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"In a position in which there is a scarcity of specialists, we have the best full-back in the Premiership, Zabaleta.
Given the largely rural population and the scarcity of specialists in rural districts, it is plausible that a managed clinical network model may confer advantages.
It was shown that the scarcity of specialists is worsened still by the uneven distribution between Provincial Hospitals of the same level, especially when compared to the work load of each hospital, as illustrated in Table 3[ 8].
49 Referral to an endocrinologist is recommended for patients with T1DM, those with T2DM and diabetes-related complications, and especially those on multiple doses of insulin, 47 but the scarcity of specialists in public health care hinder the proper assistance of referred cases.
If a managed clinical network improves child healthcare in Malawi, it may be a potential model for the other countries in sub-Saharan Africa with similar cadres in their healthcare system and face similar challenges in terms of scarcity of specialists.
Additional barriers mentioned by participants to working with specialists included the high cost of specialized care and treatment, lack of coverage for such care by most insurance companies, and a scarcity of specialists to cover the volume and geographic dispersion of need for their services.
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Inspectors found that pressure on their budgets is increasing due to the high cost of placements and scarcity of specialist resources.
The scarcity of specialist roles project managers, engineers and O&M technicians is not likely to be solved unless a series of educational, mobility and dissemination measures are put into practice.
The Ministry of Health (MOH) managed to make up for its severe scarcity of specialist MDs especially through contracting expatriate technical assistance.
Almost all GP visits and most hospitalisations take place in the Spanish public health system, therefore it is highly unlikely to be unbalanced, with a scarcity of specialist physicians versus an adequate supply of GPs and hospital physicians.
The scarcity of specialist human resources in these settings indicates that these packages of care should be delivered by non-specialists working under the supervision of specialists, who provide capacity-building, continued supervision and referral pathways to enhance the effectiveness of these interventions.
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Justyna Jupowicz-Kozak
CEO of Professional Science Editing for Scientists @ prosciediting.com