and it is widely accepted that the health workforce plays a vital role in the health system. Shortage of health staff including dentists is a major public health problem in many countries, particularly in developing nations, and Thailand is one of these cases. Consequently, a shortage of dentists, inequitable distribution of dental staff, and a lack of competencies in dental graduates are major hindrances to enhancing the health status of the population. Thus, the Ministry of Public Health (MoPH) of Thailand has put much effort into trying to tackle these problems through several health workforce policies.

Full project description: 

Since 1960, several new dental schools in Thailand were estab­lished outside the capital city with the aim to recruit students from the countryside. Another vital policy is compulsory rural service through contract bonding with the MoPH, set up since 1967, which is imposed on all dental students in all dental schools in the public sector. Under this contract bond, most dental students have to clinically practice in public hos­pitals outside Bangkok for at least 3 years after graduation, or pay a fee of USD $1,330 to break the contract.

Financial incentives are one of the mechanisms used to boost the number of dentists in remote areas. In 1975, an incentive of a USD $60–$88 monthly salary was introduced as a supplement for those working at hospitals in remote areas. This salary supple­ment was gradually increased over the years and, at present, it is USD $250–$500 per month.

In Thailand, there are two distinct modes of admission for dental students. The first track is called the normal track, whereby any grade 12 student can apply to take the national entrance examination for dental school. Prior to the national entrance exam, some faculty conduct their own recruit­ment (so-called “direct admission”).

The second method of recruitment is the special track, composed of two ongoing national programs. One is the “Collaborative Project to Increase Production of Rural Doctors (CPIRD) program,” launched in 1995, and the other is the “One District One Doctor (ODOD),” program launched in 2005. The pro­grams initially focused on doctors, and then were expanded to include dentists.

Authors of a study examining 'confidence in dental care and public health competency during rural practice among new dental graduates in Thailand' concluded that "new dentists who graduated from dental schools in Bangkok and vicinity had lower levels of confidence in their public-health competencies compared to those who graduated from dental schools outside Bangkok. Thus, working in rural areas after graduation could help new dentists gain more experience in rural practice, leading to higher confidence levels. The findings from this study could contribute to the improvement of the dental curriculum and contract-bonding policy to work in rural areas".

References

Confidence in dental care and public health competency during rural practice among new dental graduates in Thailand. Wisaijohn T et al., Advances in Medical Education and Practice 2015:6 1–9, URL: https://www.dovepress.com/confidence-in-dental-care-and-public-health-competency-during-rural-pr-peer-reviewed-article-AMEP (Accessed 29 June 2016)

Health workforce contributions to health system development: a platform for universal health coverage. Tangcharoensathien V et al., Bull World Health Organ 2013;91:874–880. URL: http://www.who.int/bulletin/volumes/91/11/13-120774.pdf (Accessed 29 June 2016)

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Quality: 
Yes
Quantity: 
Yes
Relevance: 
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Sustainability: 
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