WONCA News December 2022

VOL 48 | NUMBER 10

NEWS

2022

D E C E M B E R

WONCA PRESIDENT DR ANNA STAVDAL (NORWAY) EMAIL: PRESIDENT@WONCA.NET TWITTER: @ASTAVDAL WONCA IMMEDIATE PAST - PRESIDENT DR DONALD LI (HONG KONG) PRESIDENT-ELECT ASSOC PROF KAREN FLEGG (AUSTRALIA) EXECUTIVE MEMBER AT LARGE & HONORARY TREASURER PROF VAL WASS (UK) EXECUTIVE MEMBER AT LARGE DR MARÍA PILAR ASTIER PEÑA (SPAIN) EXECUTIVE MEMBER AT LARGE PROF SHABIR MOOSA (SOUTH AFRICA) REGIONAL PRESIDENT, WONCA AFRICA DR DAN ABUBAKAR (NIGERIA) REGIONAL PRESIDENT, WONCA ASIA PACIFIC ASSOC PROF MOHAMMAD HUSNI JAMAL (MALAYSIA) REGIONAL PRESIDENT, WONCA EAST MEDITERRANEAN PROF TAGHREED MOHAMED FARAHAT (EGYPT) REGIONAL PRESIDENT, WONCA EUROPE PROF SHLOMO VINKER (ISRAEL) REGIONAL PRESIDENT, WONCA IBEROAMERICANACIMF ADJ/PROF JACQUELINE PONZO (URUGUAY) REGIONAL PRESIDENT, WONCA NORTH AMERICA DR JEFF MARKUNS (USA) REGIONAL PRESIDENT, WONCA SOUTH ASIA DR TARIQ AZIZ (PAKISTAN) YOUNG DOCTORS' REPRESENTATIVE DR SANKHA RANDENIKUMARA (SRI LANKA) WONCA CHIEF EXECUTIVE OFFICER DR HARRIS LYGIDAKIS WONCA WORLD SECRETARIAT WORLD ORGANIZATION OF FAMILY DOCTORS AVENUE DES ARTS 7-8 1210 BRUSSELS BELGIUM EMAIL: SECRETARIAT@WONCA.NET PHONE: +32 (0) 2 329 00 75 WONCA EDITOR MARIA DOLORES ZAVALA EMAIL: EDITOR@WONCA.NET TRANSLATIONS DR JIE GU DR HUA YANG DR JULIEN ARTIGNY

CONTENT FROM THE PRESIDENT

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PRESIDENT ELECT

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THINKING OF WONCA 2023

FROM THE HEADQUARTERS

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LEAN INNOVATION: DOING MORE WITH LESS

WONCA & WHO NEWS

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WHAT IS THE INTERGOVERNMENTAL NEGOTIATING BODY ?

WONCA REGIONS

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7TH WONCA AFRICA REGION CONFERENCE WONCA ASIA PACIFIC REGION CONFERENCE

WP & SIGS NEWS

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WP ON EDUCATION: FREE ACCESS DECEMBER WP ON ENVIRONMENT: ENVIRONMENTAL IMPACT OF INHALERS OUT OF BREATH INAUGURAL WEBINAR OF PRIMARY CARE ASIA SERIES HELD IN SUPPORT OF WORLD MENTAL HEALTH DAY WORKING PARTY ON QUALITY & SAFETY

MEMBER ORGANIZATION NEWS

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BESROUR CENTRE FOR GLOBAL FAMILY MEDICINE SOCIEDAD CHILENA DE MEDICINA FAMILIAR (SOCHIMEF)

FEATURED STORIES

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WONCA FIVE-STAR DOCTORS 2022 UNIVERSAL HEALTH COVERAGE DAY 2022 PRIMARY HEALTH CARE FOR UNIVERSAL HEALTH COVERAGE, CAIRO, EGYPT 16 DAYS OF ACTIVISM AGAINST GENDERBASED VIOLENCE

WONCA CONFERENCES

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SUPPORT THE REVIEW OF PROGRAM SUBMISSIONS! 28TH WONCA EUROPE CONFERENCE

ANNOUNCEMENTS & UPDATES

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FROM THE PRESIDENT D E C E M B E R

WONCA NEWS

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HOME VISITS As a physician, I’ve always liked making house calls. They nurture the patient-doctor relationship. When meeting in the patient’s home context, we both recognize and share other aspects of ourselves. I find that the realities of my patients’ lives come more clearly into focus once I’ve met them where they live.

Now, in November and December, I’ve been invited to visit the ‘homes’ of four, far-flung WONCA regions.

From my Scandinavian Norway, I’ve been to Central America’s Guatemala, North America’s Arizona, Africa’s Nigeria, and now, as I write, I’m heading to Indonesia’s Bali!

After two years of life saving isolation during the pandemic, of being deprived of meeting each other in person, our various types of ‘home visits’ carry a new poignancy. And an added enthusiasm. At this stage of the pandemic, everyone, all at once, seems eager to organize face-to-face meetings.

A brief travelogue:

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Early in November, WONCA Iberoamericana held their Health Summit, the eighth in the region since 2007, this time in Guatemala.

The region has developed a method for “La Cumbre”, which, by the way, means both the summit and a pinnacle in Spanish. I’ve now seen – in person – how worthwhile their Summit method would be for other WONCA regions as well.

The Summit was organized and conducted by the CIMF leadership in collaboration both with regional colleagues and various National Health authorities. The aim is to identify areas for development, and to agree on joint actions. Guatemala has neither training schemes for Family Medicine nor a basic system for Primary Health Care. During just two intense days, the Summit produced the “Guatemala Declaration” and an “Action Plan”.

WONCA Iberoamericana CIMF Summit in Guatemala

What a privilege it was to participate in that intense process. I’m certain that the Summit built a momentum, helping to hold the Ministers of Health and Social Welfare accountable for the development of Primary Health Care. WONCA will play a task force role, exerting appropriate pressure from outside.

This conference was a case-in-point of the beauty of international solidarity in action.

And of the gift of ‘home visits’! My excursions into the countryside and to health facilities in the Capitol left me with the sort of insight into their need for Primary Health Care that only a face-to-face visit could have afforded.

Next stop, Phoenix, Arizona, U.S.A.: Some days after the Summit concluded, NAPCRG (North American Primary Care Research Group) celebrated its 50th anniversary. I was invited to give the opening keynote address. My ‘home visit’ to that context enabled me to recognize and discuss future collaboration opportunities between WONCA and NAPCRG. My visit confirmed what may not always be apparent: clinicians and researchers do share a common goal, and our constituencies do overlap to some degree.

WONCA President Anna Stavdal and Dr. Tochi Iroku-Malize, President of the AAFP at the NAPCRG meeting in Arizona.

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WONCA Africa Region Conference in Abuja, Nigeria

Quite a few NAPCRG members are based outside North America, and nourishing the potential synergies within the international Family Medicine community is a priority for both our organizations.

It’s increasingly important to make the case for Family Medicine and Primary Health Care, and such joint actions are a powerful tool to increase the impact of our advocacy.

Some NAPCRG members have already decided to attend the WONCA World Conference in Sydney next year, and I‘m looking forward to developing our relationship further.

On to Africa: WONCA Africa held their conference at the end of November, in Abuja, Nigeria, where our CEO, Harris Lygidakis, and I represented WONCA World. Even before the conference, the program was extensive.

We visited several health facilities and the Department of Family Medicine in Abuja. And, we were there to help celebrate the 25th anniversary of SOFPON, one of Nigeria’s three WONCA member organizations. Then began the regional conference’s impressive program. The enthusiasm among the participants was energizing to experience.

Thanks to this ‘home visit, we made contact with colleagues from African countries that do not have WONCA member organizations – yet. My hope is that we can develop these relationships, and grow our membership, including among Francophone African countries.

Another highlight from our days in Abuja was our meeting with Dame Pauline Tallen, Nigeria’s Minister of Women Affairs and Social Development.

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She underlined the importance that Primary Health Care carries for her population of more than 200 million people. We agreed to take joint action during the annual, global campaign against gender-based violence, which started the day we left Nigeria.

