This document discusses scaling up family practice to progress towards universal health care coverage in the WHO Eastern Mediterranean Region. It outlines the characteristics of family practice and assessments showing gaps in family physicians across countries in the region. WHO strategies to increase the number of family physicians include increasing production of family medicine specialists and a bridging program to train general practitioners. A framework is proposed with actions around governance, financing, service delivery, quality, and community empowerment to advance family practice. The conclusion calls for incorporating family practice in national health policies, strengthening family medicine training and universal essential services, improving primary care quality, and public-private partnerships in service delivery.

1. Scaling up family practice:
progressing towards
universal health coverage
Agenda item 4(a)
63rd Session of the WHO Regional
Committee for the Eastern Mediterranean
36 October 2016
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2. 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 coverage

3. 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
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Scaling up family practice: progressing towards universal health coverage

4. 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 14100%
Group 2 countries 0 63%
Group 3 countries 014%
 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
Scaling up family practice: progressing towards universal health coverage
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

5. 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
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Scaling up family practice: progressing towards universal health coverage

6.  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 10 000
If 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
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Scaling up family practice: progressing towards universal health coverage

7. Strategy 2: Bridging programme for general
practitioners on family medicine
 Compulsory training
covering all general
practitioners (GPs) working
in public facilities
 Duration (1224 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
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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 coverage

8. 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
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Scaling up family practice: progressing towards universal health coverage

9. Conclusions
1. 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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Scaling up family practice: progressing towards universal health coverage

10. Thank you
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