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Background The World Health Organization’s global strategy on human resources for health includes an objective to align investment in human resources for health with the current and future needs of the population. Although oral health is a key indicator of overall health and wellbeing, and oral diseases are the most common noncommunicable diseases affecting half the world’s population, oral health workforce planning efforts have been limited to simplistic target dentist-population or constant services-population ratios which do not account for levels of and changes in population need. Against this backdrop, our aim was to develop and operationalise an oral health needs-based workforce planning simulation tool. Methods Using a conceptual framework put forward in the literature, we aimed to build the model in Microsoft Excel and apply it in a hypothetical context to demonstrate its operability. The model incorporates a provider supply component and a provider requirement component, enabling a comparison of the current and future supply of and requirement for oral health workers. Publicly available data, including the Special Eurobarometer 330 Oral Health Survey, were used to populate the model. Assumptions were made where data were not publicly available and key assumptions were tested in scenario analyses. Results We have systematically developed a needs-based workforce planning model for the oral health workforce and applied the model in a hypothetical context over a 30-year time span. In the 2017 baseline scenario, the model produced a full-time equivalent (FTE) provider requirement figure of 899 dentists compared with an FTE provider supply figure of 1985. In the scenario analyses, the FTE provider requirement figure ranged from 1123 to 1629 illustrating the extent of the impact of changing parameter values. Conclusions In response to policy makers’ recognition of the pressing need to better plan human resources for health and the scarcity of work in this area for dentistry, we have demonstrated the feasibility of producing a workable, practical and useful needs-based workforce planning simulation tool for the oral health workforce. In doing so, we have highlighted the challenges faced in accessing timely and relevant data needed to populate such models and ensure the reliability of model outputs.

Background Current methods for oral health workforce planning lack responsiveness to dynamic needs, hampering efficiency, equity and sustainability. Effective workforce planning is vital for resilient health care systems and achieving universal health coverage. Given this context, we developed and operationalised a needs-adaptive oral health workforce planning model and explored the potential of various future scenarios. Methods Using publicly available data, including the Special Eurobarometer 330 Oral Health Survey, we applied the model in a hypothetical context focusing on the Dutch population’s dental needs from 2022 to 2050. We compared current and future provider supply and requirement and examined, in addition to a base case scenario, several alternative scenarios. These included epidemiological transition scenarios with different oral health morbidity trajectories, skill-mix scenarios with independent oral hygienists conducting check-ups and multiple dental student intake and training duration (5 instead of 6 years) scenarios. Results Based on the aforementioned historical data, our model projects that provider requirement will exceed supply for the planning period. If the percentage of people having all natural teeth increases by 10% or 20% in 2032, 34 or 68 additional full-time equivalent (FTE) dentists will be required, respectively, compared to the base case scenario. In the skill-mix scenario, the model indicates that prioritising oral hygienists for check-ups and shifting dentists’ focus to primarily complex care could address population needs more efficiently. Among the student intake and training duration scenarios, increasing intake to 375 and, to a lesser extent, reducing training to 5 years is projected to most effectively close the provider gap. Conclusions The study underscores the importance of understanding oral health morbidity trajectories for effective capacity planning. Due to limited dental epidemiological data, projections carry substantial uncertainty. Currently, demand for FTE dentists seems to exceed supply, though this may vary with epidemiological changes. Skill-mix strategies could offer efficiency gains by redistributing tasks, while adjustments in dental intake and training duration could also help address the requirement-supply gap. Resolving dentistry workforce challenges requires a multifaceted approach, including strengthening oral epidemiology projections, addressing the root causes of dental health issues and prioritising harmonious dental public health and general practice prevention measures.

Introduction: We analyze a 2014 policy that increased physician supply in rural Bangladesh and assess its impact on access to care and health outcomes for rural residents. Methods: We use data from the Household Income and Expenditure Survey for 2005–2016 and employ a difference-indifferences model. Our analysis focuses on five key outcome categories: access to providers, access to medicine, cost of care, health status, and travel time to reach healthcare providers. Results: Rural residents’ likelihood of visiting a government doctor increased by 14 percentage points, while visits to private doctors decreased by 15 percentage points. Rural residents are more likely to receive medication from public facilities, and their total monthly cost of care has decreased. We found a rise in reported cases of chronic conditions like heart disease and arthritis among rural residents. Conclusion: Our findings indicate that increasing physician availability in rural Bangladesh positively impacted healthcare access and utilization.