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Now, as I write, I’m on my way to Indonesia: The final ‘home visit’ of this journey brings me to the WONCA Asia Pacific Regional Conference in Bali. Theirs is yet another carefully planned program. People have been working for months to make sure the Family Doctors of the region get to meet, learn from, and support each other. I am humbled and happy to be invited to experience the results of their efforts.

I hereby send a big Thank You to all our hosts! For your kind hospitality – and your work.

WONCA APR Conference 2022 in Bali, Indonesia

It has now been a year since the Executive Board and I took office.

With one year left before we hand the baton on to our next WONCA relay team, this would be a good moment for each of us to take stock and review our work. What have we achieved? Where might we work even harder?

As we celebrate International Universal Health Coverage Day this December 12th, we remember that ‘Health for All’ and ’A Family Doctor for Every Family’ are our goals.

Primary Health Care is our political instrument as we work to improve people’s lives.

Also available in: Français Español

The title Dr. Akim Moses chose for his main keynote address at SOFPONs 25th anniversary celebration says it so well: “The Family Physician: The Shepherd of Humane and Compassionate Care.”

Now, at the close of 2022, I send warm greetings to all of you, my fellow shepherds, Family Doctors of the World. Thank you for your support, your companionship, and your inspiration.

DR ANNA STAVDAL

WONCA PRESIDENT

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PRESIDENT-ELECT:

THINKING OF WONCA 2023 During the last week of November I attended the annual conference of my own college - the Royal Australian College of GPs (RACGP).

Next year, the RACGP is honoured to be hosting the world conference of WONCA, in conjunction with our own conference. In some ways, this year’s conference felt like a trial run for our WONCA2023 event.

I’m pleased to report things ran very smoothly. As a participant, I did some of the same things that we all treasure about WONCA conferences: chat with eminent colleagues, and meet old and new friends from overseas.

A/PROF KAREN FLEGG

WONCA PRESIDENT-ELECT

As I walked back from my morning tea one day, I encountered Prof John Murtagh, perhaps our most famous Australian GP through being the author of “Murtagh’s General Practice”. Young doctors were starting to line up for photos with him. He is always so obliging and has an encouraging word for those who want photographs and autographs.

Our hope is that we will see him in Sydney, next year.

IMPORTANT DEADLINES ABSTRACT SUBMISSION NOW CLOSING FEBRUARY 9, 2023 BURSARY APPLICATIONS CLOSING: FEBRUARY 10, 2023 EARLY BIRD REGISTRATION CLOSING JULY 13, 2023 CONFERENCE WEBSITE

Lucky to meet with Prof John Murtagh

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Prof Michael Kidd, WONCA Past President

Prof Michael Kidd also humoured me with a photograph, but in the WONCA 2023 conference frame with a kangaroo. Michael is one of our keynote speakers for the conference.

At last week’s conference, I was also lucky enough to catch up with colleagues from the Royal New Zealand College of General Practitioners’ (RNZCGP), the Academy of Family Physicians of Malaysia (AFPM), and the Fiji College of GPs(FCGP).

NZ colleagues – Dr Kylie McQuellin (RNZCGP head of membership services), Dr Samantha Murton (RNZCGP President); Dr Kerryn Lum (RNZCGP Censor-in-Chief) and Lynne Hayman (RNZCGP CEO)

I have always treasured the social and learning interactions with international colleagues at WONCA conferences.

Your Australian colleagues are starting to look forward to this as an opportunity for them next year.

One thing that will be quite different next year is the scientific program with our international presenters.

Exchanging ideas with colleagues from overseas is one of those wonderful things of WONCA conferences.

The themes of WONCA2023 are “Recovery, reconnection and revival.

A celebration of primary care”.

Malaysian colleagues - Dr Lee Cheng Yew (president AFPM) and WONCA Asia-Pacific region secretary, Dr “Kavi” Sailin.

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We hope many of you submit abstracts and note the closing date has now extended until February 9, 2023.

Prof Mark Morgan is our Scientific Committee chair.

Mark’s messages for those considering abstract submission are: We hope WONCA2023 will challenge, enlighten and enthuse each person who attends, so we would like conference sessions to be as interactive as possible.

The abstract submission process asks for a description of your presentation/session in up to 300 words. It also asks you to identify three learning objectives.

Fijian colleague - Dr Shanita Sen(Vice president FCGP) and Prof Frank Jones (RACGP WONCA representative)

We would be pleased to receive abstracts that use innovative presentation styles such as dance, poetry, song, narration, imbedded audio-visual content.

More traditional formats such as illustrated talks, debates, discussion panels, research presentations will also be welcome.

Our peer review process will assess each abstract looking for topics that are relevant to family doctors.

Mark reminds us that to allow for new and emerging research to be presented, there is a separate opportunity for research abstract submissions closer to the dates of WONCA23. We have called this subsequent opportunity ‘’latebreaking”. Abstracts of this type may be submitted from May 24 to June 8.

Abstract submission information can be found here.

My Australian colleagues and I look forward to welcoming so many of you to my country and home town Sydney next year.

Prof Mark Morgan is our Scientific Committee chair.

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WONCA NEWS

FROM THE HEADQUARTERS LEAN INNOVATION:

DOING MORE WITH LESS DR HARRIS LYGIDAKIS WONCA CEO

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ave you ever heard of the concept of ‘Jugaad’? Neither had I, until very recently. But

I have certainly encountered it in the world, and you probably have too.

Jugaad is a Hindi word which can be roughly translated to mean finding a makeshift solution, an ingenious hack, improvising with limited resources or creating something useful out of adversity. You may have heard to the related term ‘frugal innovation’.

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Many people and organisations across the globe facing limited resources are engaging in it, seeking bold solutions to big problems, without much investment.

A few years ago, while doing research in Rwanda, I was lucky enough to see such an innovation in action. I didn’t know the term at the time, but I could see something impressive was going on. I was there to study how community health workers were operating, and what their challenges were.

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To overcome the difficulty in data collection and reporting due to a lack of infrastructure and a widely dispersed population, community health workers were using a simple but powerful solution; text messages. They would send updates to the Ministry of Health via SMS. This innovation was smart and certainly frugal, and it demonstrated ‘Jugaad’ because they looked at the resources they already had available (their cell phones) and devised a comms system around them. Genius.

However, an unexpected problem emerged. In some areas, there were frequent power outages. The community health workers weren’t able to charge their phones. As a result, some could face up to sixhour walks to find the nearest ‘charging station’ (often a savvy entrepreneur charging devices out of their car—another great example of ‘frugal innovation’). This meant less time serving their communities, and more frustration for the workers.

It strikes me, years later, that this notion of ‘frugal innovation’ could benefit from an innovation of its own, one which builds in a feedback and development process. For me, this is where the principles of the ‘Lean Startup’ [1] approach are the perfect fit: it is about doing more with less—and in the world of primary care and non-profits the limited resources often compel such approach—while focusing on engaging stakeholders and looking at a bottom-up approach.

So, in the interests of bringing together these ideas to help our community find creative and affordable solutions to problems they face, here are a set of principles to innovate by.

1. KEEP IT SIMPLE In low resource environments, knowledge is truly the most valuable currency available. Here comes perhaps the most fundamental part of the lean approach: the concept of building a ‘minimum viable product’ to test an idea. Don’t worry – this isn’t as complicated as it might sound!

You have a hypothetical solution to a problem. The most critical step in the entire process is to get something out in front of potential users (your target audience: your patients, fellow team members or decision-makers) as quickly as possible.

This means coming up with the most basic, rudimentary, low-cost version of a deliverable (a ‘product’ or ‘service’) which will still allow users to experience it, or the idea of it, enough for them to give meaningful feedback. In lean terminology, this means getting out of the planning stage and into the ‘Build Measure Learn’ circle as soon as possible.

This ‘product’ could be anything from a new website to a newsletter, to a system in place at your clinic, to a basic service. It can even be a mock-up or a prototype of the idea, not the real deal, as long as it is enough to get feedback from.

Dropbox, for example, got started with a simple three-minute video from the CEO explaining the idea which, at that time, was difficult to be explained to investors. They got a hugely positive response and helpful input, which ultimately led to the success of the company.

1. Ries, Eric. The Lean Startup: How Today's Entrepreneurs Use Continuous Innovation to Create Radically Successful Businesses. New York: Crown Business, 2011.

