Global Engagement Network for Primary Health Care: Working to Create a Stronger Health Care Workforce
Members of the GEN-PHC secretariat meet at the University of Minnesota. From left to right: Esther Johnston, Ramakrishna Prasad, Bassim Birkland and Shailey Prasad.
A group of global health experts from around the world is working to strengthen the health care workforce with the ultimate goal of advancing Primary Health Care (PHC).
The Global Engagement Network for Primary Health Care (GEN-PHC) has created a three-part framework that focuses on physician workforce development, the primary care market, and health policy.
These components are critical to PHC, which emphasizes health care that is equitable, holistic, and focused on social medicine. Social medicine focuses on the social, environmental, and economic factors that impact health. PHC envisions a world where preventive medicine lowers health care costs and improves quality of life.
GEN-PHC recently completed a Delphi study that engaged 23 experts in family medicine faculty development from around the world. The study results defined three major areas of expertise that should be included in family medicine faculty development, including technical skills, knowledge of systems and principles, and personal development and professional role-modeling.
Researching and improving the quality of primary care education is one component of a much larger portfolio of work for the GEN-PHC team, which is also exploring the composition of primary care in different settings, and how to optimize this.
“A big part of this is figuring out what the ideal mix of disciplines is in primary care and how we can assess care equally,” said Esther Johnston, MD, MPH, a faculty member at the University of Minnesota Medical School and GEN-PHC’s director.
In addition to Johnston, GEN-PHC’s secretariat includes: Center for Global Health and Social Responsibility Executive Director and Associate Vice President of Global & Rural Health Shailey Prasad, MD, MPH; Ramakrishna Prasad, MD, MPH, of the Academy of Family Physicians of India; Bassim Birkland, MD, MPH, of the University of Zambia; Klaus von Pressentin, MBChB, MMed, PhD, of the University of Cape Town; Sophie Watson, of the University of Minnesota; and Annika Carlson.
Shailey Prasad stressed the importance of the group’s geographic diversity.
“It’s a global network democratized in its decision making,” he said.
Primary Health Care: A Bold Vision
If you live in the United States, the idea of equitable, socially conscious health care might seem like a utopian idea.
Between a lack of insurance, access to providers and exorbitant costs, the health care system can seem more like an intractable quagmire than a nexus for meaningful reform.
But in other parts of the world, systems have emerged that embrace health care as a human right instead of a commodity, centralizing services to prioritize holistic, preventative care.
In Rwanda, community-based insurance has helped to ensure more than 90 percent of the country’s population has health insurance. Costa Rica has emphasized community health workers to improve health outcomes.
While the above examples are by no means perfect, they all share one thing in common: traits of PHC.
The idea of PHC came into the mainstream in 1978, when its importance was emphasized in the Alma Ata Declaration. The Declaration was signed by all members of the World Health Organization and made PHC one of the WHO’s priorities.
Taking Meaningful Steps Forward
GEN-PHC is working towards implementing PHC models by disseminating research and ideas that can guide workforce development. One study published by the group examined the pain points experienced by family medicine training programs.
The study found that a lack of government recognition hindered programs’ ability to recruit or train residents.
GEN-PHC’s Delphi study will provide further recommendations for best practices in training the next generation of family physicians.
A holistic view of PHC is needed for progress to be made, and that’s why GEN-PHC has developed its three-pronged approach, emphasizing workforce development, the market, and policy.
“In Zambia, they’re rolling out a plan where everyone has access to health care, but there aren’t the structures to provide equitable and accessible care to people,” said Birkland, a lecturer at the University of Zambia and the director of clinical practice and education at Seed Global Health.
“It’s a great initiative — and it’s nice to see taxpayer money going towards this — but even if it all works out well, if you don’t have the actual system to provide that care, you’re not going to get very far.”
Shailey Prasad emphasized the infrastructure needed to produce more equitable health systems.
“One of the huge conversations around the world right now is about universal health coverage. And while we all acknowledge that is important, that misses the point in creating the structures that would allow for the coverage to occur,” he said.
GEN-PHC’s Delphi study will be released before the end of 2025.