Confidence in dental care and public health competency during rural practice among new dental graduates in Thailand

Thunthita Wisaijohn,1 Rapeepong Suphanchaimat,1,2 Thitikorn Topothai,1 Parinda Seneerattanaprayul,1 Nareerut Pudpong,1 Weerasak Putthasri1 1International Health Policy Program, Ministry of Public Health, Nonthaburi, Thailand; 2Banphai Hospital, KhonKaen, Thailand Objective: The dental profession has played an important role in the development of the health system in Thailand. However, it is not known if dental graduates' standards of knowledge, skills, and capabilities are fulfilling the health needs of Thais. This study aimed to assess the level of confidence in dental public health competency among final-year dental students who graduated in 2013. Methods: A cross-sectional survey was conducted among 571 new dental graduates who participated in an official meeting arranged by the Ministry of Public Health in 2013. Self-administered questionnaires were used for collecting data on their confidence levels in selected public-health competencies. Of the total graduates, 72.5% anonymously responded to the questionnaire. Descriptive and inferential statistics, factor analysis, and stepwise regression were applied for data analysis. Results: The majority of respondents expressed confidence in their ability to care for patients, but less confidence in public-health and administration competencies. The results also show that there was no significant association between demographic and educational profiles of respondents and confidence in their clinical competency. However, significantly more students who graduated from schools located outside Bangkok and vicinity rated themselves as competent in public health (coefficient = 0.333, P=0.021). Conclusion: New dentists who graduated from dental schools in Bangkok and vicinity had lower levels of confidence in their public-health competencies compared to those who graduated from dental schools outside Bangkok. Thus, working in rural areas after graduation could help new dentists gain more experience in rural practice, leading to higher confidence levels. The findings from this study could contribute to the improvement of the dental curriculum and contract-bonding policy to work in rural areas. Keywords: competency, public health, dental school, rural area, factor analysis, stepwise regressio

HIV/AIDS health care challenges for cross- country migrants in low- and middle-income countries: a scoping review

Rapeepong Suphanchaimat,1,2 Angkana Sommanustweechai,1 Chiraporn Khitdee,1 Chompoonut Thaichinda,1 Kanang Kantamaturapoj,3 Pattara Leelahavarong,4 Pensom Jumriangrit,1 Thitikorn Topothai,1 Thunthita Wisaijohn,1 Weerasak Putthasri1 1International Health Policy Program (IHPP), Ministry of Public Health, Nonthaburi, Thailand; 2Banphai Hospital, Khon Kaen, Thailand; 3Department of Social Sciences, Faculty of Social Sciences and Humanities, Mahidol University, Nakhon Pathom, Thailand; 4Health Intervention and Technology Assessment Program, Ministry of Public Health, Nonthaburi, Thailand Introduction: HIV/AIDS has been one of the world's most important health challenges in recent history. The global solidarity in responding to HIV/AIDS through the provision of antiretroviral therapy (ART) and encouraging early screening has been proved successful in saving lives of infected populations in past decades. However, there remain several challenges, one of which is how HIV/AIDS policies keep pace with the growing speed and diversity of migration flows. This study therefore aimed to examine the nature and the extent of HIV/AIDS health services, barriers to care, and epidemic burdens among cross-country migrants in low- and middle-income countries. Methods: A scoping review was undertaken by gathering evidence from electronic databases and gray literature from the websites of relevant international initiatives. The articles were reviewed according to the defined themes: epidemic burdens of HIV/AIDS, barriers to health services and HIV/AIDS risks, and the operational management of the current health systems for HIV/AIDS. Results: Of the 437 articles selected for an initial screening, 35 were read in full and mapped with the defined research questions. A high HIV/AIDS infection rate was a major concern among cross-country migrants in many regions, in particular sub-Saharan Africa. Despite a large number of studies reported in Africa, fewer studies were found in Asia and Latin America. Barriers of access to HIV/AIDS services comprised inadequate management of guidelines and referral systems, discriminatory attitudes, language differences, unstable legal status, and financial hardship. Though health systems management varied across countries, international partners consistently played a critical role in providing support for HIV/AIDS services to uninsured migrants and refugees. Conclusion: It was evident that HIV/AIDS health care problems for migrants were a major concern in many developing nations. However, there was little evidence suggesting if the current health systems effectively addressed those problems or if such management would sustainably function if support from global partners was withdrawn. More in-depth studies were recommended to further explore those knowledge gaps. Keywords: migrant, refugee, low- and middle-income countries, HIV/AIDS, health systems, scoping revie