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You can follow this process and identify this kind of ‘minimum viable product’ whenever you are testing out an idea or service in your workplace, in your clinics, university departments, or even in your wider advocacy work. The key is to find the simplest version, not obsess over the details or making it ‘perfect’ and get it out there so that you can learn fast!

Involving as many stakeholders as possible in idea generation is such a critical component of this approach, crucially because it increases how much knowledge and insight you gain; the wider the net, the more feedback you receive. This means doing everything possible to engage with the users or people affected by the change you want to make. In a family practice, this can include doctors, nurses, support staff, patients, accountants, the wider community and beyond.

Key takeaway: knowledge is power; focus on feedback first, and you will reap the rewards.

2. FAIL CHEAPLY, AND ADAPT QUICKLY The big draw of a ‘minimum viable product’ is that it is incredibly cheap, which suits environments with limited resources. It is quick and easy to get off the ground and if it doesn’t work, it doesn’t matter too much. The most important thing is to get something out there, and get feedback on it, so you can make changes and try again. Even a ‘failure’ is not really a failure – it’s just a form of feedback. Once you have gained this, you can adapt and improve your offer. It is all about low-cost experimentation.

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WONCA NEWS

At WONCA, we were exposed to a tough challenge when COVID hit, and we had to move our Council Meeting to a virtual space for the first time.

The most critical thing was to get the business of the Council done, follow the relevant processes, convey key information and get the voting completed. Throughout the process, we encouraged and listened to feedback. We soon discovered that deprioritising the interactive part of the meeting was strongly criticised.

As a result, a workshop—a longstanding WONCA tradition—was added during our latest hybrid Council meeting and it has been very positively received. Other small changes, like online voting, online check-in and the weekly dedicated newsletter conveying key information in advance of the meetings, received positive feedback and are here to stay.

Key takeaway: innovation is messy and iterative takes lots of attempts to make it really work.

So the best way through it is to keep experimenting with the idea and adapting it often.

3. DON’T REINVENT THE WHEEL So often, we face problems that have been faced by many before us and will continue to be tackled by many to come. Yet we tend to silo ourselves into communities, sectors or groups, and feel that we need a brand-new response to a problem, when in reality there are many out there who have already come up with great innovations.

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Many solutions remain ‘undiscovered’ simply because people don’t realise their solutions already exist elsewhere. A great example of this is when health care takes inspiration from the aviation sector about the way they use thorough and exhaustive checklists as a core part of their safety process [2]. When they applied similar checklists, it led to a drastic decrease in errors in performances.

Key takeaway: don’t just think outside the box, but look outside of it. Take inspiration from other working groups, other members, other countries, or even other sectors.

4. USE WHAT IS IN ABUNDANCE When facing limited resources, it can feel like nothing is possible. But the concept of ‘Jugaad’ teaches us that there are always clever solutions to be found. One approach to this is by focusing instead on what resources are plentiful and available. This may be in the form of physical resources, such as in the case of ‘Conceptos Plasticos’, a Colombian company which aims to tackle the housing crisis by using what is in abundance– plastic–and turning it into durable, cheap, and brilliantly self-insulating bricks to build houses.

2. Clay-Williams R, Colligan L Back to basics: checklists in aviation and healthcare BMJ Quality & Safety 2015;24:428-431. Available from: https://qualitysafety.bmj.com/content/24/7/428

It also may be in the form of less obvious resources, such as people, community support, time, or expertise. On this front, we have an example from within WONCA itself.

We have been facing a challenge around our website: it is difficult to navigate and use, and this has led to missed opportunities for communication with and between members as a result. However, building and migrating to a new website is very expensive, and with inflation rising, this cannot be prioritised now.

So we asked instead, what does WONCA have in abundance? One answer, aside from the enormous level of expertise, is community. This inspired us to work on the Membership Portal, which is a space for members to participate in groups and communicate easily within them.

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We have also chosen to launch one group at a time, as a form of ‘minimum viable product’ so that we can receive feedback, learn, and adapt for the next group. The Working Party on Research has already launched its group on the Membership Portal, and other groups are coming very soon.

The emphasis on ‘low cost’ or ‘limited resource’ innovation can lead some to believe that they are of inferior quality. This is simply not true, and it’s important to challenge these assumptions. An example of this is Safari Comm’s ‘Empesa’ business, launched in Kenya in 2007, which used the widely available cell phones to facilitate money transfers by developing a simple mobile money system.

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This is such a powerful example because not only was it an ingenious and low-cost innovation, but it has also been adopted globally since, including inspiring higher income countries to do the same, proving the cheap innovation doesn’t mean sub-standard innovation.

Key takeaway: focus on what is available and plentiful, and use it to help solve your biggest problems.

5. DON’T BE VAIN! Often, when companies and NGOs alike launch innovations and seek feedback, they do so using vanity metrics rather than meaningful measures. This means that while they can give themselves a pat on the back for a job well done, or look good to their investors and donors, they haven’t actually got useful feedback which will help improve the product or service they are providing.

WONCA NEWS

To provide a different example: communication campaigns often measure the ‘reach’ (the number of users that are exposed to the message of the campaign). But wait, how much of an impact indicator is this? Does the number of users that have (passively) read a message on a newsletter or a social media platform indicate how many of them have increased their knowledge of your advocacy message or changed their behaviour?

At WONCA, we are planning to start doing more fundraising in the form of crowdfunding campaigns. We are mapping out a long-term strategy, including our assets and areas of expertise, and what is already available to us. We are developing a set of clear objectives we are working to. From this place, we will start running small pilot programmes to test different ideas, experiment and learn from what does/doesn’t work.

It’s crucial to ask for feedback which is truly relevant, and which will help push forward change and new ideas, even if that feedback might be negative or hard to receive.

Key takeaway: think long term, test short term.

Key takeaway: focus on meaningful indicators to build something great.

6. KEEP YOUR EYE ON THE PRIZE! This is something we have mentioned before when discussing effective communication: it is crucial to ensure that alongside the small experiments and quick adaptations, there is a long-term vision and strategy in place. It is key to have some clear goals and objectives to keep you moving towards a desired outcome, and to identify all relevant stakeholders and channels required as part of the process, and to keep checking in against this longer-term strategy. Of course, this can be adapted over time, but it is key to ensure that it doesn’t become a haphazard or random approach to trying things.

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We would love to hear from you about your experiences—good and bad—with innovation.

What problems have you faced, and how have you solved them? What are you working on now which could use a little extra direction from others?

How have you coped when facing limited resources in response to a challenge? Where have you failed?

And succeeded? These don’t have to be big or complex, they can be small, simple and cheap changes you have made in response to problems and adapted based on need. They can be around communication, processes or systems in your practice or institution, practices you have adopted, or products you have introduced.

We want to showcase examples to our membership, highlight what works and learn from what doesn’t, and build more support across our community to step in when individuals or groups are stuck on a complex problem. We look forward to hearing from you!

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INB

WHAT IS THE INTERGOVERNMENTAL NEGOTIATING BODY ?

The WHA established an Intergovernmental Negotiating Body (INB) to draft and negotiate a convention, agreement, or other international instrument under the Constitution of the WHO to strengthen pandemic prevention, preparedness and response. The INB’s work is based on the principles of inclusiveness, transparency, efficiency, Member State leadership and consensus.

The COVID-19 pandemic has had a profound impact on human lives, economies, and societies. To avoid a repeat of the past, the international community should collaborate to be much better prepared and aligned in responding to possible future pandemic threats.

In December 2021, the World Health Assembly Special Session (WHASS) took place in Geneva, Switzerland.

This is only the second time in the history of the World Health Organization (WHO) that the Health Assembly (WHA) has met for a second time in the same year.

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The INB should hold meetings to deliver a progress report to the 76th WHA in 2023, with the aim to adopt the instrument by 2024. In the decision establishing the INB, the WHA also requested the WHO Director-General to convene the INB meetings and support its work, including by holding public hearings to inform its deliberations. The United Nations system bodies, nonstate actors, and other relevant stakeholders can participate in the process to the extent decided by the INB. Together with other non-state actors, including the International Federation of Social Workers (IFSW), the International Hospital Federation (IHF), and the World Organization of Family Doctors (WONCA), the World Federation of Public Health Associations WFPHA provided several statements during the INB public hearing.

