chapter  32
8 Pages

The World Health Organization on Family medicine development in the nations of the Middle East (2014)

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