WONCA News August 2024

VOL 50 | NUMBER 5

NEWS

2024

A U G U S T

WONCA PRESIDENT ASSOCIATE PROFESSOR KAREN FLEGG (AUSTRALIA) EMAIL: PRESIDENT@WONCA.NET PRESIDENT-ELECT DR VIVIANA MARTINEZ BIANCHI (US/ARGENTINA) WONCA IMMEDIATE PAST PRESIDENT & WHO LIAISON DR ANNA STAVDAL (NORWAY) EXECUTIVE MEMBER AT LARGE & HONORARY TREASURER DR STEVE MOWLE (UK) EXECUTIVE MEMBER AT LARGE ADJ PROFESSOR KAREN PRICE (AUSTRALIA) EXECUTIVE MEMBER AT LARGE DR MARÍA PILAR ASTIER PEÑA (SPAIN) REGIONAL PRESIDENT, WONCA AFRICA DR JANE FRANCES NAMATOVU (UGANDA) REGIONAL PRESIDENT, WONCA ASIA PACIFIC DR. BRIAN CHANG (TAIWAN) REGIONAL PRESIDENT, WONCA EAST MEDITERRANEAN DR ABDULAZIZ MAHMOOD NASSER AL-MAHREZI (OMAN) REGIONAL PRESIDENT, WONCA EUROPE PROF SHLOMO VINKER (ISRAEL) REGIONAL PRESIDENT, WONCA IBEROAMERICANACIMF DR DORA PATRICIA BERNAL OCAMPO (COLOMBIA) REGIONAL PRESIDENT, WONCA NORTH AMERICA DR VICTOR K NG (CANADA) REGIONAL PRESIDENT, WONCA SOUTH ASIA DR KANAPATHIPILLAI SRI RANJAN (SRI LANKA) YOUNG DOCTORS' REPRESENTATIVE DR CHAN YUEN CHING CHERYL (HONG KONG) 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 DIARMUID HAYES EMAIL: COMMUNICATIONS@WONCA.NET

CONTENT FROM THE PRESIDENT

PAGE 4

WHO NEWS

PAGE 9

WONCA AT THE 77TH WORLD HEALTH ASSEMBLY

FEATURED STORIES

PAGE 13

8 REASONS WHY FAMILY PHYSICIANS ARE THE ACTUAL STARS OF MEDICINE MY FIRST RURAL HEALTH CONFERENCE

WONCA REGIONS AFRIWON ACTIVITIES AT 8TH AFRICA CONFERENCE

WONCA NEWS

PAGE 21

PAGE 25

CORE VALUES PROJECT HAIZHU JIANGNANZHONGJIE COMMUNITY HEALTH CENTRE - WONCA PRACTICE ACCREDITATION STRENGTHENING PRIMARY HEALTH CARE IN THE AMERICAS WONCA PAST PRESIDENT AWARDED HONORARY DOCTORATE

GREEN STORIES

PAGE 36

GREEN PRACTICE JAPAN SYNDEMIC

FEATURED DOCTORS

PAGE 39

DR FATHIA MOHAMED NOUR - SOMALILAND DR ANNE MWIKYA - KENYA

WONCA CONFERENCES

PAGE 43

WONCA WEBINARS

PAGE 48

ANNOUNCEMENTS & UPDATES

PAGE 49

CRISP REPORTING CHECKLIST HELPS ADVANCE PRIMARY CARE RESEARCH

FROM THE PRESIDENT J U L Y

WONCA NEWS

2 0 2 4

WFDD, HEALTHY SUCCESS

M

ost of our readers will realise that on May 19th we celebrated World

Our main promotional video was produced by Young Doctors and Working Party on Planetary Health.

Family Doctor Day (WFDD) and this year all theme was Healthy Planet Healthy People.

I have watched World Family Doctor Day grow from its beginnings in 2010 and it is truly fantastic how widespread, varied and enthusiastic celebrations are. We use this day to celebrate the great job we do as Family Doctors, so this year it was a little different to promote Planetary Health and its link to our work, and better outcomes for our patients.

4

F R O M

T H E

WONCA NEWS

P R E S I D E N T

Prof Sir Andy Haines, WONCA life Direct member and eminent international leader on Planetary health and a member of our WONCA Working Party on Planetary Health helped create three specific short videos on: mental health, novel diseases and the Global Health Care sector.

There were also two “press conference” chat sessions recorded.

I am taking this opportunity to show a random selection of some of the many fantastic activities that were held. Congratulations to all who participated in a WFDD event and thank you all for making this day the huge success it has become. My apologies in advance that I can’t feature every country or every activity. That indeed would fill a very large book!

Short social media videos produced for World Family Doctor Day 2024.

background to celebrate the event WONCA. These included WONCA East Mediterranean President elect, Prof Faisal Alnasir (pictured) who was also involved in making a video.

The Bangladesh Academy of Family Physicians observed the day for the first time in Bangladesh in 2014. The Board of Governors of the Academy has held a program at its head office inside Dhaka. A rally was organized at Dhaka. (pictured) After the Rally a sumptuous breakfast was served to the participants. A discussion meeting was held where Prof Md Nurul Islam, former WONCA South Asia President presented keynote paper. Others discussed about the significance of the day.

Bahrain Family Physicians Association (BFPA) used WONCA’s excellent social media toolkit to post key messages to support the global campaign through its official Instagram and WhatsApp. WONCA pages and hashtags were mentioned with the posts. Organization leaders changed their social media profile pictures using the WONCA

5

F R O M

T H E

WONCA NEWS

P R E S I D E N T

The Hong Kong College Family The event reiterated the importance Physicians (HKCFP) issued a Press of "Healthy People, Healthy Planet" Release on World Family Doctor Day and encouraged the community to 2024: Healthy Planet, Healthy take active steps towards a People, A Call to Action for Healthier sustainable future.

Communities in Hong Kong.

Slovak Society of General Practice Over a hundred representatives from WONCA Africa Region Conference in Abuja, Nigeria celebrated with general practitioners public and private healthcare in their communities organising a sectors, patient groups leaders, etc, series of "Stepwalking" events. By celebrated the WFDD 2024 together literally “stepping out” of their and what an amazing sight in the practices, family doctors invited photo above. patients and members of community Association of Family Physicians of to walk and join them in honouring India (AFPI) are hosting our 2025 their special day. Why? To show by WONCA South Asia Region example that walking is a great conference. Watch the promotional preventive measure against a video about next year’s conference number of serious diseases at zero financial and ecological cost. in Bangalore.

For WFDD, one of their events was held in Bangalore and led by the organisation’s secretary, Dr Roshni Jhan Ganguly. The community engagement program included: tree planting and adoption; a road cleaning initiative on Yemalur Road to reduce pollution; distribution of recycled t-shirts as a token of appreciation, reinforcing the importance of recycling and sustainable practices.

6

"Stepwalks" were held across Slovakia – in the lowlands and mountains, in towns and small villages, as well as in the capital city.

The first walk began on 11 May in Veľký Biel, a little village in Western Slovakia, and the final walk closed this great series of events on 30 May in Prešov, a small town in Eastern Slovakia.

F R O M

T H E

WONCA NEWS

P R E S I D E N T

Taiwan Association of Family Medicine took the initiative to organize a hiking event up the Jiantan Mountain on May 19th to promote healthy lifestyles.

The group is photographed high up the mountain with a specially designed WFDD promotional banner.

The Venezuelan Society of Family Medicine (SOVEMEFA), held a workshop on May 3 with leaders and decision makers of the country related to health and the environment. The idea was to generate joint actions that can be maintained and followed over time with the commitment of the different institutions involved.