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ABUJA, NIGERIA 7TH WONCA AFRICA REGION CONFERENCE The 7th WONCA Africa Region Conference was organised in Abuja, Nigeria on 24–26 November.

The Hon Minister for Women Affairs and Social Development, Her Excellency Dame Pauline Tallen giving a gift to Dr Anna Stavdal.

WONCA Africa President Dr Dan Abubakar, and his team Dr Austin Aipoh, Dr Blessing Chukwukelu, Dr Dako Mamudu, and Dr Olusola Oluwasuen worked with passion and determination for a successful conference. The three WONCA Member Organisations of Nigeria and their leaders r Kayode Adesola, Dr Nicholas Baamlong and Prof Musa Dankyau, were united by the effort to bring together the

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Dr Kayode Adesola, president ANPMP & Dr Jane Namatovu, President elect WONCA Africa Region

Dr John Borowski and Dr Dan Abubakar, Dan, president Africa Region

African community for the first time in-person after the onset of the pandemic.

During the preconference day, there were sessions organised by the African Chapter of the WONCA Working Party on Women in Family Medicine and the Afriwon Movement.

Dr Anna Stavdal, WONCA President, and Dr Harris Lygidakis, WONCA CEO, visited Abuja to support the region.

Prior to the conference they met with the residents at the Family Medicine Department at the Abuja National Hospital;

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visited practices where they gained insight into the context, challenges and aspirations of the Nigerian colleagues; and spoke with colleagues and leaders of the broader Africa region.

They also had the opportunity to the meet with Dame Pauline Tallen, Minister for Women Affairs and Social Development of Nigeria, who was about to launch the campaign of 16 days of Activism against GenderBased Violence.

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BALI INDONESIA WONCA ASIA PACIFIC REGION CONFERENCE More than 600 family doctors and health care professionals from Asia Pacific and the world gathered at the WONCA Asia Pacific Conference 2022, held in Bali, Indonesia, on 5 - 7 December 2022.

The event, hosted by the Indonesian Association of Family Physicians, focused on Primary Health Care Transformation, addressing the current challenges and opportunities for family medicine.

The conference represented a perfect opportunity to exchange knowledge and experiences after the covid-19 pandemic. The programme included a pre-conference dedicated to young doctors, followed by the three-day event, with multiple workshops, plenary sessions, symposiums, and oral and poster presentations, along with various representations of Indonesian culture that captivated the attendees.

WONCA APR Conference 2022 - Opening Ceremony

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Dr Isti Fujiati as Chair of the Indonesian Association of Family Physicians and Professor Mohammad Husni Jamal, WONCA Regional President for the Asia Pacific Region

Professor Meng-Chih Lee, former regional president of WONCA Asia Pacific, was recognised as the 5 Star Doctor.

The opening ceremony included speeches by Dr Budi Gunadi Sadikin, Minister of Health of Indonesia, Dr Isti Fujiati, Chair of the Indonesian Association of Family Physicians, Dr Trevino Pakasi, Chair of the Host Organizing committee HOC, WONCA President, Dr Anna Stavdal, and Associate Professor Mohammad Husni Jamal, WONCA Regional President for the Asia Pacific Region.

At the opening ceremony, Professor Meng-Chih Lee, former regional president of WONCA Asia Pacific, was recognised as the 5 Star Doctor.

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WONCA APR Council Meeting 2022

Professor Mohammad Husni Jamal, WONCA Regional President for the Asia Pacific Region

During her presentation, WONCA President, Dr Anna Stavdal focused on the Role of Family Medicine in achieving UHC. “Now, more than ever, what the world needs is High-quality Primary Care. A close-to-home, healthcare hub, that functions in seamless collaboration with Social Care and Public Health services, as well as with hospitals. That requires a strong, interprofessional team, with a qualified Family Doctor onboard”

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After the conference, WONCA President, Dr Anna Stavdal thanked the conferences organisers with an emotive message: To Dr Isti Fujiati as Chair of the Indonesian Association of Family Physicians, Dr Trevino Pakasi as Chair of the Host Organising committee HOC, and Dr Putri Eyanoer as ViceChair of the HOC of the WONCA Asia Pacific Conference in Bali December 2022:

I am looking forward to the continuation of the development of primary care and family medicine in Indonesia. I will support you as best as I can, and to do that, you must keep us posted and make sure you keep each other posted on developments and actions.

It was a humbling and heartwarming experience to join you. I learned a lot, a lot of informal learning.

You built momentum, now it is up to us together to make the most of it.

And I was reassured that companionship, collaboration and unity are the only way forward we shall achieve recognition of family medicine in all countries of the world.

My best wishes to you all and a big thank you on behalf of WONCA World.

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From the WONCA Secretariat, we would like to express our deepest gratitude to Dr Isti Fujiati, Chair of the Indonesian Association of Family Physicians, Dr Trevino Pakasi, Chair of the Host Organizing committee HOC, Associate Professor Mohammad Husni Jamal, WONCA Regional President for Asia Pacific, and Dr Putri Eyanoer, Vice-Chair of the HOC of the Asia Pacific Conference for your all your attentions and congratulations on such a successful conference!

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WORKING PARTY ON EDUCATION

EDUCATION FOR PRIMARY CARE FREE ACCESS DECEMBER The annual meeting of Education for Primary Care, our affiliated WONCA journal, took place last week. Dr Victor Ng, Chair of the WONCA Education Working Party is on the Editorial Board joined virtually.

The publishers, Taylor and Francis, reported good and steady progress as paper views and downloads increase, international submissions rise and there is evidence of impact. This is so important as, to address the shortfall of Family Medicine Doctors, the role of Education in Primary Care in workforce development becomes of paramount importance.

If you are involved in postgraduate training, an excellent article from Australia on supporting GP supervisors is openly available I am delighted that the publishers have agreed to reinstate an increased monthly free access to a selected paper. We will announce these, starting with the December free access paper, in the weekly e-bulletins.

We are delighted to announce that the last issue of 2022 is now available online.

"Education for Primary Care, Vol. 33, No. 6, 02 Nov 2022" You can view the issue table of contents HERE.

We thank Taylor and Francis and the editor Professor Simon Gay, for this valuable concession to widen journal access across all our members .

For December, Education for Primary Care journal also offers free access until January 4th 2023, with the article The science of education: using learning theory to solve teaching problems in medical education

PROF VAL WASS

Former Chair WONCA Working Party on Education, writes on the latest open access items in Education for Primary Care.

Allen F. Shaughnessy & Deborah R. Erlich

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WORKING PARTY ON ENVIRONMENT

ENVIRONMENTAL IMPACT OF INHALERS The WONCA Working Party on the Environment Statement on sustainable inhaled therapies for healthier people and the planet People are well aware of air pollution being a risk factor for the development and exacerbations of chronic respiratory diseases, but generally do not know that inhaled therapy to treat respiratory diseases can contribute to climate change. In turn, climate change contributes to respiratory disease including asthma due to increasing intensity and duration of pollen seasons and risks of wildfires.

ENVIRONMENTAL IMPACT OF INHALERS The health sector is responsible for 7-8% of the carbon footprint worldwide. Pharmaceuticals are in the top 3 of carbon emissions in health care. Commonly-prescribed metered-dose inhalers (MDIs) for chronic respiratory diseases contain hydrofluorocarbons (HFCs) that are strong greenhouse gases and a significant cause of climate change.

Although all devices cause some CO2 pollution in their manufacture, it is the HFA propellant gases that contribute the large majority of the climate impact of inhalers. A typical salbutamol MDI supplying 200 puffs is responsible for a global warming equivalent effect comparable to driving 250 km in a mid-size car. The global warming impact of other inhaler types, such as dry powder inhalers (DPIs), is negligible. At this moment, less harmful alternatives (mainly DPI) for MDIs are available and affordable in many countries.

KIGALI AGREEMENT In 1995 MDIs contained chlorofluorocarbons (CFCs) that caused the ozone hole in the stratosphere. Under the strict regulation of the 1987 Montreal Protocol CFCs were replaced by HFCs in 30 years. In 2016 the Kigali agreement (an amendment to the Montreal protocol) was developed to phase out HFCs from 2020-2050 and was signed by 170 countries.