For many years, barriers to access have been a significant concern in the Medicaid program. In November 2015, the Centers for Medicare & Medicaid Services issued a Final Rule that requires states to submit access monitoring plans every three years beginning in October 2016. State access monitoring plans must focus on five categories of service and three domains for measuring and monitoring access to care. This article presents findings from the first national survey that examines what states were doing to measure access to fee-for-service Medicaid care prior to the Final Rule. Our findings show states generally collected some type of access to care measure, relied on a multitude of data sources to assess access, and most commonly used these measures to assess adequacy of access. Data from this survey provide a basis for understanding how close states are to complying with the new federal regulation's access monitoring requirements.

Objectives To examine disparities in use and access to different health care providers by community and individual race-ethnicity and to test provider supply as a potential mediator. Data Sources National secondary data from 2014 Medical Expenditure Panel Survey, 5-year estimates (2010–2014) from American Community Survey, and 2014 InfoUSA. Study Design Multiple logistic regression models examined the association of community and individual race-ethnicity with reported health care visits and access. Mediation analyses tested the role of provider supply. Data Extraction Methods Individual-level survey data were linked to race-ethnic composition and health business counts of the respondent’s primary care service area (PCSA). Principal Findings Minority PCSAs are significantly and independently associated with lower odds of having a visit to a physician assistant/nurse practitioner, dentist, or other health professionals and having a usual care provider (all p  < 0.05). Few significant associations were observed for integrated PCSAs or for health provider supply. A modest mediation effect for provider supply was observed for travel time to usual care provider and visit to other health professionals. Conclusions Use of a range of health services is lower in minority communities and individuals. However, provider supply was not an important explanatory factor of these disparities.

A water safety plan (WSP) is a tool proposed by the World Health Organization (WHO) for the mitigation of risks in water consumption, and little is known about the challenges of its implementation stage. The goal of this work was to identify the facilitating factors and challenges regarding WSP implementation from a case study in Brazil. Semi-structured interviews were conducted with water supply public service providers who already have implemented such policy and with supporting institutions that helped with the process implementation. As a result, it has been identified that the WSP implementation is strongly influenced by the quality of WSP preparation process, which means that this process is the foundation of the WSP implementation; through internal management of the organization, whose administrative discontinuities thwart the actions’ implementation; and through the relationship of the service provider with the external actors, which can interfere be it in the data collection or the WSP implementation scope’s entirety. Lastly, it was possible to conclude that the WSP preparation process, the organization’s internal management, and its relationship with external actors are the specific factors that impact the WSP implementation. The conduction and deepening of studies aiming to improve the tools of support for WSP implementation are thus recommended.

Background: Supply chains in South Africa operate in a challenging business environment. This environment influences the efficiency and effectiveness of South African businesses and supply chains. These factors further influence the competitiveness of products produced in the country, the economic growth and development of South Africa.Objectives: The purpose of this study was two-fold: Firstly, to obtain insight into the main business environment risks and other factors, from a logistics perspective; and secondly, to demonstrate the use of methodology not often used in logistics research − the sequential mixed method.Method: The explorative study was conducted amongst logistics service providers and cargo owners in 2013 by means of a sequential mixed method study, consisting of a survey to determine the importance of risk factors in the business environment, followed by a qualitative study in the form of a focus group discussion to obtain richer data and insight into these risks and factors. The results of these two methods were integrated with industry literature.Results: It was found that increasing transportation costs, operational management of infrastructure and human resources-related problems pose the biggest challenges in the logistics industry. In addition, it was found that the mixed method research study has application possibilities in logistics research.Conclusion: The factors identified as particularly problematic for the logistics industry, namely ineffective operational management of infrastructure, the general conditions in the labour market and increasing costs (to some extent) are outside the control of individual organisations. However, organisations can control how they react and mitigate these risk factors. It is shown that these factors and risks can change overnight. The use of the explorative mixed method in obtaining qualitative and quantitative inputs and integrating it with existing literature proved to be a workable and usable methodology.