It’s not surprising that many of our WFDD events have significant community impact and are reported in the press – two examples follow.

The Caribbean College of Family Physicians - Jamaica Chapter were reported in local newspaper “The Gleaner” and parts of the article are repeated above.

The 2024 celebration was a two-day function to honour family physicians.

Awardee categories included signature awards for persons that provided long standing service to community; adding to the development of the family doctor movement through involvement in associations, academia, research, teaching and outstanding medical community work.

On May 18, a comprehensive medical day was held with the participation of family doctors in a rural area called Bariro where more than 400 people were treated, at the level of the outpatient network and through home visits, a very vulnerable area with great need for assistance.

7

F R O M

T H E

WONCA NEWS

P R E S I D E N T

The Family Doctor of Excellence Awards, highlights family doctors each year who are deserving of recognition for their hard work and consistently high standards of medical practice.

Society of Family Physicians of Nigeria (SOFPON) were similarly noted in local press “Voice of Nigeria” as having planted 300 trees in major health institutions in JosBukuru metropolis in Plateau to commemorate the 2024 World Family Doctor Day.

Finally our South Asia Region (SAR) reported on a webinar.

WONCA South Asia Region held a webinar with six areas to cover: climate change, infectious diseases, air water and land pollution, mental health, diet and food systems, and health inequalities. I loved the points made on this slide (pictured). The speakers, all family physicians/ general practitioners from South Asian countries, presented data and evidence-based information related to their countries.

I found the content of this slide particularly shocking and worth sharing as widely as we can.

8

I thank all colleagues who take the time to make OUR day a special day in their part of the world. We deserve the accolades!

ASSOC PROF KAREN FLEGG WONCA PRESIDENT

WONCA NEWS

AT THE 77TH WORLD HEALTH ASSEMBLY

GENEVA, JUNE 2024

T

his past week at the World Health Organization headquarters in

Geneva the atmosphere was electric as health leaders from around the world gathered for the 77th World Health Assembly.

Among the participants the delegation from WONCA including Anna Stavdal, Maria Pilar Astier Pena, and Harris Lygidakis engaged in key discussions on enhancing primary health care, integrating multi-professional teams, managing non-communicable diseases,

DR ANNA STAVDAL WHO LIAISON

ASSOC PROF MARIA PILAR ASTIER PEÑA MEMBER AT LARGE

DR HARRIS LYGIDAKIS WONCA CEO

and addressing the urgent threats posed by climate change.

Concurrently WONCA has finalized its WHO triennial collaborative plan and is considering new projects with WHO for the 2025-2027 period aiming to continue and expand its influence in global health initiatives.

9

W H O

WONCA NEWS

N E W S

During the Assembly WONCA engaged with WHO's Workforce Department on the Core Values Project, an initiative aimed at defining the global role of family medicine.

This engagement highlights WONCA's commitment to facilitating a unified approach to health care that can be adapted by regions worldwide.

WONCA’s collaboration with WHO on refining clinical algorithms using the International Classification of Primary Care version 3 (ICPC-3) is critical for enhancing global health responses and underscores the importance of this classification.

Digital transformation themes continued with discussions about the evolution of the ICOPE training program. The shift towards digital platforms is aimed at enhancing accessibility and effectiveness in geriatric care training representing a forward-thinking approach to global health education.

A highlight of the assembly was the side event "Accelerating Primary Health Care Transformation with Evidence." This session brought together a diverse group of health leaders including the Regional Directors of the Americas, the Eastern Mediterranean Region, and Europe as well as the Ministers of Health from Spain and Uruguay.

They discussed evidence-based strategies to enhance PHC systems.

The discussion underscored the critical role of family doctors in driving these reforms showcasing their essential position at the intersection of clinical care and public health advocacy. Read the full report on this transformative event here.

10

Spanish Minister for Health, Dr. Monica Garcia, WHO Liaison for WONCA, Anna Stavdal, and WONCA Member at Large, Maria Pilar Astier-Peña

Additionally WONCA met with key non-state actors such as the International Federation of Medical Students Associations (IFMSA), the World Federation for Medical Education (WFME), the Partnership for Maternal Newborn & Child Health (PMNCH), and the World Federation of Public Health Associations (WFPHA) to explore synergies and collaborative opportunities.

W H O

WONCA NEWS

N E W S

The Assembly underscored the urgent need to address noncommunicable diseases—a leading cause of mortality worldwide.

Building on the foundation laid by the NCD statement published in October 2023 during the Meeting of the Council in Sydney, WONCA highlighted the pivotal role of PHC in managing these health crises. The new statement advocated for an integrated care model that emphasizes preventive care and robust community partnerships.

A STRONG VOICE ON CLIMATE CHANGE A notable moment at the assembly was the presentation of a jointly developed statement on climate change urging health systems worldwide to adopt practices resilient to environmental challenges. This statement connects the dots between climate change and its direct impacts on public health calling for immediate action.

LOOKING AHEAD As WONCA continues to influence global health policies its role at WHA77 has solidified its reputation as a leader in shaping the future of family medicine. With a call to its members and partners to engage actively WONCA is poised to continue its advocacy for family medicine ensuring it remains integral to the global health dialogue.

WATCH VIDEO OF WONCA AT WHA77 READ MORE: WHA77 ACCELERATING PRIMARY HEALTH CARE TRANSFORMATION WITH EVIDENCE 11

W H O

WONCA NEWS

N E W S

Dr Maria Nera, WHO Director, Department of Environment, Climate Change and Health WONCA Member at Large, Maria Pilar Astier-Peña

WONCA Leadership at World Health Assembly, Geneva.

WHO Director-General Tedros Adhanom Ghebreyesus with Maria Pilar Astier-Peña.

WONCA STATEMENTS AT WHA77

STATEMENT ON PREVENTION AND CONTROL OF NCDS STATEMENT ON CLIMATE AND HEALTH

17

STATEMENT ON REDUCING MATERNAL, NEWBORN AND CHILD MORTALITY

F E A T U R E D

WONCA NEWS

S T O R I E S

8 REASONS WHY FAMILY PHYSICIANS ARE THE ACTUAL STARS OF MEDICINE Family medicine is neither the most prestigious nor the

titioner and primary care researcher, it was always

highest paid medical profession. Is that appropri- ate, or

fascinating for me to delve into the scientific litera- ture to

should it be the opposite? Should GPs actually be

investigate this issue. Here are the key results.

treated as the stars of medicine? As a general prac-

DR FLORIAN STIGLER, MPH

General Practitioner (Austria), Primary Care Researcher (trained in London/UK) Chair, Global Forum on Universal Health Coverage & Primary Health Care Editor, Golden Nuggets of Family Medicine & The Family Medicine Blog

1. GPs Are the Backbone of Effective Healthcare Systems Countries with a stronger focus on primary care and family medicine, rather than on hospitals and specialists, enjoy better health, lower health in- equalities, and prevent hospitalizations. I believe this is crucial and that all politicians should know about it. The following graph shows the striking difference in premature mortality between coun- tries with weak or strong primary care:

Read this article online complete with footnotes and references.

13

My journey was long I felt my work was and unusual... I’ve just sitting on the had a deep passion shelf. Determined to for medicine, research find a solution, I and organizing decided to ‘invent’ my projects for a long own dream job. And time, but these here it is!

This interests never Newsletter & Blog seemed to fit unite my life passions together. Also, and I’m excited to although I love to share them with you. I write and was even truly hope you will published in The find them engaging Lancet and NEJM, and useful!