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However, the regulation is less strict, countries are free to choose how to phase out HFCs during this period and most countries have chosen to start with regulations for refrigerators and air conditioners.

Recommendation advocacy:

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Request GINA to consider healthcare systems’ carbon footprint when developing their guidelines.

Reducing air pollution exposure, both indoors and outdoors, is cost-effective to reduce asthma burden, and externalities affecting planetary health.

Develop regulation regarding the use of potent HFCs in MDIs. Make DPIs more accessible to vulnerable populations.

Access to DPIs should be part of health equity strategies and climate action.

Consider recommendation procurement.

WHO´s on green

Consider adjusting cost-effective analysis to account for climate change and planetary health

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Recommendation to pharmaceutical companies Progress development of MDIs which use alternate propellant gases with a lower global warming potential (such as HFC152a).

Phase out MDIs with HFCs with a high global warming potential according to “race to zero”.

Further research and development of DPIs and soft mist inhalers, including reducing the cost of these inhalers internationally to improve their availability.

Include dose counters on all MDIs to reduce wasted resources when inhalers are disposed of before they are empty.

Stop including polluting HFCs in placebo devices.

Work with health services and governments to develop programs to recycle plastic and metal components of inhalers and to capture unspent HFC gases.

This policy statement is in line with WONCA´s call for planetary health action.

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OUT OF BREATH Community health work features at a Brazilian “favela”.

Image credits: Victor Juca

THE DOCUMENTARY ABOUT THE PANDEMIC IN THE BRAZILIAN PUBLIC HEALTH SYSTEM ELIGIBLE FOR OSCAR It is common for family doctors during conferences to search for art inspirations to translate the challenges of Primary Healthcare.

When the pandemic started, everything was new but also unequal, like access to health, masks, respirators, and oxygen. The Brazilian Public Health System (acronym in Portuguese, SUS) was challenged in many ways as one of the major health systems in the world and also with one of the worst governments in our history. When the pandemic arrived in Brazil, we had heavy financial cuts in our system and were also really fragile to fight the pandemic and a disinfodemic.

DR MAYARA FLOSS

WONCA WP ON ENVIRONMENT

Health team dislocating in Amazon. Image credits: Tarso Sarraf

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Ana Petta and Helena Petta behind the scenes.

Image credits: Victor Juca

Before the vaccines were available, two sisters, Helena Petta and Ana Petta decided to do a risky thing: to document how the SUS was dealing with the pandemic. Helena had a baby just at the beginning of the pandemic and started to work from home, seeing patients online and discussing cases with students.

However, it was a burden for her to listen to their colleagues and feel that she was doing nothing, so she decided to start recording some testimonies. She shared some ideas with her sister Ana, an actress, and they decided to document the pandemic through the routine of the health system with a highlight on Primary Care and the role of family doctors.

The “Out of Breath” (Quando falta o ar, in Portuguese) movie includes scenes of prisons, “favelas” (slums) and ICUs. It tells the story of the frontline, mainly through the female healthcare workforce.

Women in the frontline are one of the highlights of the documentary Out of Breath. A scene with Conceição, a community health worker. Image credits: Victor Juca

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It does not look like a traditional documentary with different people talking about an issue in front of a camera. The film truly follows the routine of community healthcare workers, the steps of patients recovering from COVID-19, and the tears and challenges of living in a necropolitical environment. The documentary is a masterpiece. The soundtrack, camera movements, and sound capture are flawless, and it is easy to start to cry just with the trailer.

Imagine the challenge and responsibility to bring the technical team over ten thousand kilometres crossing the country from southeast to north, from São Paulo to remote Amazon. “Out of Breath” is a precious memory for all the world.

And we, as family doctors, should not miss the opportunity to watch and support this art piece.

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Mayara Floss and the hashtag #SUSnoOSCAR or #SUSatOSCAR

The filmmakers Helena and Ana are doing an organic campaign about the documentary due to financial constraints, as we could expect of a small production. However, because of its sensible narrative, on December 6th, Out of Breath was shortlisted as one of the 145 incredible movies competing for this year’s Oscars edition.

I have personally been involved, trying to raise the promotion of the movie through the hashtag #SUSnoOSCAR (Portuguese) or #SUSatOSCAR. So I truly recommend all family doctors and health professionals of the world to join this campaign and use our social media to make this movie reach the final list of Oscars.

The documentary beign short-listed for the Oscars represents a reward for us, as frontline health professionals and survivors of one of the worst political management of the pandemic in the globe. It also has a powerful meaning of art: we survived, and we won't forget the scars and teachings of the COVID-19 pandemic. And surely, the movie's message will always remind us of the importance of a health system for all, everywhere in the world.

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Movie director and actor Wagner Moura with the hashtag #SUSnoOSCAR

Follow more information about the movie exhibitions: Twitter Instagram Linktree Out of Breath information

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INAUGURAL WEBINAR OF PRIMARY CARE ASIA SERIES HELD IN SUPPORT OF WORLD MENTAL HEALTH DAY

Around 250 doctors from Hong Kong, Singapore, Malaysia and the Philippines attended a #webinar on “Optimizing Mental Health Management in Primary Care” on October 13th.

MIMS, in collaboration with experts from the World Organization of Family Doctors (WONCA), held the event in time to mark #WorldMentalHealthDay (October 10) and support its objective to “Ensure Mental Health & Well-Being becomes a Global Priority for All”.

Chaired by Dr Nazrila Hairn binti Nasir, a Family Medicine Specialist from Malaysia, the webinar gathered esteemed #experts from the #WONCA world community to

talk on diagnosing and treating #depression, #anxiety and related #mentalhealth conditions, focusing on the latest developments and thinking around mental health #primarycare, as well as on how to address the clinical practice challenges wrought by the #COVID19 pandemic.

The experts included: Professor Christos Lionis, Chair, WONCA Working Party on Mental Health (Speaker) Dr Ferdinando Petrazzuoli, European Regional Vice Chair, WONCA Working Party on Mental Health (Speaker) Dr Flávio Dias Silva, Professor, Federal University of Tocantins, Brazil (Presenter)

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Juan Manuel Mandive, Secretary, WONCA Working Party on Mental Health (Presenter) Dr Helen Sigua, Fellow, Philippine Academy of Family Physicians (Panelist) Dr Syed Harun Alhabsyi, Honorary Secretary, Singapore Psychiatric Association (Panelist) The webinar is the first in the Primary Care Asia Webinar Series and is brought to you by the Philippine Academy of Family Physicians, the Malaysian Family Medicine Specialists' Association, the Singapore Psychiatric Association, the Hong Kong Society of Psychiatrists, and MIMS Education.

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WORKING PARTY ON QUALITY & SAFETY

INTRODUCING HUMAN FACTOR SCIENCE IN PRIMARY HEALTH CARE The WONCA Working Party on Quality and Safety held a 1.5-hour webinar on introduction to human factors and the role of this science in primary health care.

To implement the WHO Global Patient Safety Action Plan 2021-2030 strategy 2.4 requires a strong Human Factors perspective and input from primary health care in order to strengthen the resilience of primary care organizations and clinical practices.

This free webinar for healthcare professionals, policy makers, researchers, and medical educators, aimed to explain what human factor science is, how it affects primary health care and Understand shared lessons on human factors from other high-risk industries, such as aviation.

The session was hosted by Prof. Jose M Valderas, Chair of WONCA Working Party on Quality and Safety, Head Division of Family Medicine, Yong Loo Lin School of Medicine Singapore, and Dr Maud Nauta, GP and WONCA Working Party on Quality and Safety lead on Human Factors.

Speaker: Dr Maud Nauta MRCGP MAS Patient Safety and Healthcare Quality, Human Factor Trainer and WONCA Working Party on Quality and Safety lead on Human Factors, Affiliate Member Chartered Institute of Ergonomics and Human Factors.

Using a Human Factors Approach to Improve Electronic Health Record (EHR) use in Primary Care.

Speaker: John W. Beasley MD, Professor Emeritus, Department of Family Medicine, and Community Health, University of Wisconsin and Honorary Associate University of Wisconsin School of Engineering, Department of Industrial and Systems Engineering.

Lessons learned from Human Factor integration in Aviation.

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Speaker: Peter Nataraj, Senior First Officer, and Human Factor Trainer Commercial Aviation.

