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      Capacity building in health care professions within the Gulf cooperation council countries: paving the way forward

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          Abstract

          Background

          There is a worldwide shortage of health care workers. This problem is particularly severe in the Gulf Cooperation Council (GCC) countries because of shortages in certain medical disciplines, due to a lack of nationally-trained professionals and a less developed educational system compared to other high income countries. Consequently, GCC countries are heavily dependent on an expatriate health care workforce; a problem exacerbated by high turnover. We discuss challenges and potential strategies for improving and strengthening capacity building efforts in health care professions in the GCC.

          Main text

          In the GCC, there are 139 schools providing professional health education in medicine, dentistry, pharmacy, nursing, midwifery, and other specialties. Health education school density reported for the GCC countries ranges between 2.2 and 2.8 schools per one million inhabitants, except in Oman where it is 4.0 per one million inhabitants. The GCC countries rely heavily on expatriate health professionals. The number of physicians and nurses in the GCC countries are 2.1 and 4.5 per 1000 respectively, compared to 2.8 and 7.9 among member countries of the Organisation for Economic Cooperation and Development (OECD). Interestingly, the number of dentists and pharmacists is higher in the GCC countries compared to OECD countries. A nationally trained health care workforce is essential for the GCC countries. Physiotherapy and occupational therapy are two identified areas where growth and development are recommended. Custom-tailored continuing medical education and continuing professional development (CPD) programs can augment the skills of health practitioners, and allow for the expansion of their scope of practice when warranted.

          Conclusion

          Capacity building can play an essential role in addressing the major health challenges and improving the overall quality of health care in the region. Efforts aimed at increasing the number of locally-trained graduates and developing and implementing need-based CPD programs are vital for capacity building and lifelong learning in health care professions.

          Electronic supplementary material

          The online version of this article (10.1186/s12909-019-1513-2) contains supplementary material, which is available to authorized users.

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          Most cited references22

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          The impact of physician–nurse task shifting in primary care on the course of disease: a systematic review

          Background Physician–nurse task shifting in primary care appeals greatly to health policymakers. It promises to address workforce shortages and demands of high-quality, affordable care in the healthcare systems of many countries. This systematic review was conducted to assess the evidence about physician–nurse task shifting in primary care in relation to the course of disease and nurses’ roles. Methods We searched MEDLINE, Embase, The Cochrane Library and CINAHL, up to August 2012, and the reference list of included studies and relevant reviews. All searches were updated in February 2014. We selected and critically appraised published randomized controlled trials (RCTs). Results Twelve RCTs comprising 22 617 randomized patients conducted mainly in Europe met the inclusion criteria. Nurse-led care was delivered mainly by nurse practitioners following structured protocols and validated instruments in most studies. Twenty-five unique disease-specific measures of the course of disease were reported in the 12 RCTs. While most (84 %) study estimates showed no significant differences between nurse-led care and physician-led care, nurses achieved better outcomes in the secondary prevention of heart disease and a greater positive effect in managing dyspepsia and at lowering cardiovascular risk in diabetic patients. The studies were generally small, of varying follow-up episodes and were at risk of biases. Descriptive details about roles, qualifications or interventions were also incomplete or not reported. Conclusion Trained nurses may have the ability to achieve outcome results that are at least similar to physicians’ for managing the course of disease, when following structured protocols and validated instruments. The evidence, however, is limited by a small number of studies reporting a broad range of disease-specific outcomes; low reporting standards of interventions, roles and clinicians’ characteristics, skills and qualifications; and the quality of studies. More rigorous studies using validated tools could clarify these findings. Electronic supplementary material The online version of this article (doi:10.1186/s12960-015-0049-8) contains supplementary material, which is available to authorized users.
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            Strengthening of Oral Health Systems: Oral Health through Primary Health Care

            Around the globe many people are suffering from oral pain and other problems of the mouth or teeth. This public health problem is growing rapidly in developing countries where oral health services are limited. Significant proportions of people are underserved; insufficient oral health care is either due to low availability and accessibility of oral health care or because oral health care is costly. In all countries, the poor and disadvantaged population groups are heavily affected by a high burden of oral disease compared to well-off people. Promotion of oral health and prevention of oral diseases must be provided through financially fair primary health care and public health intervention. Integrated approaches are the most cost-effective and realistic way to close the gap in oral health between rich and poor. The World Health Organization (WHO) Oral Health Programme will work with the newly established WHO Collaborating Centre, Kuwait University, to strengthen the development of appropriate models for primary oral health care.
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              An analysis of the Saudi health-care system’s readiness to change in the context of the Saudi National Health-care Plan in Vision 2030

              Change management studies have emphasized the significance of an organization’s readiness for change and transformation and have recommended strategies to affect change. Organizational readiness for change is a multi-faceted, multi-level, and multi-dimensional activity; its most important aspect is organizational members’ willingness to accept and implement change because ignoring the human factors may result in resistance and failure. Through its National Transformation Program 2020, the Saudi Arabian government is attempting to effect radical changes in the structure and function of its health-care system to achieve quality care and effective service delivery. The aim of the present review is to discuss the Saudi health-care system’s readiness to change that Saudi Arabia intends to implement by 2020, based on extensive review of different reports, documents, and empirical studies in the field of organizational readiness for change. The study concludes that if organizational readiness for change is high, resources are available, and situational factors are aligned, members of organizations will take the initiative to change, exert optimal effort, demonstrate greater determination, and engage in more cooperative behavior that may lead to efficient and effective implementation of the Saudi health-care transformational plan with fewer complications and less resistance.
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                Author and article information

                Contributors
                jsheikh@qatar-med.cornell.edu
                soc2005@qatar-med.cornell.edu
                kac2047@qatar-med.cornell.edu
                al_lowenfels@nymc.edu
                ram2026@qatar-med.cornell.edu
                Journal
                BMC Med Educ
                BMC Med Educ
                BMC Medical Education
                BioMed Central (London )
                1472-6920
                14 March 2019
                14 March 2019
                2019
                : 19
                : 83
                Affiliations
                [1 ]Office of the Dean, Weill Cornell Medicine-Qatar, Doha, Qatar
                [2 ]Institute for Population Health, Weill Cornell Medicine-Qatar, Doha, Qatar
                [3 ]ISNI 0000 0001 0728 151X, GRID grid.260917.b, Department of Surgery and Family Medicine, , New York Medical College, ; Valhalla, NY USA
                Author information
                http://orcid.org/0000-0002-5874-4059
                Article
                1513
                10.1186/s12909-019-1513-2
                6417223
                30871521
                b5a749fa-904a-4fd9-9fa5-981f0000c3b0
                © The Author(s). 2019

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 11 June 2018
                : 7 March 2019
                Categories
                Debate
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                © The Author(s) 2019

                Education
                capacity building,continuing education,continuing professional development,human resource development,health care workforce development,gcc countries

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