F E A T U R E D

WONCA NEWS

S T O R I E S

2. More GPs = Higher Life Expectancy Did you know that people in areas prevented 127,617 deaths per year with more GPs live longer? Stud- in the USA.² This graph shows the ies from the USA showed that association between prima- ry care adding one GP per 10,000 inhab- physician

density

and

itants was associated with 2-5 expectancy among US states: fewer deaths and 4 fewer hospitalizations¹ annually. On average, life expectancy increased by 52 days. Overall, such an increase in the number of GPs could have

14

life

F E A T U R E D

WONCA NEWS

S T O R I E S

3. Having Your Own LongTerm GP Can Save Your Life

Why do long-term GP-patient relationships improve health and reduce costs?11,13

Patients who choose a GP rather than a specialist as their primary care provider have a 19% lower mortality and produce 22%-33% lower

•

You no longer need to review all medical records

healthcare spending. Also, systematic reviews on ‘continuity’ found mortality reductions in most included studies. In other words, having your

or repeat the whole medical and personal history.

•

their family, friends, coworkers, and the peculiari-

than a specialist), might just save your life and (based on 4.5 million people in 2018), shows

ties of their local community.

•

years decrease acute hospital ad- missions by

Over time, more trust develops. Adherence to medical advice improves and unnecessary self-re-

that the longer you know your GP, the better off you are. Patients who know their GP for over 15

Over time, GPs put their patients into context.

You know your patients’ evolving story as well as

own GP and contacting him or her first (rather save us money. A fantastic study from Norway12

Over time, GPs come to know their patients well.

ferrals to other doctors decrease.

•

Over time, communication improves. Patients share personal issues more easily and medical

28%, out-of-hours services by 30%, and even

errors are more easily avoided.

their risk of dying by 25%. This graph illustrates that the benefit of long-term GP-pa- tient relationships is even dose-dependent (lon- ger GP-patient-relationship = lower risk of dying prematurely):

15

F E A T U R E D

WONCA NEWS

S T O R I E S

4. GPs Provide Most Healthcare The following graph shows that by far most patient/doctor contacts are with GPs. On average, twice as many patients have contact with GPs than with all specialists (in offices and/or outpatient clinics) combined. While the media and politicians talk mainly about heroic intensive care or impressive new technologies, the real work happens nonetheless in family medicine offices.

Ehent Quam, Ea Volupta Temporeptas Quas Quiaero Family physicians provide accessible and comprehensive care for most healthcare needs, most diseases, and all organs. They are therefore the foundation of every healthcare system. The numbers above leave no room for doubt.

5. GPs Improve Chronic Disease • Management

Patients with multimorbidity account for 78% of GP

chronic diseases, multimorbidity, and polypharma-

diseases are largely managed in primary care

on

100,000

UK

have multi- morbidity (based on 700,000 US patients). Family physicians are the sole care

•

providers for 86% of hypertensive patients and

cy. Family medicine today is therefore more import- ant than ever. Why? Because chronic

(based

patients). More than 45% of primary care patients

•

We live in a world of aging populations, with rising

appointments

for 71% of dia- betics (based on 2.7 million Canadian patients). Patients with multimorbidity

•

who usually visit pri- mary care rather than

and are therefore the GPs’ daily business:

specialists showed 2% lower mortality, 6% less hospitalizations, and 9% lower healthcare costs (based on 4 million US patients).

16

F E A T U R E D

WONCA NEWS

S T O R I E S

6. GPs Prioritize Prevention One reason why GPs can improve health and save costs is their stronger focus on prevention. A recent study of almost 3 million US patients showed that those who visited primary care were much more likely to receive preventive services: 127% more vaccinations, 122% more colonoscopies, and 75% more mammograms.25 As the following graph shows, patients with a primary care doctor are much more likely to receive preventive checks:

Source: Continelli

7. GPs Save Money GPs can save money by: •

Improving prevention and chronic per year. A further study of 6 million had less unnecessary hospitalizadisease

•

and each additional visit saves $721 countries with stronger primary care

management

Avoiding veteran patients showed, as men- tions, especially concerning Asthma,

potentially harmful di- agnostic tioned previously, that having your COPD,

and

diabetes.

This

is

a

and therapeutic proce- dures own primary care provider reduced remark- able statistic, especially as Reducing unnecessary specialist healthcare costs by 22% (another GP visits are relatively inexpensive.

•

visits and hospitalizations

study showed a 33% reduction). As shown in the following graph, Also,

healthcare

systems

with primary care services amount for

That’s why a recent study of 5 mil-

stronger fo- cus on primary care only 8.1% of healthcare costs in the

lion US patients showed that the

might be associ- ated with lower EU 2018.

first primary care visit saves $3,976

costs or at least with slower growth in costs. In Europe,

Source: OECD Health Statistics 2020 (without dental care)

17

F E A T U R E D

WONCA NEWS

S T O R I E S

8. GPs Counteract Health Inequalities The chances of living a healthy life are not distributed equally or fairly. Life expectancy is hugely influenced by education, income, and oc- cupation as illustrated here: As shown, stronger primary care orientation3 and higher GP densities are both associated with reductions of health disparities. But why? Well, strong

primary

care

improves

access

for taged individuals with more risk factors, more chronic diseasdeprived populations, it offers more comprehen- es, more medications, and lower health literacy. Last year, I sive services, and GPs know their patients lon- was honored to interview Sir Michael Marmot, former Chair of ger and better. In other words, patients can get the WHO Commission on Social Determinants of Health and more services, more easily, more appropriately. former President of the World Medical Association, about his All of that is especially important for disadvanperspectives on primary care and health inequalities.

Conclusion

Mechanisms

Healthcare systems which focus on family

So, in a nutshell, WHY are GPs so important and HOW do they improve health and save money?

•

results in better outcomes. They are easily accessible and offer more affordable services.

GPs are highly trusted, which encourages adher-

Also, because by far most healthcare happens

ence to medical advice.

•

GPs improve prevention, which avoids diseases.

•

GPs improve early detection, which improves

in primary care offices (rather than in hospitals), that is where the quality of prevention and chronic disease management is really deter-

treatment outcomes.

•

GPs improve chronic disease management, which prevents complications.

•

GPs avoid unnecessary duplications of diagnostic procedures.

•

long-term GP enjoy many benefits. GPs know their patients best and are highly trusted, which

GPs know their patients well, which improves diagnostic accuracy.

•

medicine and patients who have their own

mined and where unnecessary and potentially harmful procedures can be avoided. Without a doubt, primary care is the backbone of all effective healthcare systems and family physicians are the actual Stars of Medicine.

GPs avoid unnecessary and potentially harmful medications.

•

GPs prevent unnecessary specialist visits and

•

GPs offer the same services more affordably than

•

GPs offer guidance and coordination within a

hospitalizations. specialists or hospitals. complex system.

Subscribe to “Golden Nuggets of Family Medi- cine” (Newsletter by & for GPs).

18

F E A T U R E D

WONCA NEWS

S T O R I E S

MY FIRST RURAL HEALTH CONFERENCE I attended my first rural health conference in my second year of medical school and I am incredibly grateful that I did. This was the 2022 WONCA World Rural Health Conference held in Limerick, Ireland.

I played a role in organizing the conference, an opportunity provided to me by my school and my role as a Rural Seeds Ambassador. Although I had been involved in the planning, I was hesitant to attend the conference in person as I was in the midst of my medical training and did not personally know anyone else attending. Nevertheless, I made the decision to attend and had an incredible experience.

Each day was filled with delightful conversation with individuals from all over the world in various stages of their careers, including medical students like myself.

