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The relationship between democracy and corruption and the global physician workforce
Amrit Kirpalani1,2, Eray Yilmaz1
1Department of Paediatrics, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada.
PLOS Global Public Health
|November 27, 2024
Summary
Stronger democracy and less corruption are linked to more doctors per capita, regardless of health spending. These governance factors are key for achieving universal health coverage by improving healthcare workforce density.
Area of Science:
- Global Health Policy
- Health Workforce Research
- Political Science and Health
Background:
- Governance factors like democracy and corruption significantly influence healthcare workforce dynamics.
- Effective health workforce planning and resource allocation are essential for achieving Universal Health Coverage (UHC).
- This study investigates the interplay between political governance and key healthcare workforce metrics globally.
Purpose of the Study:
- To examine the relationship between democracy and corruption and healthcare workforce metrics.
- To determine if governance impacts physician density, generalist-to-specialist ratios, and the proportion of female physicians.
- To understand the implications for achieving Universal Health Coverage.
Main Methods:
- Cross-sectional study using global data from 2020-2022.
- Primary outcome: Physician Density (doctors per 10,000 people). Secondary outcomes: generalist to specialist ratio, % Female Physicians.
- Analysis included partial correlations, MANOVA, and ANOVA, controlling for domestic health expenditure.
Main Results:
- Significant positive associations found between higher democracy index (DI) and corruption perception index (CPI) with physician density.
- MANOVA revealed significant multivariate effects of DI and CPI on combined workforce variables.
- Univariate ANOVAs confirmed DI and CPI significantly impacted physician density, independent of health expenditure; no significant impact on other workforce ratios was observed.
Conclusions:
- Higher democracy and lower corruption correlate with increased physician density, irrespective of healthcare expenditure.
- Governance reforms promoting democracy and reducing corruption are vital for strengthening the healthcare workforce.
- These findings underscore the importance of good governance in advancing the goal of Universal Health Coverage.
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