The chiropractic workforce: a global review

Mette Jensen Stochkendahl, Mana Rezai, Paola Torres, Deborah Sutton, Peter Tuchin, Richard Brown, Pierre Côté

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Abstract

Background: The world is faced with a chronic shortage of health workers, and the World Health Organization (WHO) has estimated a global shortage of 7.2 million health workers resulting in large gaps in service provision for people with disability. The magnitude of the unmet needs, especially within musculoskeletal conditions, is not well established as global data on health work resources are scarce.

Methods: We conducted an international, cross-sectional survey of all 193 United Nation member countries and seven dependencies to describe the global chiropractic workforce in terms of the availability (numbers and where they are practising), quality (education and licensing), accessibility (entry and reimbursement), and acceptability (scope of practice and legal rights). An electronic survey was issued to contact persons of constituent member associations of the World Federation of Chiropractic (WFC). In addition, data were collected from government websites, personal communication and internet searches. Data were analysed using descriptive statistics. Worldwide density maps of the distribution of numbers of chiropractors and providers of chiropractic education were graphically presented.

Results: Information was available from 90 countries in which at least one chiropractor was present. The total number of chiropractors worldwide was 103,469. The number of chiropractors per country ranged from 1 to 77,000 (median = 10; IQR = [4-113]). Chiropractic education was offered in 48 institutions in 19 countries. Direct access to chiropractic services was available in 81 (90%) countries, and services were partially or fully covered by government and/or private health schemes in 46 (51.1%) countries. The practice of chiropractic was legally recognized in 68 (75.6%) of the 90 countries. It was explicitly illegal in 12 (13.3%) countries.

Conclusion: We have provided information about the global chiropractic workforce. The profession is represented in 90 countries, but the distribution of chiropractors and chiropractic educational institutions, and governing legislations and regulations largely favour high-income countries. There is a large under-representation in low- and middle-income countries in terms of provision of services, education and legislative and regulatory frameworks, and the available data from these countries are limited.

Original languageEnglish
Article number36
JournalChiropractic & Manual Therapies
Volume27
ISSN1746-1340
DOIs
Publication statusPublished - 24. Jul 2019

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Chiropractic
Education
Health
Civil Rights
United Nations
Health Resources
Licensure
Disabled Persons
Legislation
Internet
Cross-Sectional Studies
Communication

Keywords

  • Chiropractic
  • Cross-sectional
  • Education
  • Global Health
  • Health workforce
  • Rehabilitation
  • Survey
  • Chiropractic/statistics & numerical data
  • Musculoskeletal Diseases/therapy
  • Health Workforce/statistics & numerical data
  • Humans
  • Health Personnel/statistics & numerical data

Cite this

Stochkendahl, Mette Jensen ; Rezai, Mana ; Torres, Paola ; Sutton, Deborah ; Tuchin, Peter ; Brown, Richard ; Côté, Pierre. / The chiropractic workforce : a global review. In: Chiropractic & Manual Therapies. 2019 ; Vol. 27.
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abstract = "Background: The world is faced with a chronic shortage of health workers, and the World Health Organization (WHO) has estimated a global shortage of 7.2 million health workers resulting in large gaps in service provision for people with disability. The magnitude of the unmet needs, especially within musculoskeletal conditions, is not well established as global data on health work resources are scarce.Methods: We conducted an international, cross-sectional survey of all 193 United Nation member countries and seven dependencies to describe the global chiropractic workforce in terms of the availability (numbers and where they are practising), quality (education and licensing), accessibility (entry and reimbursement), and acceptability (scope of practice and legal rights). An electronic survey was issued to contact persons of constituent member associations of the World Federation of Chiropractic (WFC). In addition, data were collected from government websites, personal communication and internet searches. Data were analysed using descriptive statistics. Worldwide density maps of the distribution of numbers of chiropractors and providers of chiropractic education were graphically presented.Results: Information was available from 90 countries in which at least one chiropractor was present. The total number of chiropractors worldwide was 103,469. The number of chiropractors per country ranged from 1 to 77,000 (median = 10; IQR = [4-113]). Chiropractic education was offered in 48 institutions in 19 countries. Direct access to chiropractic services was available in 81 (90{\%}) countries, and services were partially or fully covered by government and/or private health schemes in 46 (51.1{\%}) countries. The practice of chiropractic was legally recognized in 68 (75.6{\%}) of the 90 countries. It was explicitly illegal in 12 (13.3{\%}) countries.Conclusion: We have provided information about the global chiropractic workforce. The profession is represented in 90 countries, but the distribution of chiropractors and chiropractic educational institutions, and governing legislations and regulations largely favour high-income countries. There is a large under-representation in low- and middle-income countries in terms of provision of services, education and legislative and regulatory frameworks, and the available data from these countries are limited.",
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The chiropractic workforce : a global review. / Stochkendahl, Mette Jensen; Rezai, Mana; Torres, Paola; Sutton, Deborah; Tuchin, Peter; Brown, Richard; Côté, Pierre.