This experience not only significantly expanded my professional network but also opened doors that ultimately supported my goal of securing a residency position in Canada.

These opportunities included invaluable experiences in research, clinical electives, and mentorship.

At the conference, I attended many insightful workshops and presentations which strengthened my passion for rural health. At my very first workshop, I remember feeling a sense of comfort as I was surrounded by people with similar passions and experiences in rural health. We were all looking for innovative solutions to the inequities faced by rural communities. Being from a rural town, it is easy to feel like a small fish in a big pond.

Rural Seeds and WONCA Rural Conference, Limerick 2022.

19

ALEXANDRA FERRARA

RURAL SEEDS AMBASSADOR

However, at this conference, I felt as though I was part of a very large community working towards the same goals.

My own experience at the rural health conference not only broadened my horizons but also made my dedication to advocating for rural communities stronger. It is my goal to attend rural health conferences on an annual basis to reconnect with peers, mentor others, and continue my journey of lifelong learning. My current interest lies in the upcoming Ubuntu conference in Cape Town, South Africa, September 10-13th. It is a fully hybrid conference which provides the opportunity for virtual attendance if you cannot attend in person. I am impressed by the broad range of workshops and presentations that will be held, which can be found on the conference website.

F E A T U R E D

WONCA NEWS

S T O R I E S

I am particularly interested in the workshop ‘Rural Stars Project: Developing a Practical Guide for Rural Health Promotion and Advocacy’ which will be facilitated by my fellow Rural Seeds Ambassadors!

I strongly encourage medical professionals in any stage of their career to attend rural health conferences, even if you find yourself a bit hesitant like I once was. I also encourage you to explore the various bursaries and other opportunities available to students and young doctors looking to learn and gain experience.

These professional events offer an invaluable platform to learn, connect, and grow both personally and professionally. By participating in conferences, you can stay updated on the latest advancements in medicine, build a supportive network of peers and mentors, and gain insights that can shape your future practice.

Rural health conferences provide a unique opportunity to gain insight into rural health inequities and understand how to advocate for underserved populations.

Whether you're interested in research, clinical practice, or healthcare policy, attending rural health conferences provides an enriching environment where ideas are exchanged, innovations are showcased, and community is at the forefront. Embrace the chance to immerse yourself in these transformative experiences—they have the potential to shape your career trajectory and inspire you to make a meaningful impact in the field of medicine!

ALEXANDRA FERRARA FAMILY MEDICINE RESIDENT PHYSICIAN RURAL SEEDS AMBASSADOR WONCA RURAL WORKING PARTY EXECUTIVE MEMBER

20

W O N C A

WONCA NEWS

R E G I O N S

NAIROBI, KENYA AFRIWON ACTIVITIES AT WONCA AFRICA CONFERENCE

On the morning of the 4th of June, a team of international delegates embarked on a visit to Makadara, a vibrant health centre offering primary care services to an underserved community

in the lower wealth quantiles in Nairobi County. This visit was not just a tour but an immersion into the heart of community health and primary care where dedicated workers and compassionate care intersect to create a robust healthcare system. The primary health care system has been organised into a primary care network with a hub and spoke model connecting level 2 and 3 facilities referred to as spokes to a level 4.

Our first stop was the Makadara Health Centre, the hub - a beacon of hope and wellness for the local community. As we entered the facility, we were greeted by a vibrant mural depicting scenes of health and vitality, a testament to the community's commitment to wellness.

AgaKhan University - Conference 2023

21

W O N C A

R E G I O N S

WONCA NEWS

Visit to Makadara Health Centre.

We began with a presentation and discussion with the multidisciplinary team, gaining an understanding of the organization functions and activities as well as success stories of the Primary Care Network. The bustling corridors echoed with the sounds of healthcare in action— nurses attending to patients, doctors consulting with families, and the hum of medical equipment in the background.

We were introduced to the community health workers (CHWs) Community Health Assistant and Community Health Promoters stationed at the community desks.

Their smiles and warm greetings were the first indication of the incredible work they do. These desks serve as the frontline of health education, providing vital information on disease prevention, maternal and child health, and chronic disease management.

Dr Elena Klusova leads a workshop on ‘Most Threatening Rhythms for the Family Doctor’.

Jericho Health Centre: The Spoke of Support Our journey continued to the Jericho Health Centre, a spoke in the PCN model where we witnessed the seamless extension of care from the hub. This smaller but equally important facility caters to a wide array of health needs, ensuring that even the most remote community members have access to quality healthcare.

22

W O N C A

R E G I O N S

A Home Visit: Compassion in Action The home visit was a humbling experience. We saw firsthand the challenges faced by the client and her family. The CHW not only provided a key connection to medical care but also emotional support, answering questions and offering reassurance. This visit underscored the holistic approach of the PCN model, where care extends beyond physical health to encompass emotional and psychological well-being. We are grateful to the Makadara PCN multidisciplinary team and the Nairobi County leadership for hosting this learning exchange.

Successful Second International AfriWon Preconference/2nd International WONCA Emergency Medicine SIG Workshop: A Milestone in Emergency Medicine Training for Young Family Doctors The 2nd International AfriWon Preconference/2nd International WONCA Emergency Medicine SIG Workshop, held on June 5th, 2024, at the Aga Khan University in Nairobi, was a resounding success, drawing 46 enthusiastic participants from across the region.

This preconference themed "Rapid Response: Empowering Young Doctors for Emergency Excellence" aimed to enhance the emergency medical skills of young family doctors, preparing them to manage urgent care situations effectively.

WONCA NEWS

AfriWon Preconference Attendees at Aga Khan University.

About AfriWon Renaissance AfriWon Renaissance is the African wing of the WONCA Young Doctors' Movement, dedicated to supporting young and future general practitioners and family physicians in Africa. The movement focuses on fostering development in family medicine and primary healthcare through service, training, and research. It also aims to establish a communication network among African trainees and young GPs, addressing their concerns and promoting leadership development.

Preconference Highlights The preconference featured three intensive workshops, each meticulously designed to equip participants with critical emergency medical skills: Point of Care Ultrasound (POCUS) ECHO Modules: This workshop provided hands-on training in point-of-care ultrasound, focusing on echocardiography modules. Participants learned to rapidly assess and diagnose patients using POCUS, an invaluable skill in emergency settings.

23

ECG: Most Threatening Rhythms for the Family Doctor: Facilitators led by Dr. Elena Klusova and Dr. Miriam Rey guided participants through identifying and managing life-threatening cardiac rhythms using dynamic styles such as improv, videos, and dancing, among others. Participants were trained to identify and manage lifethreatening cardiac rhythms through a live, practical, timed session. The workshop empowered family doctors to act swiftly and accurately in critical situations.

Mass Casualty Incident Management: This session, led by Dr. Miriam Rey and Dr. Rabee Kazan, prepared doctors for mass casualty incidents, focusing on triage, emergency response coordination, and effective management strategies. Through fun-filled tabletop simulations, participants practiced handling various disaster scenarios, enhancing their readiness for reallife emergencies.

