National cross-sectional study of the sociodemographic characteristics of Aotearoa New Zealands regulated health workforce pre-registration students: a mirror on society?

Objectives
To provide a sociodemographic profile of students enrolled in their first year of a health professional pre-registration programme offered within New Zealand (NZ) tertiary institutions.

Design
Observational, cross-sectional study. Data were sought from NZ tertiary education institutions for all eligible students accepted into the first ‘professional’ year of a health professional programme for the 5-year period 2016–2020 inclusive. Variables of interest: gender, citizenship, ethnicity, rural classification, socioeconomic deprivation, school type and school socioeconomic scores. Analyses were carried out using the R statistics software.

Setting
Aotearoa NZ.

Participants
All students (domestic and international) accepted into the first ‘professional’ year of a health professional programme leading to registration under the Health Practitioners Competence Assurance Act 2003.

Results
NZ’s health workforce pre-registration students do not reflect the diverse communities they will serve in several important dimensions. There is a systematic under-representation of students who identify as Māori and Pacific, and students who come from low socioeconomic and rural backgrounds. The enrolment rate for Māori students is about 99 per 100 000 eligible population and for some Pacific ethnic groups is lower still, compared with 152 per 100 000 for NZ European students. The unadjusted rate ratio for enrolment for both Māori students and Pacific students versus ‘NZ European and Other’ students is approximately 0.7.

Conclusions
We recommend that: (1) there should be a nationally coordinated system for collecting and reporting on the sociodemographic characteristics of the health workforce pre-registration; (2) mechanisms be developed to allow the agencies that fund tertiary education to base their funding decisions directly on the projected health workforce needs of the health system and (3) tertiary education funding decisions be based on Te Tiriti o Waitangi (the foundational constitutional agreement between the Indigenous people, Māori and the British Crown signed in 1840) and have a strong pro-equity focus.

Leggi
Marzo 2023

Socioeconomic position and eye health outcomes: identifying inequality in rapid population-based surveys

Objective
Monitoring health outcomes disaggregated by socioeconomic position (SEP) is crucial to ensure no one is left behind in efforts to achieve universal health coverage. In eye health planning, rapid population surveys are most commonly implemented; these need an SEP measure that is feasible to collect within the constraints of a streamlined examination protocol. We aimed to assess whether each of four SEP measures identified inequality—an underserved group or socioeconomic gradient—in key eye health outcomes.

Design
Population-based cross-sectional survey.

Participants
A subset of 4020 adults 50 years and older from a nationally representative sample of 9188 adults aged 35 years and older in The Gambia.

Outcome measures
Blindness (presenting visual acuity (PVA)

Leggi
Marzo 2023