Dentist availability in Egypt: a 20-year study of supply, potential demand and economic factors

Background: Egypt is one of the most populated countries in the Eastern Mediterranean Region with historically large numbers of trained professionals providing services in and outside the country. Data about dentist availability are needed to plan for workforce production and training. Aims: We assessed dentist availability in Egypt including (1) changes over 20 years; (2) spatial distribution; and (3) association with supply, potential demand for care and economic conditions. Methods: In an ecological study (1995-2014), we used data from the Central Agency for Public Mobilization and Statistics. The outcome variable was dentist availability (dentists per 1000 population). The explanatory variables were: (1) population size; (2) number of dental graduates; (3) previous dentist availability; (4) increase in wages; and (5) percentage of population migrating internally seeking jobs. We assessed variation in availability using statistical process control and spatial autocorrelation. The impact of explanatory variables was assessed using general linear models with partial eta(2) to measure effect size. Results: Dentists per 1000 population were randomly distributed over the country and the ratio reached 0.18 in 2014, indicating a shortage despite the increasing number of dental graduates since 1995 (667.1%). Previous dentist availability (eta(2) = 0.60) and increase in wages (eta(2) = 0.48) had the greatest impact on dentist availability. Conclusions: Egypt faces a problem of dentist shortage that has not been offset by the increase in dental graduates. Improving the economic conditions and incorporating health care into the national development plan may improve the situation.