W O N C A

R E G I O N S

WONCA NEWS

Dr. Miriam Rey preparing doctors for Mass Casualty Incidents

Acknowledgments The success of this preconference would not have been possible without the dedicated efforts of several key contributors. We extend our heartfelt gratitude to the WONCA Emergency Medicine Special Interest Group (SIG) for their invaluable support and expertise. Special thanks to the planning team members: Dr. Nisanth Menon Dr. Elena Klusova Dr. Miriam Rey Seoane Dr. Rabee Kazan Dr. Raisa Alvarez Paniagua Dr. Roshan Mathew

We also acknowledge the contributions of the facilitators from the Aga Khan University Family Medicine and Aga Khan Hospital Emergency Department: Dr. Cynthia Mureithi Dr. Norah Obungu Dr. Nimai Kharva Dr. Grace Muthoni Dr. Sokhi Daljiv Dr. Emma Khabure Dr. Edward Maina Dr. Sheila Ayesa Dr. Ebrahim Abdiwahid

24

Impact and Future Directions The preconference successfully provided a dynamic and informative session, offering young doctors the opportunity to enhance their skills in emergency medicine, network with peers, and learn from experts. The event underscored the commitment of AfriWon Renaissance to improve urgent care delivery and patient outcomes in primary care across Africa.

The feedback from participants highlighted the practical value of the workshops and the immediate applicability of the skills learned, with discussions on collaboration for ongoing trainings of this nature.

As AfriWon Renaissance continues to grow, future events will build on this foundation, expanding the scope and reach of training programs to further empower young doctors across the continent.

W P

&

S I G S

N E W S

WONCA NEWS

CORE VALUES IN FAMILY MEDICINE INSPIRING GLOBAL CHANGE The WONCA Core Values Project was launched in March 2023 with an open invitation in my president message in the WONCA newsletter.

Following up on an idea I shared already in my inauguration speech in 2021: “for a definition of family medicine to impact identity, members need to have a stake in it, that sense of ownership that comes from having won it for themselves.”

A designated e-mail address was included, for members to respond to with the invitation: “Please reflect on the values that mean most to you as a healthcare professional – both personally, within your specific context, and globally, within our shared profession”.

Background Understanding, developing and defining family medicine is not something we do once and then we’ve got it. It’s an ongoing process; professional development is a core activity for family doctors, integrating research, experiential knowledge, reflection and implementation in a dynamic circular reciprocity.

when we develop training programs, define research agendas, agree on advocacy actions and plan activities that are well-dimensioned.

Our values are our guiding principles. At the same time, practices and standards vary with different contexts, particularly when it comes to local needs, what the public demands and available resources. Diversity also reflects culture, religion, and where on the primary care journey the local community find itself.

Family medicine has traditionally been defined and described from Western High Income Country (HIC) perspectives. The WONCA membership is growing, to large extent in Low/Middle Income Countries (LMIC). The discipline should reflect local context, it is not a copy/paste exercise to develop primary care and family medicine, it should be done with awareness of local culture and national health systems. That is why engagement from the broad WONCA community is important for a fruitful outcome of the Core Values Project.

We can recognize our differences better when we’re aware of our common ground, it also makes us better prepared to meet the challenges we face with shifts in societal trends, which are always reflected in health systems, not least in primary care Knowledge of our common ground also enables our collective efforts to be effective, such as

25

W P

&

S I G S

N E W S

WONCA NEWS

How is it organized?

What might emerge?

The project lead group consists of Prof Felicity Goodyear Smith (New Zealand), Prof Johann Sigurdsson (Iceland/Norway), and WONCA Immediate Past President Anna Stavdal.

Handpicked regional leads were invited to recruit three additional persons each, preferably from different countries in their regions, to share responsibility and facilitate process on country level.

Dilemmas, needs for conceptualization, and clarifications are identified in the ongoing process, which takes place in writing, in online calls, and at face-to-face events. Input will be condensed and discussed further in the core group. A book abstract is accepted by the WONCA publisher Taylor & Francis, describing the state-of-the-art from regional perspectives and will be on the market in 2026. In the course of the project, maybe a manifesto will be drafted for Council handling, a step toward a statement of Global Family Medicine Core Values and Principles on which we could agree?

Nina Monteiro, liaison person to the WONCA Lisbon Conference 2024, is also part of the core group. The WONCA President, President Elect, and CEO are ex officio members.

Outcomes will be presented at the WONCA World conference in Lisbon in September 2025.

Project goals In short, our goal is to encourage and support WONCA member organizations (MOs) to define their profession in their local context, and to map what already exists of definitions, vision and mission statements.

The Core Values project was the topic of the workshop at the annual WONCA Council, which took place online in the end of June. It was met with enthusiasm and the workshop provided fruitful input.

The main objective of the project is to contribute to the development of A SHARED VOCABULARY OF OUR HUMANITY ENABLING US TO REACH OUT TO COLLEAGUES THROUGHOUT THE WORLD, ENRICHED RATHER THAN HINDERED BY OUR DIFFERENCES.

Thanks to Felicity Goodyear Smith’s extensive efforts, we had a preliminary overview when the project took off for real: 40% of our member MOs do not have local descriptions of the discipline of family medicine available online and/or on their websites/other online entries.

Do you want to take part?

We are now working on finalizing the map, and we are encouraging development where such documentation doesn’t exist. This year, all WONCA regions organize conferences, an opportunity for regional workshops for face-toface discussions to happen. South Asia and Africa already organized well-attended workshops, and discussions sparked. APR is next, followed by Europe, EMR, CIMF, and North America.

Attend the workshops at the regional conferences.

Contact your regional lead for guidance on how you can contribute. Write to CoreValues@wonca.net and we will forward requests. Use the same e-mail address should you have input or feedback to the project leads.

Happy brainstorming!

Allen F. Shaughnessy & Deborah R. Erlich ANNA STAVDAL

PROF FELICITY GOODYEAR-SMITH

PROF JOHANN SIGURDSSON

Core Values Project Lead

Core Values Project Lead

WONCA Immediate Past-President & Core Values Project Lead

26

W P

&

S I G S

N E W S

WONCA NEWS

HAIZHU JIANGNANZHONGJIE COMMUNITY HEALTH CENTRE

WONCA PRACTICE ACCREDITATION Guangzhou, China, July 2, 2024 The World Organization of Family Doctors (WONCA) announced the achievement of Practice Accreditation for the Haizhu Jiangnanzhongjie Community Health Centre. This accreditation highlights the Centre’s dedication to delivering high-quality healthcare and aligns it with international standards of practice.

The accreditation process overseen

by WONCA’s expert panel involved a rigorous assessment of the Centre’s facilities, staff qualifications, patient care practices, and operational standards. This evaluation included a virtual assessment in April 2024 conducted by Prof. Samuel Y.S. Wong, Director of the School of Public Health and Primary Care at The Chinese University of Hong Kong (CUHK), and Prof. Jose M. (Chema) Valderas, Professor of Medicine at the National University of Singapore and Head of the Department of Family Medicine, followed by an inperson assessment in May 2024 with Prof. Wong.

阅读中文 The review confirmed that Haizhu Jiangnanzhongjie Community Health Centre, located in the Haizhu District of Guangzhou, meets the stringent WONCA Global Standards, ensuring excellence in all aspects of healthcare delivery. The center is staffed by 70 professionals, including 20 General Practitioners and 23 community nurses.

Prof.

Wong remarked, “The commitment to quality and patient care demonstrated by Haizhu Jiangnanzhongjie Community Health Centre is exemplary. This accreditation is a testament to their hard work and dedication to improving community health standards.” He added, “The Centre’s approach to maintaining patient privacy and implementing a one doctor, one patient, one room policy is a model for others to follow.”

27

W P

&

S I G S

N E W S

Prof. Valderas also praised the Centre, stating, “Haizhu Jiangnanzhongjie Community Health Centre has shown outstanding dedication to patientcentered care. Their robust policies for monitoring and managing laboratory results and clinical correspondence ensure that patients receive timely and appropriate care.”

He further noted, “The integration of Traditional Chinese Medicine within the same clinic area demonstrates their holistic approach to healthcare.”

