Where are the paediatricians? An international survey to understand the global paediatric workforce
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Author
Nganga, Waceke
Armstrong, Robert
Forsyth, Kevin D
Ham, Hazen P
Keenan, William J
Published Version
https://doi.org/10.1136/bmjpo-2018-000397Metadata
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Harper, Beth, Waceke Nganga, Robert Armstrong, Kevin D Forsyth, Hazen P Ham, William J Keenan, Christiana Russ. "Where are the paediatricians? An international survey to understand the global paediatric workforce." BMJ Paediatrics Open 3, no. 1 (2019): bmjpo-2018-000397. DOI: 10.1136/bmjpo-2018-000397Abstract
ObjectiveOur primary objective was to examine the global paediatric workforce and to better understand geographic differences in the number of paediatricians globally. Secondary objectives were to describe paediatric workforce expectations, who provides children with preventative care and when children transition out of paediatric care.
Design
Survey of identified paediatric leaders in each country.
Setting
Paediatric association leaders worldwide.
Main outcome measures
Paediatrician numbers, provision of primary care for children, age of transition to adult care.
Results
Responses were obtained from 121 countries (73% of countries approached). The number of paediatricians per 100 000 children ranged from a median of 0.5 (IQR 0.3–1.4) in low-income countries to 72 (IQR 4–118) in high-income countries. Africa and South-East Asia reported the lowest paediatrician density (median of 0.8 paediatricians per 100 000 children, IQR 0.4–2.6 and median of 4, IQR 3–9, respectively) and fewest paediatricians entering the workforce. 82% of countries reported transition to adult care by age 18% and 39% by age 15. Most countries (91%) but only 64% of low-income countries reported provision of paediatric preventative care (p<0.001, Cochran-Armitage trend test). Systems of primary care provision varied widely. A majority of countries (63%) anticipated increases in their paediatric workforce in the next decade.
Conclusions
Paediatrician density mirrors known inequities in health provider distribution. Fewer paediatricians are entering the workforce in areas with already low paediatrician density, which may exacerbate disparities in child health outcomes. In some regions, children transition to adult care during adolescence, with implications for healthcare training and delivery. Paediatrician roles are heterogeneous worldwide, and country-specific strategies should be used to address inequity in child health provision.
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https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6361365/Terms of Use
This article is made available under the terms and conditions applicable to Other Posted Material, as set forth at http://nrs.harvard.edu/urn-3:HUL.InstRepos:dash.current.terms-of-use#PassThruCitable link to this page
https://nrs.harvard.edu/URN-3:HUL.INSTREPOS:37371210
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