Barriers and enablers to skill-mix in the oral health workforce: a systematic review
Wilson, A and Hoang, Ha and Barnett, T, Barriers and enablers to skill-mix in the oral health workforce: a systematic review, Community Dental Health, 38 pp. 1-11. ISSN 0265-539X (2021) [Refereed Article]
Introduction: In dentistry, the term "skill-mix" is used to describe the combinations of dentists and dental care professionals in delivering
activities that are commonly established by their level of education, training and scope of practice. However, the literature has indicated
an under-utilisation of skill-mix in the oral health care team. Further work is required to understand the poor uptake of skill-mix in oral
health care and what could be done to address this issue.
Objective: To identify and synthesise the available evidence on the barriers
and enablers to skill-mix in the oral health workforce using a macro-, meso- and micro-level framework.
Materials and methods: The
databases MEDLINE, CINAHL and Scopus between January 2010 to April 2020 were searched. Primary research studies published in
English were included.
Results: Thirty-two articles were included. Key barriers and enablers at each level of analysis were identified.
Macro-level barriers and enablers included structural, regulatory and policy conditions and dental health care needs of populations. Mesolevel barriers and enablers defined the parameters of service delivery and included workplace characteristics, referral systems and patterns,
and workplace productivity and efficiency. Micro-level barriers and enablers pertained to the perceptions, attitudes, and social acceptability
of stakeholders that affected the delivery of services.
Conclusion: Understanding the barriers and enablers from a multi-level framework
requires further high-quality research to fully appreciate its importance in addressing health care needs within populations and increase
generalisability to oral health settings.
health workforce, dental health services, systematic review