Dr. Pan, Director of Haizhu Jiangnanzhongjie Community Health Centre, expressed her gratitude, stating, “We are honored to receive this accreditation. It reinforces our commitment to providing the highest quality of care to our patients.

WONCA NEWS

This recognition motivates us to continue enhancing our services and to strive for excellence in all aspects of community healthcare.”

Harris Lygidakis, CEO of WONCA, added, “The WONCA accreditation program is designed to support and recognize primary care practices that are committed to excellence. Haizhu Jiangnanzhongjie Community Health Centre’s achievement of this accreditation reflects their dedication to maintaining high standards in family medicine and their ongoing efforts to improve healthcare outcomes for their community.”

WONCA’s accreditation process helps healthcare facilities enhance their services through a structured supportive framework, ensuring they meet the highest international standards.

28

Staff of Haizhu Jiangnanzhongjie Community Health Centre with Prof.

Samuel Y.S. Wong, WONCA Accreditation Expert

W P

&

S I G S

N E W S

WONCA NEWS

ABOUT HAIZHU JIANGNANZHONGJIE COMMUNITY HEALTH CENTRE Haizhu Jiangnanzhongjie Community Health Centre, located in Guangzhou, China, is a leading healthcare provider dedicated to offering comprehensive medical services to the local community. The Centre is staffed by a team of experienced General Practitioners and community nurses who are committed to delivering personalized and effective healthcare solutions.

Diarmuid Hayes Communications Officer, WONCA Dr. LOU Yueqi Yuki Senior Chief of Clinical Team, Haizhu Jiangnanzhongjie Community Health Service Center

Assessment in May 2024 with Prof. Samuel Y.S. Wong, WONCA Accreditation Expert

29

F E A T U R E D

S T O R I E S

WONCA NEWS

INSIGHTS FROM PAHO/ABFM EVENT AT THE BRAZILIAN EMBASSY, WASHINGTON D.C.

STRENGTHENING PRIMARY HEALTH CARE IN THE AMERICAS The COVID-19 pandemic exposed significant weaknesses in health systems across the Americas, highlighting the urgent need to invest boldly in Primary Health Care (PHC) as the foundation of resilient health systems.

In response, the Pan-American Health Organization (PAHO) launched the Alliance for Primary Health Care in the Americas in Uruguay at the end of 2023, with leadership from the World Organization of Family Doctors (WONCA) in attendance to discuss how primary healthcare is providing effective care for our populations.

To address these pressing issues and discuss the impacts of this initiative, PAHO and the American Board of Family Medicine Foundation/Center for Professionalism & Value in Healthcare, with support and advisement from WONCA, hosted a special Primary Care "Embassy Series" Event on June 25th, 2024, at the Brazilian Embassy in Washington D.C. Intentionally timed to take advantage of the presence of Ministers of Health and senior staff from countries across the region, this event highlighted the Alliance and turned attention to the critical role of PHC in building and sustaining robust health systems.

WONCA President-elect Dr. Viviana Martinez-Bianchi attended to ensure that the voices of North American and Ibero American Family Medicine were heard, crucial contacts across the regional ministries were made, and the prospects for future collaborations between WONCA and PAHO were advanced.

30

F E A T U R E D

S T O R I E S

The event began with welcoming remarks from H.E. Maria Luiza Ribeiro Viotti, Ambassador of Brazil to the United States. She emphasized the importance of international collaboration in healthcare and the shared goal of enhancing PHC systems across the Americas. Jarbas Barbosa da Silva Jr., Director of the Pan American Health Organization (PAHO), followed with opening comments on the essential role of primary health care in the region, particularly in the aftermath of the pandemic.

WONCA NEWS

Director Barbosa highlighted how, the Declaration of Alma Ata, was a revolution that located health not just in the hospitals, but in the communities, and yet it had only focused on maternal and child health, which are still very important for Latin America and the Caribbean, but “if we want the primary healthcare that is providing effective care for our population we need to cover much more than just maternal and child health, we need to provide health promotion, prevention surveillance, the first line for early detection and first response, a primary health care that can deal with the persistent communicable diseases that are prevalent in the region (TB, Malaria, Dengue, etc), and to also respond to the new burden represented by new communicable diseases and mental health”.

31

“When we talk about this renewed and strengthened primary health care, we are talking about health centers that can have training for a health care workforce, and connectivity to improve the quality of care…. a new era for primary health care to provide a better use of the limited resources you have in the health sector, and also to identify the barriers to developing a primary health care strategy and transform universal health coverage into a reality in our region.”

F E A T U R E D

S T O R I E S

PRIMARY HEALTH CARE: THE FOUNDATION OF THE BRAZILIAN HEALTH SYSTEM H.E. Alexandre Pena Ghisleni, Head of the Special Office for International Affairs, Ministry of Health, Brazil, provided an overview of Brazil's health system with a focus on primary health care. He discussed how PHC serves as the bedrock of Brazil's health system, is wellfinanced, and able to address challenges posed by a complex and evolving epidemiological context, an aging population, increased mental health needs, and the impact of climate change. Loyce Pace, Assistant Secretary for Global Affairs at the U.S. Department of Health and Human Services and past CEO of the Global Health Council, shared insights on the U.S. perspectives on global health partnerships and the vital role of equitable and community-engaged primary health care in fostering a resilient health system.

WONCA NEWS

Dr. Phillips emphasized how the COVID-19 pandemic has reinforced the need for robust PHC investments, necessitating sustained commitment from both countries and the international community. He highlighted how the recent establishment of the Alliance for Primary Health Care in the Americas offers a unique opportunity for the United States Department of Health & Human Services to craft strategic partnerships to enhance PHC resilience and cooperation across our hemisphere. A roundtable conversation among panelists followed, starting with Dr. James Fitzgerald, Director of Health Systems and Services at PAHO, who highlighted the importance of PHC in health promotion, prevention, surveillance, and care for prevalent health conditions. He stressed that PHC is the first wall of defense in emergency situations, crucial for early detection and response to disease outbreaks.

GUIDED DISCUSSION ON PHC AND RESILIENT HEALTH SYSTEMS The event featured a guided discussion moderated by Dr. Robert Phillips, Executive Director of the Center for Professionalism & Value in Healthcare and representative of the American Board of Family Medicine Foundation.

32

Dr. Juan Pablo Uribe, Global Director for Health Nutrition and Population and the Global Financing Facility for Women, Children, and Adolescents at the World Bank, discussed financing mechanisms for primary health care. He emphasized the role of the Alliance for Primary Health Care in the Americas, established in December 2023, in advancing PHC through strategic partnerships and quality investment plans.

Dr. Ferdinando Regalia, Manager of the Social Sector Department at the Inter-American Development Bank, offered perspectives on the social determinants of health and the necessity of investment in primary health care. He pointed out that expanding PHC enhances capacity for early disease detection and community-level responses, forming the cornerstone of resilient health systems.

F E A T U R E D

S T O R I E S

COMMENTS AND BROADER DISCUSSION The comments and discussion segment began with a reaction from Mag. Gabriela Gomez Castillo, Director of the Department of External Relations and Cooperation at the Ministry of Health, Uruguay.

She discussed the importance of the Initiatives in Uruguay, a country that has long embraced CommunityOriented Primary Care. Like her Brazilian counterpart, Director Gomez Castillo noted the centrality of primary health care in the Uruguayan health care system. She cited the importance of investing 2530% of their federal budget for health into primary health care. For comparison, the U.S. invests 5-7% of its health care budget into primary care. She also outlined a series of structural advantages that allow Uruguayan primary care to be flexible and adaptive to community and pandemic demands.