DR MAUD NAUTA

A second webinar is planned for 2023: on how practicial human factor toolkits can help in day-to-day primary health care practice. Stay tunned for more information and registration details.

The programme included: Introduction: Human factors in Primary Health Care-what does it mean?

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EVEN A CHILD CAN SEE COLLABORATION IS ESSENTIAL TO SAVE THE CANADIAN HEALTHCARE SYSTEM

By David Ponka, Director of the Besrour Centre for Global Family Medicine at the College of Family Physicians of Canada.

Now that international work travel has resumed, my three daughters looked at me quizzically as I frantically packed my bags on a recent evening. They were still fighting with their vegetables when my eldest daughter, Ella, took the commotion as an excuse to help me.

“Where are you going, daddy?” she asked.

“I have to talk about Canadian health care in Brussels, sweetie.”

“What are you going to teach them?”

(Ella thinks that because I teach medical students and family medicine residents, that’s all I do anywhere I go).

“Well, they asked me to talk, and learn, about inter-professional primary health care.”

“What’s that?” she asked.

Good question.

It’s easy to confuse multi- and interprofessional medical care. In Canada, and in most of the world, we are either working in solo practices (mono-professionally) or, if we are luckier, in multi-professional clinics where we share space with nurses and allied health professionals such as physiotherapists and social workers, allowing us to meet the needs of our aging population and address the prevalence of complex multi-morbidity increasingly common in our communities.

But most of the time, while we work in parallel with these other disciplines, occupying the same space, we are not really working together.

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We typically share a medical record, but don’t always find ways to schedule and see patients either in tandem or at the same time. The idea was right, but it has not led to the efficient or coordinated level of care we had hoped to provide.

What we need instead is truly interprofessional and increasingly transprofessional care.

This becomes critical as more patients age in place and home care again regains importance. Yet, we do not yet have a geographic catchment system to deliver health care in Canada. I am a family physician in Ottawa but have patients in Kanata and Orleans (I have one that travels from Cornwall because she can’t find a family physician there).

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This is what they do in Belgium. Not only for home visits, but primary care in general. If an average physician has 2,000 patients, there is no reason that the physician will need to see them for every one of their needs, every time. The team can help triage, see well babies, and offer routine care such as Pap smears so that the physician can devote more time to episodic illness, new diagnoses and management of complex chronic care.

At this point Ella was staring back at me blankly.

So, I said, “OK, let’s draw a picture.”

“Imagine yourself in school and you are trying to learn about a subject – say climate change. You probably want to get all kinds of different teachers teaching you different parts of it, like geography, chemistry, health.

Maybe history.

Interdisciplinary means taking in all those things together, rather than studying them all separately.”

I added: “There is another level that we call trans-disciplinary, where the only thing that matters is climate change and getting all the disciplines together to find solutions. That’s in the future.”

Ella proceeded to draw a picture that I have used in every lecture I have given since – a picture with increasingly confluent colors mixing into the background fabric of the canvas. It explains what is important in a way that only a child could relate, and it explains a difficult concept simply.

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There are many examples of where trans-disciplinary collaboration is important. In some sectors, it has already happened.

Take transportation, with its truck-railship-plane-back to truck chain. The pandemic has highlighted how disciplines and sectors should be collaborating better, even the delivery supply chain.

In health care, as we continue to oscillate between the acute infectious waves of a pandemic and the more chronic additive impacts on individuals and community wellbeing, we need a more stable, unified approach.

Every parent remembers the torment of trying to balance protecting their children and loved ones from COVID-19 and ensuring their children’s well-being and education. We should be doing both, yet the health and education sectors remain siloed.

The health sector itself is siloed: In Canada, the communication between primary care and public health is made difficult because of the lack of established geographic catchment areas, among other factors. Then there is the obvious and ongoing shortcoming that professionals typically do not work out of the same buildings, let alone offices.

We need to create capacity and collaboration in the general disciplines to ensure nimble transitions as priorities shift and evolve and ensure the patient experience becomes more seamless.

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Imagine this scenario: Mrs. A, an 80year-old breast-cancer survivor with multiple chronic diseases including diabetes, arthritis, and pulmonary fibrosis, desperately wants to stay independent and avoid institutionalization. She visits her integrated patient medical home clinic a 10-minute walk from her apartment. This makes her feel secure, and the proximity and exercise make her wonder whether she still needs her increasingly unused driver’s license. She has a 90minute appointment scheduled with multiple providers to monitor her use of medication (pharmacist), her diabetes (diabetic educator and podiatrist) and her mobility (physiotherapist).

Her family physician sees her to maintain a long-term trusting relationship and to coordinate her care. All her providers shared her medical record and exchanged opinions ahead of time.

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Illustration info: A pictorial representation by 10-year-old, Ella, the author’s daughter, to explain where we are falling short in interdisciplinary collaboration in our health-­care system, and why this is important for other sectors emerging out of the pandemic.

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On this single visit, a recommendation is made to switch her puffer to a dry powder inhaler to make it easier for her and protect the environment (switching to a drypowder inhaler could save the equivalent emissions of 54 km of driving per patient per month). She is treated for a foot condition before it can get worse, and her physiotherapist and family doctor work together to treat a shoulder injury so that she can stay independent. The family doctor notices a new mole but can get a quick consultation as several specialties have begun working out of the same clinic. Mrs. A also receives her annual flu and COVID-19 shots thanks to an integrated public health centre in the same building.

On the way home, she makes her weekly visit to the school associated with that integrated health centre to interact and read with the kindergarten children.

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This scenario could be reality with the proper investments and leadership. While there are many examples of innovative clinics, these remain the exception: We need more transformative models moving forward. We need to put patients first while seeking efficiencies. Above all, we need primary care and public health to join forces to prepare us for the next big challenge – climate change.

Society is entrenched in a very Cartesian, subspecialized approach to human problems. We see increasing specialization and the increasing use of technologies as inherently good, but the pandemic should make us pause and reassess.

The current polycrisis in multiple sectors of society is a reminder that everything is related; solutions must once again be aligned, locally scaled and human centred.

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SOCIEDAD CHILENA DE MEDICINA FAMILIAR (SOCHIMEF)

LOS TRES PILARES DE LA MEDICINA FAMILIAR, PRESENTES EN EL XXIII CONGRESO CHILENO DE MEDICINA FAMILIAR La Sociedad Chilena de Medicina Familiar (SOCHIMEF) organiza cada año un congreso sin marca, sin apoyo de la industria. El XXIII Congreso Chileno de Medicina Familiar con el lema “Personas Cuidando Personas” se realizó en modalidad virtual los días 17, 18 y 19 de noviembre de 2022, con sede “virtual” en la Región de Aysén, al Sur de Chile. La idea fuerza es que las personas somos el capital más importante en salud y que hay un aspecto comunitario que se refleja en el lema, como lo comentó la presidenta de esta versión, la Dra. Sandra Paredes, en su discurso de bienvenida.

En el discurso de cierre la Dra. Roxana Sepúlveda, presidenta de la Sociedad Chilena de Medicina Familiar, en consonancia con una de las plenarias, destacó que los y las especialistas en Medicina Familiar, somos los únicos médicos especialistas en la estrategia de atención primaria y, por tanto, los que debemos encabezar los procesos de transformación tendientes hacia la universalización esta estrategia.

El Comité Congreso, que reúne a un grupo de Médicos Familiares entusiasmados en generar año a año un espacio de encuentro, plasma la importancia de reconocer el capital humano

que conforma cada territorio y dispositivo de salud, comenta la Dra. Gina Brun. La particularidad de este comité, comenta la Dra. Gladys Caro, es que está abierto a cualquier socio que desee participar, todos tienen derecho a opinión y voto, incluyendo a todas las regiones del país, logrando que la experiencia y el conocimiento local alcancen un lugar muy relevante en el Congreso.

Desde la Coordinación del Grupo de Trabajo de Bioética, la Dra. Carmen Nadal, destaca el interés generado por los bloques de discusión Bioética. Se abordaron temas como la organización de los comités de ética en Atención Primaria, el modelo de atención con enfoque centrado en las personas con múltiples patologías crónicas y la nutrición e hidratación en cuidados de fin de vida. Surgiendo las ideas fuerza del respeto por la autonomía, las decisiones compartidas y la importancia de la educación en salud, para apoyar a las personas en decisiones basadas en sus preferencias.

