Addressing Oral Health Workforce Training in the Pacific

1. Addressing Oral Health Workforce Training in the Pacific Dr Rodel G Nodora Technical Officer, HRH/POLHN WHO/WPRO

2. Health Workers Save Lives Thenumber of health professionals world-wide, and the quality and relevance of their education, is insufficient to meet the current and future health needs of local populations. … a critical shortage was found in 57 countries.

3. Country specific context Including labour market Critical Success Factors Results-focused planning and practices System-linked alignment Knowledge-based decision-making Learning-oriented perspectives Innovative solutions Comprehensive and integrated approaches Preparation & Planning Policy Leadership Finance BETTER HEALTH SERVICES Improved Health Workforce Outcomes BETTER HEALTH OUTCOMES Human Resources for Health Systems Situation Analysis Implementation EquityEffectivenessEfficiencyAccessibility Responsiveness Partnership Education Critical Success Factors Country-led initiatives Government-supported actions Multi-sector engagement Multi-stakeholder involvement Donor alignment Gender sensitivity Monitoring & Evaluation Governance Health Information Health Care Financing Service Delivery Medical Products and Technologies HRH Action Framework WHO/WPROadapted from: Human Resources for Health Technical Framework: achieving a sustainable health workforce World Health Report 2006 HRH Vision 2020 Population with access to adequate, competent, productive and supportedhealth workforce

4. 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: • 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

5. Pacific Health Workforce Density (Doctors, Nurses and Midwives per 1,000 population) 2.3 / 1,000 (indicative minimum threshold; WHO)

6. Transformative scale up of health professional education Source: Lancet 2010; 376: 1923-58

7. WHO’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.

8. Numbers/Quantity Challenge Number of Dentists in WPRO Range: 1 in NRU and 149,000 in AUS

9. Number of Dentists in PICs

10. Number of Dentists in PICs

11. 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

12. Approach for the Oral HWF

13. Dental Assistant Career Diploma through

14. Background • 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.

15. 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

16. External 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

17. Accreditation 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.

18. POLHN The Pacific Open Learning Health Net (POLHN) is a partnership between Pacific Ministries of Health and WHO. POLHN’s goals are: • Improve health professionals’ access to continuing professional development (CPD). • Provide CPD for Pacific health professionals. • Build capacity among local and regional academic institutions to develop and deliver online CPD.

19. Aims of POLHN Up-skilled and competent Motivated and confident health workers People Processes Technologically literate Equipped with the knowledge to respond to changing health needs Partners Products

20. 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

21. Career Roles Continuum C A R E E R Technical/Clinical Roles Management/Administrative Roles Technical/Clinical Roles

22. POLHN and training modes Formal Non- Accredited Accredited Informal

23. Example: CPD for Dental Cadre

24. Example of Technical Course Skills

25. General Courses for Oral Health Cadre

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

27. Learning Opportunities in WHO Formal Non- Accredited Accredited Informal