WONCA NEWS

Questions and comments from the audience highlighted the importance of integration and collaboration across sectors, and the need for generating data informing effective primary health care workforce and delivery.

CONCLUSION AND CALL TO ACTION The event concluded with a summary of key takeaways from the initiative’s successes and its future utilization in U.S. policy work, underscoring the critical need for international collaboration in strengthening primary health care systems. The panelists emphasized the transformational changes required to embed resilience within societies and national health systems, with PHC at the core. They also highlighted the role of the Alliance for Primary Health Care in the Americas in facilitating these changes. WONCA will play a clear role in promoting the importance of postgraduate training in Family Care

33

In closing, participants were encouraged to continue engaging in global health partnerships and collaborative efforts to enhance PHC. PAHO representatives shared planned next steps for the Alliance, inviting stakeholders to remain active in these crucial discussions.

The Embassy Series Event at the Brazilian Embassy showcased the vital importance of PHC as the foundation of resilient health systems, offering a roadmap for renewed and expanded efforts through strategic partnerships and sustained commitment from countries and the international community.

W O N C A

WONCA NEWS

N E W S

WONCA PAST PRESIDENT AWARDED HONORARY DOCTORATE Anna's personal contributions but also the collective efforts and dedication of the World Organization of Family Doctors (WONCA) and its commitment to general medicine over the decades.

The event took place on Friday, 17th May, underscoring the significant impact that general medicine and primary healthcare have had on global health, thanks to the collaborative efforts of the entire WONCA family.

"The awarding of this honorary doctorate is not just about my work," said Stavdal. "It is about the collective work of many within WONCA over decades.

The development and promotion of the value-based foundation of our discipline is the main reason for this honor."

Immediate Past President of WONCA Dr Anna Stavdal

In a momentous event for the WONCA family, the University of Oulu, Finland, recently awarded an honorary doctorate to our immediate past president, Anna Stavdal. This prestigious accolade highlights not only of

34

Stavdal’s career exemplifies these values. Having first studied sociology at the University of Oslo before transitioning to medicine, she graduated as a doctor in 1987 and specialized in general medicine in 1999. Since 1989, she has maintained her patient list in Oslo, demonstrating the continuity of care that WONCA champions. Her parttime role at the University of Oslo since 1996 reflects her commitment to education and the dissemination of these core values to future generations of doctors.

WONCA NEWS

Stavdal’s career exemplifies these values. Having first studied sociology at the University of Oslo before transitioning to medicine, she graduated as a doctor in 1987 and specialized in general medicine in 1999. Since 1989, she has maintained her patient list in Oslo, demonstrating the continuity of care that WONCA champions. Her parttime role at the University of Oslo since 1996 reflects her commitment to education and the dissemination of these core values to future generations of doctors.

The University of Oulu emphasized the impact of Stavdal’s work in enhancing continuity in Finnish primary healthcare. Inspired by WONCA’s principles, many areas in Northern Finland have now implemented continuity models, reaffirming the central role of primary healthcare in sustainable health systems.

Stavdal’s honorary doctorate is a collective achievement for WONCA and its members. It is a recognition of the organization’s decades-long commitment to developing and promoting a value-based foundation for general medicine. This honor celebrates the collaborative efforts of countless professionals who have worked to ensure that general practice remains a cornerstone of effective, sustainable healthcare systems worldwide.

Throughout her career, Stavdal has been a vocal advocate for the integral role of general practitioners in the healthcare system. Her tenure as president of WONCA World and her previous leadership roles in WONCA Europe have been marked by significant strides in strengthening primary healthcare.

During the pandemic, she served on As Stavdal herself humbly noted, “I the WHO Europe Pandemic was the lucky one to receive the Commission, contributing to global honor on behalf of us all.” This health policy discussions and accolade is a reminder of the power highlighting the critical role of of collective effort and the enduring primary healthcare during crises. impact of shared values in the The honorary doctorate awarded to pursuit of better health for all.

Stavdal is a prestigious recognition, placing her alongside notable figures For more information about the such as President of Iceland Guðni honorary doctorate and other Th. Jóhannesson and Nobel Prize honorees, please visit the University Winner Professor William G. Kaelin of Oulu's honorary doctors page.

Jr. This honor emphasizes the global importance of the values upheld by WONCA and celebrated through this award.

The hat and sword are the insignia of a doctor at the University of Oulu.

35

W P

&

S I G S

N E W S

WONCA NEWS

GREEN STORIES For World Family Doctor Day on May 19, we invited family doctors to share stories of actions or initiatives they have taken in their practices or communities aligned with this year's theme: Healthy Planet, Healthy People. In this issue, we are excited to feature our favourite stories. You can find more inspiring stories on the WONCA website.

GREEN PRACTICE JAPAN TAKAFUMI SASAKI JAPAN

In Japan, there had been no activities by healthcare professionals to tackle climate change from the medical side until Takafumi Sasaki took initiative. In 2021, Sasaki studied an online course at the Centre for Sustainable Healthcare in the U.K. With the support of Greener Practice in the U.K., he gathered a group of like-minded medical doctors in Japan. In 2022, Sasaki formed Green Practice Japan, a group of medical professionals working on climate change. The circle of activities expanded around primary care physicians, and they formed the Planetary Health Working Group at the Japan Primary Care Association, continuing to focus on workshops and symposia.

Health team dislocating in Amazon. Image credits: Tarso Sarraf

36

W P

&

S I G S

N E W S

Thanks to these activities, the number of Green Practice Japan’s members has increased to around 50, including orthopaedic surgeons, paediatricians, obstetricians and gynaecologists, respiratory physicians, pharmacists, and public health nurses.

At the same time, they worked with other organizations and think tanks in Japan such as the Health and Global Policy Institute, Institute for Global Environmental Strategies, Planetary Health Alliance Japan Hub, Climate Integrate, and Climate Dialogue. They continue to inform the public about climate change from a health perspective, as it is a life-threatening issue that directly affects lives. The media has also picked up on their work.

WONCA NEWS

They would like to thank all the members for their advice and warm messages regarding the declaration from the WONCA Planetary Health Party. The Japan Primary Care Association's Climate Emergency Declaration is the first full-fledged declaration by the Japanese clinical community, and they are committed to taking responsibility for its implementation.

Green Practice Japan signed the Planetary Health Party's 'Call to Secure a Just & Equitable Transition to Sustainable Energy & Safeguard Health' at WONCA Sydney in 2023 and 'an Open Letter on fossil fuels from the Global Medical and Health Community' addressed to the COP28 President. They were the only Japanese healthcare professional organization to participate in these signings. They also worked toward Japan's membership in the Alliance for Transformative Action on Climate and Health.

The JPCA Planetary Health Working Group assisted in the declaration of climate emergency in primary care (the Hamamatsu Declaration, below) and the sustainable operation of the conference.

37

Japan is the fifth largest country in the world with about 5% of global emissions. Health care emissions of GHG are about 7% in Japan. Green Practice Japan will move forward to reduce health care emissions and improve the well-being of people.

W P

&

S I G S

N E W S

WONCA NEWS

I started by asking about his sugar intake and listening to his perspective. He did not seem motivated to change on his own. To build trust, we talked about his interests in video games and music since it was clear he did not want to diet.

I introduced the idea of co-benefits of a healthy diet for both his health and the planet. I asked if he had ever thought about the amount of plastic waste he was generating and discussed the impact on the oceans, including the Pacific garbage patch. I showed him some images of the consequences of plastic pollution.

