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Scaling up family practice: progressing towards

universal health coverage

Agenda item 4(a)63rd Session of the WHO Regional

Committee for the Eastern Mediterranean36 October 2016

Scaling up family practice: progressing towards universal health coverage

Outline Characteristics of family practice Family practice assessment in the Region WHO strategies to increase number of family

physicians Framework of action for advancing family

practice Conclusion

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Scaling up family practice: progressing towards universal health coverage3

Characteristics of the family practice approach

Delivery of comprehensive, continuous, integrated and community-oriented services by a family physician and multidisciplinary team

Defined catchment population

Availability of sufficient trained health workforce and multidisciplinary team

Provision of quality essential health services package and a functional referral system

Scaling up family practice: progressing towards universal health coverage

Assessment of family practice in the Region Family practice in 16 national health policy and plans

Service delivery based on family practice Group 1 countries 14100% Group 2 countries 0 63% Group 3 countries 014%

Gaps in family physicians in three groups of countries

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Family physician density varies from zero to 1.84 per 10 000 population

Minimum requirement is 3 per 10 000

Group Available family physicians in 2015

Total needs (1 family physician/ 10 000 population)

1 1340 5000

2 1798 29 000

3 87 30 000

Total 3225 64 000

Scaling up family practice: progressing towards universal health coverage5

2020

2016

2030

Strategy 2: Bridging programme for general practitioners in family

medicine

Strategy 1: Increase the number of family medicine specialists

WHO strategies to increase the number of family physicians

Scaling up family practice: progressing towards universal health coverage6

Increase annual production of family physicians

Strengthen family medicine education/departments

WHO recommends that physicians who want to pursue general practice should be specialized in family medicine

Strategy 1: Increase the number of family medicine specialists Objective: to reach a density of 3 family physicians per 10 000 population by 2030

Groups

Number of family

physicians per 10 000

if present trend continues

Number of family physicians

per 10 000If WHO recommended

interventions are made

2015 2030 Annual % increase

By 2030

1 0.31 0.79 19 3.34

2 0.11 0.62 30 3.25

3 0.13 1.19 10 2.77

Scaling up family practice: progressing towards universal health coverage7

Strategy 2: Bridging programme for general practitioners on family medicine

Compulsory training covering all general practitioners (GPs) working in public facilities

Duration (1224 months): First 6 months: WHO

bridging programme “Online course on building capacities of GPs in family medicine”

Each country to decide on practical training duration and recognition system

Number of GPs working in public facilities

Country # of GPs

Afghanistan NA

Bahrain 98

Djibouti NA

Egypt 14 973

Iran, Islamic Republic of

9500

Iraq 8000

Jordan 1645

Kuwait 832

Qatar NA

Lebanon 436

Libya 2009

Country # of GPs

Morocco 3105

Oman 3837

Pakistan 168 803

Palestine 369

Saudi Arabia 6107

Somalia 1065

Sudan 4700

Syria 951

Tunisia 5000

United Arab Emirates

261

Yemen 4804

Examples of short courses on family medicine in the Region

Egypt: 2 year diploma

Islamic Republic of Iran: 1 ½ year distance training

Morocco: 2 year diploma

Saudi Arabia: 14 month diploma

Sudan: 1 year diploma

Scaling up family practice: progressing towards universal health coverage8

Framework for action on advancing family practice in the Region

Governance/regulations • Linkages of family practice with developmental plans • Implement updated essential package of health

services

Scaling up production of family physicians

• Bridging programme for general practitioners and strengthening family medicine education

Financing • Sustainable funding for family practice

Service delivery • Integration of preventive, curative, promotive and rehabilitative services

Quality and safety • Implementation of the WHO framework on quality at PHC level and introduction of accreditation

Community empowerment

• Advocacy campaigns and community awareness

Scaling up family practice: progressing towards universal health coverage9

Conclusions1. Incorporate family practice into national health policies

and plans

2. Strengthen the capacity of family medicine departments and establish a bridging programme for general practitioners

3. Ensure access of all to equitable essential health service package

4. Adopt WHO quality indicators for improving quality of care at primary care facilities

5. Establish strategic purchasing/ provider payment methods at primary health care level

6. Strengthen public–private partnerships in service delivery through the family practice approach

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Thank you