ABSTRACT
Advocate with policy-makers to adopt strengthening of family practice as a national health goal for universal health coverage
Incorporate family practice as an overarching strategy for service provision within framework of universal health coverage (including projection of future needs for family physicians and other family practice team members)
Establish public private partnership through contracting out mechanism with defined catchment population and defined package of services
Establish/ strengthen a national high-level multisectoral commission for universal health coverage that sets goals, develop roadmap and oversee progress in scaling up family practice
Assign and provide resources to the appropriate unit in the Ministry of Health to take responsibility for coordinating family practice activities
Define/adapt the elements of family practice and identify family practice team members that suit the national context
Update laws/ regulations for supporting implementation and expansion of family practice programme
Establish standards for regulation of family practice programme (whether implemented through the public or private sector)
Develop a health information and reporting system (manual/electronic) to monitor health facility (risk factors, health status, system) performance
Present an evidence informed case for family practice with policy-makers in high level forums, including the Regional Committee
Assist in making rational projections for production of family physicians and family practice team members
Provide terms of reference/roles and functions of the family practice unit within the Ministry of Health
Frame a generic public health law/legislation in support of family practice, covering training and delivery aspects for adaption by countries
Develop essential standards for family practice for adaptation by countries
Build capacity in family practice facilities to report on core indicators agreed by Member States
Scaling up of family practice training programmes
Advocate with university presidents/chancellors and deans of Faculties of Medicine to establish, strengthen and expand family medicine departments and increase intake of family medicine trainees
Develop and implement competency based short courses to orient general practitioners, nurses and allied health workers on principles and elements of family practice
Introduce incentives for physicians to be enrolled in postgraduate family medicine programmes based on work experience in rural areas and primary health care services
Develop continuous professional development programmes for recertification in family medicine
Harmonize curricula, evaluation and standards of family medicine board certified programmes in countries of the Region
Establish departments of family medicine in all medical schools and integrate a family medicine teaching programme into medical and nursing curricula
Prepare policy briefs and present before deans and chancellors of medical institutions the need to strengthen family medicine departments
Collaborate with WONCA to develop short courses for orientation of general practitioners and nurses in family practice
Develop a policy paper on options for incentives for health care professionals to participate in family practice training programmes
Establish a group of regional experts to review and harmonize family medicine training programmes across the Region
Financing (strategic purchasing)
Introduce family practice financing as integral part of the national health financing strategy in a manner to ensure sufficient and sustainable funding for implementing expanding family practice
Engage in strategic purchasing for family practice from
Update tools and guidelines for design and costing of essential health services packages and provide training in their use and implementation
Synthesize and disseminate country experiences in financing family practice under
Major area Short-term actions (2-year term) WHO technical support public and private providers to achieve pre-set goals
Design and cost essential health services packages to be implemented through family practice and identify target population to be covered
Agree on implementation modalities of essential health services packages delivered by public, not-for-profit or for-profit private health care providers
Build capacity to undertake contracting for family practice including outsourcing of services provision
Decide and pilot provider payment modalities, e.g. capitation, case payment and necessary performancebased payment or their combinations
different health financing systems and provided related technical support to Member States
Share and disseminate evidence on the advantages and limitations of different modalities of contracting (including outsourcing) and organize related capacity building activities
Disseminate WHO guidelines as well as a organize a regional consultation on strategic purchasing and provider payment methods
Provide evidence-based programme budgeting for financial sustainability
Vertical/ horizontal integration of services
Undertake an assessment of service delivery to review status of integration of priority programmes
Develop and pilot a prototype referral system between primary, secondary and tertiary level including feedback and follow up (includes policies and procedures, instruments and staff training)
Introduce functional integration of health services (preventive, curative, others) by multi-tasking and refresher training of staff
Implement integration in all programmes in certain areas: training, supervision, health promotion, health information systems, drug supply and laboratories
Develop and update WHO guidelines, tools and policy papers on integration of health services
Continue to share best practices and exchange experiences of successful integration of programmes within primary care
Develop “integrated district health system based on family practice approach” assessment tool
Quality and safety/ standards/ accreditation process
Develop quality standards and indicators for family practice (inputs, process, outputs and outcomes)
Develop training and continuous professional development programmes for primary health care workers on improving the quality of service delivery
Strengthen supervision and monitoring functions including through interventions to improve the quality of care
Introduce/institutionalize accreditation programmes to support higher primary health care performance
Enforcing the accreditation of primary health care facilities
Develop framework for quality standards for primary care including those for family practice
Pilot and validate assessment framework in countries
Organize a regional consultation/workshop to develop consensus and build capacity in the use of framework
Support countries in the monitoring quality of care using the endorsed framework
Guide for set up monitoring tool to measure progress in family practice implementation with list of indicators
Community empowerment (demand, marketing and participation)
Establish a community health board to oversee the establishment of family practice
Launch a community-wide campaign to encourage populations to register with reformed health facilities in the catchment population (including civil registration and vital statistics)
Strengthen/initiate and support training of community health workers/outreach teams in scaling up home health care as integral part of the family practice approach
Encourage the health volunteer approach as a bridge between households and health care facilities and train volunteers in the use of WHO manuals
Organize orientation training for staff of health facilities on communication skills
Develop multimedia educational campaigns
Update tools and guides for community engagement in family practice
Provide technical support in developing a communication strategy for family practice programmes
Exchange successful experiences of community volunteer programmes in support of family practice
Provide technical support to increase access to primary health care services through community health workers, outreach teams and home health care strategies