Las grandes temáticas de este congreso se plasmaron en las Plenarias que abordaron el Desarrollo de la Atención Primaria y la Salud Familiar en Aysén (región de la sede virtual), en una excelente

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presentación del Dr. Iván Lemus, Médico Familiar de la región; la Eficiencia en la Gestión de la APS en Chile, con José Luis Contreras, Ingeniero de la Comisión Nacional de Evaluación y Productividad; el Monitoreo de los sistemas de salud, a través del lente de la APS, con una presentación orientadora del Dr. Hernán Montenegro, Médico Salubrista de la OMS/OPS; el Abordaje de la Salud Mental en el personal de APS: Saludablemente, una nueva estrategia, en una maravillosa presentación de Viviana Harcha, Psicóloga, del Servicio de Salud De Reloncaví, respecto del cómo se puede cuidar a las personas que cuidan personas; para finalizar con la plenaria de la Universalización de la Atención Primaria de Salud con el Dr. Ricardo Fábrega, Médico Gestor Público, Asesor del Ministerio de Salud.

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Previo al Congreso se desarrolló la Jornada Pre-Congreso Waynakay (residentes y médicos de familia jóvenes). Su coordinador, Dr. Patricio Thieme, Residente de MF destaca que asistieron más de 140 personas que analizaron la importancia de las organizaciones de residentes y Médicos de Familia; y los desafíos actuales y futuros, como son la formación en la especialidad y el trabajo comunitario desde la experiencia.

Es importante recordar que SOCHIMEF, no podría abordar tamaña aventura sin el aporte permanente de sus socios, que financian este Congreso sin marca y sin el generoso aporte de los más de 80 expositores, que entregan su conocimiento y experiencia para el desarrollo de este y anteriores Congresos.

Esta última plenaria tiene particular relevancia en cuanto a que es el camino que quiere emprender Chile en el desarrollo de una atención centrada en las personas, con integralidad y continuidad, tres pilares fundamentales de la Medicina Familiar, comenta la Dra. Macarena Moral, Coordinadora del Comité Congreso. Sin olvidar la importancia de generar espacios para la reflexión conjunta y el abordaje de temas clínicos de relevancia para la Medicina Familiar.

Autoras: Periodista Andrea Gómez, Médica Familiar Macarena Moral

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DISCOVER THE 2022 WONCA FIVE-STAR DOCTORS WONCA’s award of Excellence in Health Care is called the Five Star Doctor Award. It can be awarded annually by each region, with all regional winners going forward for consideration for the Global Five Star Doctor award, made each biennium, with the winner receiving his or her award at the WONCA World Conference.

The concept of the Five Star Doctor was first described by Dr Charles Boelen, then of WHO, in 2000, and is judged on the following five criteria: a CARE PROVIDER, who considers the patient holistically as an individual and as an integral part of a family and the community, and provides highquality, comprehensive, continuous, and personalized care within a long- term, trusting relationship. a DECISION MAKER, who makes scientifically sound judgments about investigations, treatments and use of technologies that

take into account the person’s wishes, ethical values, cost- effective considerations, and the best possible care for the patient. a COMMUNICATOR, who is able to promote healthy lifestyles by effective explanation and advocacy, thereby empowering individuals and groups to enhance and protect their health. a COMMUNITY LEADER, who, having won the trust of the people among whom he or she works, can reconcile individual and community health requirements, advise citizen groups, and initiate action on behalf of the community. a MANAGER, who can work harmoniously with individuals and organizations both within and outside the health system to meet the needs of individual patients and communities, making appropriate use of available health data.

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WONCA FIVE-STAR DOCTORS 2022 We are now to announce the WONCA Five-Star Doctors 2022!

WONCA AFRICA REGION DR MODUPE MARTHA-ALICE LADIPO (NIGERIA) WONCA ASIA PACIFIC REGION PROF MENG-CHIH LEE (TAIWAN) WONCA EAST MEDITERRANEAN REGION DR MOHAMMED TARAWNEH (JORDAN) WONCA EUROPE REGION DR PHILIPPE BINDER (FRANCE) WONCA IBEROAMERICANA – CIMF DR JULIO CEITILIN (ARGENTINA) WONCA SOUTH ASIA DR KANAPATHIPILLAI SRIRANJAN (SRI LANKA)

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BUILD THE WORLD WE WANT A HEALTHY FUTURE FOR ALL

UNIVERSAL HEALTH COVERAGE DAY On 12 December 2012, the United Nations General Assembly endorsed a resolution urging countries to accelerate progress toward universal health coverage (UHC) – the idea that everyone, everywhere should have access to quality, affordable health care. On 12 December 2017, the United Nations proclaimed 12 December as International Universal Health Coverage Day (UHC Day) by resolution 72/138.

International Universal Health Coverage Day aims to raise awareness of the need for strong and resilient health systems and universal health coverage with multistakeholder partners. Each year on 12 December, UHC advocates raise their voices to share the stories of the millions of people still waiting for health, champion what we have achieved so far, call on leaders to make bigger and smarter investments in health, and encourage diverse groups to make commitments to help move the world closer to UHC by 2030.

The COVID-19 pandemic has again shown us that UHC and health security are intertwined goals to protect everyone, everywhere, that we achieve through the same health system – in crisis and calm. For health systems to work, they must work for everyone – no matter who they are, where they live, or how much money they have. Equitable health coverage puts women, children, adolescents, and the most vulnerable first because they face the most significant barriers to essential care.

On 12 December, WONCA joined Universal Health Coverage Day with a social media campaign that included several videos and quotes from our colleagues and members of the WONCA family to demand action on universal health coverage and invest in health systems and primary healthcare for all.

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BUILD THE WORLD WE WANT A HEALTHY FUTURE FOR ALL

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BUILD THE WORLD WE WANT A HEALTHY FUTURE FOR ALL

#UHCDay

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CAIRO, EGYPT

PRIMARY HEALTH CARE FOR UNIVERSAL HEALTH COVERAGE On 12 December 2017, the United Nations officially designated 12 December as the International Universal Health Coverage (UHC) Day to commemorate the endorsement of a historic resolution in 2012 that urged all countries to accelerate progress toward UHC as an essential priority for international development.

UHC means that all people have access to the health services they need, in good quality, when and where they need them, without financial hardship. UHC should be based on strong, people-centred primary health care (PHC) with health systems rooted in the communities they serve. Many countries are making progress towards UHC but achieving UHC requires strengthening health systems in all countries and investment in quality PHC will be the cornerstone for achieving this.

In line with the theme of this year’s Day “Build the World We Want: A Healthy Future for All”, the WHO EMRO Regional Office carried out a regional meeting on “Primary health care for universal health coverage and health security in the Eastern Mediterranean Region” on 11–15 December at the Four Seasons hotel at the First Residence, Cairo, Egypt.

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EMRO leaders at the “Primary health care for universal health coverage and health security in the Eastern Mediterranean Region”

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WONCA President, Dr Anna Stavdal, Prof Taghreed Farahat, WONCA EMR president, and Dr Nagwa Nashat, WONCA EMR Honorary Secretary, joined the event during the sessions on the 14 and 15 December 2022.

During those dates, the EMR regional professional diploma steering committee was held on Wednesday as a parallel session.

On 15th of December,2022, health leaders from across the Region will signed a call for action for the national recognition of the regional Professional Diploma in Family Medicine. The aim is to build the World We Want: A Healthy Future for All. The Diploma was delivered through a partnership with the Arab Board of Health Specializations (ABHS), WHOEMRO, WONCA EMR regional office, the UNAIDSMENA, UNFPA, UNHCR and UNICEFmena.

14 Member States signed the Cairo Call for Action for the national recognition of the regional Professional Diploma in Family Medicine.