Many countries that subscribe to the Millennium Development Goals (MDGs) have committed to ensuring access to basic health services for their citizens. Health insurance has been considered and promoted as the major financing mechanism to improve access to health services, as well as to provide financial risk protection. In Africa, several countries have already spent scarce time, money, and effort on health insurance initiatives. Ethiopia, Ghana, Kenya, Nigeria, Rwanda, and Tanzania are just a few of them. However, many of these schemes, both public and private, cover only a small proportion of the population, with the poor less likely to be covered. In fact, unless carefully designed to be pro-poor, health insurance can widen inequity as higher income groups are more likely to be insured and use health care services, taking advantage of their insurance coverage. The purpose of this handbook is to provide policy makers and health insurance designers with practical, action-oriented support that will deepen their understanding of health insurance concepts, help them identify design and implementation challenges, and define realistic steps for the development and scaling up of equitable, efficient, and sustainable health insurance schemes. The handbook takes policy makers and health insurance designers through a step-by-step series of considerations and tasks that need to be achieved. The handbook's philosophy is to not be dogmatic, ideological, or prescriptive. This handbook was prepared to be used in a six-day regional workshop. Clearly, health insurance design is an intensive political and technical process that takes much longer than six days. The expectation for the workshop is that by the end of the week, each team has a clear idea of next steps that they could take back home to engage other stakeholders and move toward scaling up and improving the performance of health insurance in their country.

This study presents an analysis of the current optometry workforce, both as a unique profession and more broadly within the context of all eye care providers (optometry and ophthalmology) in New York State. The supply and distribution of eye care practitioners provides useful information for policy makers while providing insights as to the impact of the one optometry school within the state. Several databases were employed and a web based survey was developed for completion by all optometrists. The questionnaire included demographic data, whether they were actively practicing in New York State or any other state, were they full time or part time, their primary mode of practice, or if they provided care within institutional settings. Access to care was gauged by the respondents’ availability for appointments during evenings or weekends. Access to eye care services in New York State has improved significantly during the past 30 years as the supply of optometrists increased. Before this study was conducted it was generally believed that there were more optometrists than ophthalmologists in every state of the nation except New York, Maryland and the District of Columbia. Findings of this study demonstrate there are 37% more optometrists in New York State than ophthalmologists and more evenly distributed as optometrists are located in almost every county of the state. Sixteen counties have no ophthalmologists. This is attributed to the presence of the College of Optometry established in 1971. More than 60% of all optometrists in the state are SUNY College of Optometry graduates.

Purpose The purpose of this paper is to provide new insights into the reactions and lessons learned with regard to the COVID-19 pandemic in terms of how logistics service providers (LSPs) managed to maintain supply chains resilience and what focus areas have been changed to keep operations functional and uphold financial stability. Design/methodology/approach Based on data-gathering techniques in interpretive research this study collected primary data via semi-structured interviews, interviewing informants from selected LSPs that operate on a global scale. Findings The results show that LSPs have built their reactions and actions to the COVID-19 outbreak around five main themes: “create revenue streams,” “enhance operational transport flexibility,” “enforce digitalization and data management,” “optimize logistics infrastructure” and “optimize personnel capacity.” These pillars build the foundation to LSP resilience that enables supply chains to stay resilient during an external shock of high impact and low probability. Originality/value The results of this study provide insights into how LSPs have managed the downsides and found innovative ways to overcome operational and financial challenges during the COVID-19 outbreak. As one of the first studies that specially focuses on the role of LSPs during the COVID-19 pandemic, this study categorizes the LSPs’ reactions and provides a “lessons learned” framework from a managerial perspective. From a theoretical perspective, this paper discusses the strategic role of LSPs in supply chain management and thereby extends current supply chain literature with a focus on LSP resilience.