View also Recommendations at a glance
The World Health Report 2006 ‘Working Together for Health’ pointed to an estimated 57 countries globally that have a critical shortage equivalent to a global deficit of 2.4 million doctors, nurses and midwives which by implication suggests millions of people worldwide do not receive the essential health care and services that are desperately needed. Simply training and graduating more health professionals is not the answer to this vexing issue. Concerted and immediate efforts to transform and scale up health professional education are required to attain the right mix of skills and competencies of health professionals who can respond to the ever-changing and evolving needs of populations around the world. Building on an approach of global collaborative leadership, efforts that are adaptive and flexible in various cultural and socio-economic settings will be key to the successful implementation of these evidence-informed guideline recommendations.
These guidelines call for new approaches in health professional education. Approaches are needed that transform systems and encourage the move away from the traditional focus on tertiary care hospitals to initiatives that foster community engagement. The guidelines recommendations support and advocate for implementation considerations in efforts to involve communities and countries collectively for this transformational change in health professional education. It is the intent of the guidelines to encourage educational and training institutions to foster and enhance the relational activity and the interaction and planning between education, health and other sectors.
To achieve this transformational process, The WHO Initiative on transforming and scaling up health professional education and training becomes a major contribution to the challenging task of reshaping the health workforce of countries for the benefit and well-being of their citizens (Box 1).
Box 1. Defining transforming and scaling up health professional education
Transformative scaling up of health professional education and training is defined as the sustainable expansion and reform of health professional education and training to increase the quantity, quality and relevance of health professionals, and in so doing strengthen the country health systems and improve population health outcomes.
Source: Celletti et al. (2011).
These guidelines set out a vision of such a transformation of education for the health professions, and offer recommendations on how best to achieve the goal of producing graduates responsive to the health needs of the populations they serve. Specifically, the guidelines aim to: provide sound policy and technical guidance in the area of pre-service education, particularly to countries experiencing shortages of doctors, nurses, midwives and other health professionals; and guide countries on how to integrate continuing professional development (CPD) as part of medical, nursing, midwifery and other health professional education scale-up in order to ensure excellence of care, responsive health service delivery and sustainable health systems. Country ownership in determining priorities and setting policy is required in each of the five identified guideline domains:
The recommendations cover a wide range from development of community-engaged relevant curricula through to equipping health professionals with the skills to be high quality competent clinical teachers and academic faculty, all of which contribute to preparing high quality, competent health graduates to practice in areas of need. Hence, a greater alignment between educational institutions and the health care system will be the necessary ingredient to bring about transformative change and leadership in preparing future graduates who have an affinity to work in rural and remote areas where the challenging issues of health equity and equality remain.
Box 2. The vision for transformative education
Adapted from Celletti et al. (2011).
The guidelines deal with the complex issues for transforming health professional education through the presentation of key policy issues, summarizing available evidence and providing recommendations and a commentary, which includes guidance for implementation. This guidance is underpinned by good practice recommendations which provide a supportive context for implementation. The following section describes the twelve recommendations, which are a culmination of evidence-informed decision interventions to guide a focused transformational process of scaling up health professionals' education and training globally.