In: Chiropractic & Manual Therapies, Vol. 27, 36, 24.07.2019.

Research output: Contribution to journalJournal articleResearchpeer-review

TY - JOUR

T1 - The chiropractic workforce

T2 - a global review

AU - Stochkendahl, Mette Jensen

AU - Rezai, Mana

AU - Torres, Paola

AU - Sutton, Deborah

AU - Tuchin, Peter

AU - Brown, Richard

AU - Côté, Pierre

PY - 2019/7/24

Y1 - 2019/7/24

N2 - Background: The world is faced with a chronic shortage of health workers, and the World Health Organization (WHO) has estimated a global shortage of 7.2 million health workers resulting in large gaps in service provision for people with disability. The magnitude of the unmet needs, especially within musculoskeletal conditions, is not well established as global data on health work resources are scarce.Methods: We conducted an international, cross-sectional survey of all 193 United Nation member countries and seven dependencies to describe the global chiropractic workforce in terms of the availability (numbers and where they are practising), quality (education and licensing), accessibility (entry and reimbursement), and acceptability (scope of practice and legal rights). An electronic survey was issued to contact persons of constituent member associations of the World Federation of Chiropractic (WFC). In addition, data were collected from government websites, personal communication and internet searches. Data were analysed using descriptive statistics. Worldwide density maps of the distribution of numbers of chiropractors and providers of chiropractic education were graphically presented.Results: Information was available from 90 countries in which at least one chiropractor was present. The total number of chiropractors worldwide was 103,469. The number of chiropractors per country ranged from 1 to 77,000 (median = 10; IQR = [4-113]). Chiropractic education was offered in 48 institutions in 19 countries. Direct access to chiropractic services was available in 81 (90%) countries, and services were partially or fully covered by government and/or private health schemes in 46 (51.1%) countries. The practice of chiropractic was legally recognized in 68 (75.6%) of the 90 countries. It was explicitly illegal in 12 (13.3%) countries.Conclusion: We have provided information about the global chiropractic workforce. The profession is represented in 90 countries, but the distribution of chiropractors and chiropractic educational institutions, and governing legislations and regulations largely favour high-income countries. There is a large under-representation in low- and middle-income countries in terms of provision of services, education and legislative and regulatory frameworks, and the available data from these countries are limited.

AB - Background: The world is faced with a chronic shortage of health workers, and the World Health Organization (WHO) has estimated a global shortage of 7.2 million health workers resulting in large gaps in service provision for people with disability. The magnitude of the unmet needs, especially within musculoskeletal conditions, is not well established as global data on health work resources are scarce.Methods: We conducted an international, cross-sectional survey of all 193 United Nation member countries and seven dependencies to describe the global chiropractic workforce in terms of the availability (numbers and where they are practising), quality (education and licensing), accessibility (entry and reimbursement), and acceptability (scope of practice and legal rights). An electronic survey was issued to contact persons of constituent member associations of the World Federation of Chiropractic (WFC). In addition, data were collected from government websites, personal communication and internet searches. Data were analysed using descriptive statistics. Worldwide density maps of the distribution of numbers of chiropractors and providers of chiropractic education were graphically presented.Results: Information was available from 90 countries in which at least one chiropractor was present. The total number of chiropractors worldwide was 103,469. The number of chiropractors per country ranged from 1 to 77,000 (median = 10; IQR = [4-113]). Chiropractic education was offered in 48 institutions in 19 countries. Direct access to chiropractic services was available in 81 (90%) countries, and services were partially or fully covered by government and/or private health schemes in 46 (51.1%) countries. The practice of chiropractic was legally recognized in 68 (75.6%) of the 90 countries. It was explicitly illegal in 12 (13.3%) countries.Conclusion: We have provided information about the global chiropractic workforce. The profession is represented in 90 countries, but the distribution of chiropractors and chiropractic educational institutions, and governing legislations and regulations largely favour high-income countries. There is a large under-representation in low- and middle-income countries in terms of provision of services, education and legislative and regulatory frameworks, and the available data from these countries are limited.

KW - Chiropractic

KW - Cross-sectional

KW - Education

KW - Global Health

KW - Health workforce

KW - Rehabilitation

KW - Survey

KW - Chiropractic/statistics & numerical data

KW - Musculoskeletal Diseases/therapy

KW - Health Workforce/statistics & numerical data

KW - Humans

KW - Health Personnel/statistics & numerical data

U2 - 10.1186/s12998-019-0255-x

DO - 10.1186/s12998-019-0255-x

M3 - Journal article

C2 - 31367341

VL - 27

JO - Chiropractic & Manual Therapies

JF - Chiropractic & Manual Therapies

SN - 1746-1340

M1 - 36

ER -