Dentists, pharmacists and physiotherapists complement primary care teams and are critical for integrated pathways. Oral diseases remain highly prevalent and socially patterned, demanding stronger prevention and access to care (Peres et al., 2019[1]). In parallel, rehabilitation needs are widespread and growing, with an estimated one in three people worldwide benefiting from rehabilitation at some point (Cieza et al., 2020[2]). Against this epidemiological backdrop, PAHO’s NHWA-based indicators point to large cross-country variation and important data gaps for these professions in the Region of the Americas (PAHO, 2025[3]).
Dentist availability is highly uneven. Across the LAC32, there are 4.0 dentists per 10 000 population on average, compared with 7.3 in the OECD (Figure 8.7). Cuba (16.7) and Chile (14.8) report the highest densities, while Haiti (0.2), Honduras (0.3) and Nicaragua (0.4) report fewer than 0.5 dentists per 10 000. Such gaps are likely to translate into differences in timely access to preventive and restorative services, especially for lower-income groups, unless oral health is better integrated into primary healthcare and public coverage.
Pharmacist densities also vary widely, reflecting different roles in service delivery and regulation. Costa Rica reports 11.6 pharmacists per 10 000 population, above the OECD average of 8.7, while the LAC21 average is 3.6 (Figure 8.8). Several countries report fewer than 2 pharmacists per 10 000 (e.g. Guatemala 1.2; Dominican Republic 1.5; Peru 1.5), and Haiti reports 0.3. Limited pharmacist availability can constrain safe medicines use, adherence support and continuity of care for people living with chronic conditions.
Physiotherapist density is markedly lower in LAC than in the OECD. The LAC16 average is 3.7 physiotherapists per 10 000 population, compared with 12.1 in the OECD (Figure 8.9). Chile reports a high density (18.5), whereas several countries report fewer than 1 physiotherapist per 10 000 (e.g. Panama 1.0; Suriname 0.9; Jamaica 0.7) and some report near-zero availability. Low rehabilitation capacity may contribute to unmet needs and poorer functional outcomes following injury, chronic disease and ageing-related disability.
The indicators suggest a “triple gap”: large inequalities in oral health service capacity, constrained pharmaceutical workforce availability in many countries, and limited rehabilitation capacity. Policy responses include strengthening training pipelines, expanding team-based primary care with appropriate scopes of practice, and improving deployment to underserved areas. Given the high burden of preventable oral disease and growing rehabilitation needs, scaling these workforces is increasingly relevant for health system performance. The evidence base supports this direction: pharmacist-delivered hypertension care has been synthesised in recent systematic reviews showing improvements in blood pressure outcomes, and broader reviews underline the expanding role of community pharmacists in cardiovascular risk prevention and management – highly relevant for LAC’s NCD agenda (Motlohi et al., 2023[4]).