- Djibouti - Egypt - Islamic Republic of Iran - Jordan - Lebanon - Libya

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- MoroccoPakistan - Palestine - Somalia - Sudan - Syria - Tunisia - Yemen

F E A T U R E D

S T O R I E S

WONCA NEWS

Call for action for the national recognition of the regional Professional Diploma in Family Medicine

Prof.Taghreed Farahat WONCA EMR president signed on behalf of WONCA EMR More than 100 participants attended to the meeting, bringing together a range of stakeholders from government, the private sector, donors, academia and the health sector to:

Prof.Taghreed Farahat WONCA EMR president signed on behalf of WONCA EMR

Discussion focused on establishing the link between PHC and the regional priorities outlined in the Sixty-ninth session of the Regional Committee (RC69) paper on ‘Building resilient health systems to advance UHC and ensure health security in the Eastern Mediterranean Region’ to inform the development of a regional road map to put into action the key strategic and operational levers outlined in the PHC Operational Framework.

The meeting also served as an opportunity to prepare for the UN High-Level Meeting on UHC that is scheduled to take place in September 2023.

Dr Awad Mataria, Director, UHS, WHO EMRO Arwa Hany IFMSA, regional director EMR, Dr Anna Stavdal and Dr Nagwa Nashat

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F E A T U R E D

S T O R I E S

WONCA NEWS

16 DAYS OF ACTIVISM AGAINST GENDERBASED VIOLENCE

The 16 Days of Activism against Gender-Based Violence is an annual campaign that begins on 25 November, the International Day for the Elimination of Violence against Women, and runs through International Human Rights Day on 10 December.

Led by civil society, the campaign is supported by the United Nations through the Secretary General’s UNiTE by 2030 to End Violence against Women initiative. This year, the UN marks the 16 Days under the theme “UNiTE! Activism to end violence against women and girls”.

Against this setting, a backlash against women’s rights is underway around the world. Anti-feminist movements are on the rise, attacks against women human rights defenders and activists are up, and the legal status of women’s rights is increasingly imperiled in many countries. Regressive new laws are exacerbating impunity for perpetrators of domestic violence, governments are using force against femicide and gender-based violence protestors, and women’s rights organizations are being increasingly marginalized.

Violence against women and girls remains the most pervasive human rights violation around the world.

Already heightened by the COVID-19 pandemic, its prevalence is now being further increased by the intersecting crises of climate change, global conflict and economic instability.

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With information of www.unwomen.org

F E A T U R E D

S T O R I E S

Despite these discouraging trends, there is more proof than ever that violence against women and girls is preventable. Evidence shows that the single most important driver of policy change is a strong and autonomous women’s movement— making feminist mobilization in the face of anti-rights backlash a literal matter of life and death.

WONCA NEWS

This 16 Days, we’re encouraging everyone to get involved: from amplifying the voices of survivors and activists to supporting women’s organizations and strengthening feminist movements, we can all act to empower survivors, reduce and prevent violence against women and girls, and protect women’s rights.

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As part of the #16days of activism against #genderviolence, women family doctors from Latin America discussed the role of Family Medicine in eradicating violence against women.

Relive this dialogue (in Spanish) with Dr Jacqueline Ponzo, President of Wonca Iberoamericana CIMF, as a special guest. Watch the session here.

YOU ASKED,

PROGRAM SUBMISSIONS DEADLINE

EXTENDED

WONCA NEWS

W O N C A

C O N F E R E N C E S WONCA CONFERENCES

YOU ASKED. WE LISTENED

SUPPORT THE REVIEW OF PROGRAM SUBMISSIONS! APPLY TO BE A PROGRAM SUBMISSION REVIEWER

Are you:

* qualified in family medicine * can critically appraise new evidence * are up to date with evidence-informed practice * interested in lending your expertise to the submission review process?

And either * an experienced in family medicine research OR * a practising family doctor

Then we want you! We are looking for family doctor reviewers to assess the quality and relevance of submissions.

We expect to allocate each reviewer between two and 10 submissions – the final number will be determined by the total number of submissions we receive and the number of reviewers available.

The submission review process will start in January 2023 and should be completed no later than 3 March 2023.

WONCA SYDNEY EXTENDS PROGRAM SUBMISSIONS DEADLINE The WONCA community has spoken. With the end of year just around the corner, the upcoming end of year celebrations, we have revised our close date to now be in the new year. We hope this will assist you in preparing and submitting your program submission for the WONCA 2023 World Conference

PREPARE Review the presentation styles and submission guidelines before preparing your submission.

ASSEMBLE Prepare your submission following the submission guidelines, using either the clinical/educational OR// research guide.

WONCA.RACGP.ORG.AU/WONCA-2023 44

APPLY TO PRESENT Only submissions completed in the WONCA 2023 submission portal by 11.59 pm Australian Eastern Daylight Time (AEDT), 9 February 2023 will be reviewed and considered for inclusion into the program.

Emailed and incomplete submissions will not be reviewed.

WONCA NEWS

W O N C A

C O N F E R E N C E S

28TH WONCA EUROPE CONFERENCE

WONCA CONFERENCES

7 - 10 JUN 2023, BRUSSELS, BELGIUM

We are happy to introduce to you the members of the Scientific and Organising Committees. Find the complete list here.

The 28th WONCA Europe conference will be held in Brussels, Belgium, from June 7th to 10th 2023.

The theme will be “Making Choices in Primary Care”. The abstract submission deadline is January 10th 2023.

Registration is open! Do not hesitate and take the chance to get an early bird price and save.

Please contribute with your participation and register HERE. Still, hesitating about submitting an abstract?

We encourage you to contribute with your knowledge. Follow the guidelines for abstract submission

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A N N O U N C E M E N T S &

WONCA NEWS

U P D A T E S

UNIVERSITY OF TORONTO DEPARTMENT OF FAMILY AND COMMUNITY MEDICINE

VIRTUAL TORONTO INTERNATIONAL PROGRAM TO STRENGTHEN FAMILY MEDICINE AND PRIMARY CARE (V-TIPS) PROGRAM DESCRIPTION The virtual edition of the Toronto International Program to Strengthen Family Medicine and Primary Care (V-TIPS) is informed by nearly a decade of engagement with international family medicine leaders and champions through our yearly in-person TIPs-FM program. The virtual program provides an overview of how to leverage excellence in education, research, clinical services and leadership to deliver high quality family medicine globally, by sharing experience and building on lessons learned at the DFCM, in Canada and around the world.

Taught by faculty leaders from the Department of Family and Community Medicine (DFCM) and international guest faculty, this year's program will run from March 29 - June 14, 2023.

V-TIPS is delivered over 12 weeks through asynchronous and synchronous sessions with a focus on collaborative learning. The program includes weekly readings, pre-recorded videos, and a weekly 90-minute session delivered live on Zoom on Wednesdays at 7am EST. Where indicated, weekly synchronous sessions are recorded for future reference. In addition, biweekly drop-in sessions will be offere

PROGRAM GOAL This program will enable participants to strengthen family medicine (FM) and comprehensive primary care (CPC) in their own setting through state-of-the-art education, evidence-informed high-quality care and transformative leadership.

AUDIENCE V-TIPS is a program for current and emerging leaders in the areas of health services delivery, policy and academia interested in strengthening family medicine and comprehensive primary care as a core element of health systems.

FIND MORE INFORMATION AND REGISTER NOW!

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A N N O U N C E M E N T S &

WONCA NEWS

U P D A T E S

LSHTM WEBINAR SERIERS: PRIMARY HEALTH CARE: THE HEART OF EVERY HEALTH SYSTEM The London School of Hygiene & Tropical Medicine (LSHTM) invites you to a ten-part seminar series that will run from October 2022 to July 2023.

The series provides an overview of the key features and functions of PHC, the potential of PHC in all health systems and its role in achieving universal health coverage. Sessions draw on examples across different settings.

For more details and joining instructions follow links" with "For more details, joining instructions and recordings of previous events follow links: 12.45 – 13.45, Wed 5 Oct 2022: Panel Discussion. Primary Health Care: The heart of every health system?

12.45 – 13.45, Wed 2 Nov 2022, What is Primary Health Care?

12.45 – 13.45, Wed 7 Dec 2020, Achieving Primary Health Care through Multisectoral Action and Policy 12.45 – 13.45, Wed Jan 2023, Empowering People and Communities Feb 2023, Integrating Primary Care and Public Health Mar 2023, Financing Primary Care Apr 2023, Getting the Primary Care Workforce right May 2023, Holding it together: Primary Care Infrastructure Jun 2023, Measuring, regulating, and improving Primary Care Jul 23, Panel Discussion: Primary Health Care at the heart of every health system - an achievable dream?

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