He was visibly concerned.

When I met him again, he had decided to stop drinking beverages from plastic bottles. A few months later, he had lost weight and was actively advocating for waste reduction. He returned to my office to show me a school project he had done on plastic reduction and taught me about pollution from clothing and microplastics.

Promoting healthy eating without plastics: An ethical practice in primary care

SYNDEMIC MAYARA FLOSS BRAZIL

One of my patients was a 16-year-old boy who was obese. He came into my consulting room with his mother, wearing jeans and a school t-shirt.

He clearly wasn’t interested in being at the doctor's, but his mother was worried because he drank at least 2 litres of Coke and other fizzy drinks daily.

Besides obesity, he was on the verge of developing high blood glucose levels, which his mother had been monitoring for a while.

38

F E A T U R E D

D O C T O R

WONCA NEWS

FEATURED DOCTOR: DR FATHIA MOHAMED NOUR SOMALILAND - FAMILY PHYSICIAN Dr. Fathia Nour is a beacon of dedication and innovation in the field of family medicine in Somaliland. As one of the first graduates from Amoud University's Family Medicine program, she has played a pivotal role in shaping the healthcare landscape in her country.

Her journey, marked by resilience and commitment, is an inspiring tale of overcoming challenges to improve healthcare delivery.

Born in Hargeisa, Somaliland, Dr. Nour pursued her Bachelor of Science in Medicine (MBBS) from Amoud University, graduating in July 2008. She was among the first batch of graduates from the Family Medicine program established at Amoud University in 2012. This program was a collaborative effort supported by American family physicians who volunteered their expertise. "With the help of American family physicians, the faculty volunteered selflessly.

Now, we have taken over, but they mentored us and stayed with us throughout," Dr. Nour recalls.

The establishment of the Family Medicine program was a significant milestone for Somaliland.

"Somaliland is a country which was established after the collapse of central Somalia as a self-declared country. The healthcare system collapsed and started from scratch," Dr. Nour explains. She has been integral to this transformation, witnessing and contributing to the program's growth and success.

Dr. Nour's experience as one of the first batch of graduates has given her a unique perspective on the challenges and successes of family medicine in Somaliland. She highlighted the community's lack of understanding of family medicine as a specialty as a significant challenge.

"The community does not understand us as specialists who can provide varied care.

39

They often see us as just general practitioners, not recognizing the broad range of care we provide," she elaborates.

Despite these challenges, Dr. Nour and her colleagues have made remarkable strides in healthcare delivery.

They provide comprehensive care that includes both primary care and more specialized services. "From primary care at the community level to intensive care at the NICU, that’s the broad range of care that family doctors provide to the people in Somaliland," Dr. Nour emphasizes.

Dr. Nour's dedication to her profession extends beyond clinical practice to impactful research and leadership. Her studies have focused on improving essential newborn care, integrating public and private sector family medicine, and assessing the effectiveness of bedside teaching. These efforts are crucial in enhancing the quality of healthcare in Somaliland.

F E A T U R E D

D O C T O R

In her role as an educator, Dr. Nour has been instrumental in training the next generation of family physicians.

"The most important thing that graduates are doing is teaching.

They teach at the universities, producing the next generation of doctors equipped with good knowledge and skills," she states.

Her commitment to education ensures that the advancements in family medicine continue to benefit future healthcare professionals and their patients.

One of the highlights of the WONCA Africa Conference in Nairobi was Dr. Nour's presentation, where she shared the successes and challenges of family medicine in Somaliland.

Her story was motivating to others in WONCA who are championing primary health care across the continent. Her presentation received a thundering applause, reflecting the profound impact of her work and dedication.

Dr. Nour's contributions have not gone unnoticed. She extends her heartfelt appreciation to her mentors, stating, "I extend my heartfelt appreciation to Dr. Kara Beth Thompson, Professor Walhad, and Dr. Mohamed M. Jibril for their invaluable guidance and support."

Additionally, she acknowledges the support of the Montegut Scholarship, supported by the American Board of Family Medicine Foundation which enabled her participation in the WONCA Africa region Conference and furthered her professional development. "I would also like to express my gratitude to the Montegut Scholarship for enabling my participation in this conference," she adds.

WONCA NEWS

As Dr. Nour continues to inspire her peers and students, her vision for the future of healthcare in Somaliland remains clear. "Being at WONCA conferences, we are inspired and learn from those who have gone through similar challenges. We take their footsteps and may succeed based on that," she reflects.

Dr. Fathia Nour's journey is a remarkable example of how passion, perseverance, and a commitment to continuous learning can drive significant change in healthcare. Her efforts in building a robust family medicine program and her relentless pursuit of excellence in both clinical practice and medical education have made her a respected figure in the medical community. Her story is a shining beacon for all family physicians, illustrating that with dedication and support, it is possible to transform healthcare systems and improve lives, even in the most challenging environments.

INTERVIEW WITH DR. FATHIA NOUR

Recorded at the WONCA Africa Conference, Nairobi, Kenya. June 2024.

With thanks to Prof Bob Mash.

40

F E A T U R E D

D O C T O R

WONCA NEWS

FEATURED DOCTOR: DR ANNE MWIKYA KENYA - FAMILY DOCTOR MBCHB - UNIVERSITY OF NAIROBI, KENYA MMED-FP UNIVERSITY OF MEDICAL SCIENCES OF HAVANA, CUBA

MY JOURNEY MEDICINE

MY JOURNEY MEDICINE

IN

FAMILY

From the outset of my medical career, I have been deeply passionate about providing holistic patient care. This passion naturally drew me to family medicine, a specialty that offers the unique opportunity to treat patients in a person-centered way. Throughout my training, I realized the immense satisfaction that comes from building long-term relationships with patients and addressing a wide spectrum of health issues.

Working in diverse settings, from rural clinics to urban hospitals, has enriched my understanding and commitment to family medicine. I experienced firsthand the profound impact of preventive care, early diagnosis, and ongoing patient education. The versatility and breadth of family medicine allowed me to appreciate the importance of continuous and comprehensive care, a hallmark of this field.

IN

FAMILY

Currently, I serve as the Primary Health Care Network Coordinator in Nairobi County, Kenya. My role involves overseeing the integration and coordination of primary health care services through the establishment of primary health care networks across various subcounties. This includes ensuring a multidisciplinary team approach in health programs as well as ensuring effective linkages between the community, primary care facilities, and tertiary facilities.

One of my key tasks is streamlining communication and collaboration among healthcare providers, be it private, faith-based organizations, or public sectors, ensuring timeliness and appropriate care provision. This position allows me to advocate for better health policies and resource allocation, aiming to make a tangible difference in the health outcomes of the population.

THE BIGGEST CHALLENGES AND OPPORTUNITIES FOR PRIMARY HEALTH CARE IN KENYA

41

Primary health care in Kenya faces significant challenges. One of them is the shortage of healthcare professionals, exacerbated by the uneven distribution of medical personnel across the country.

Another challenge is the limited funding and resources available for primary health care. This often results in inadequate infrastructure, insufficient medical supplies, and outdated equipment. Additionally, there is a need for more robust integrated health information systems to improve data collection, analysis, and utilization in decisionmaking processes.

Despite these challenges, there are numerous opportunities to strengthen primary health care in Kenya. Leveraging technology to enhance health services presents a major opportunity. Telemedicine, mobile health applications, and electronic health records, as observed in the establishment of the electronic community health system (eCHIS), can greatly improve access to care. Furthermore, community health worker programs have shown great promise in extending the reach of primary health care services.

F E A T U R E D

D O C T O R

KEY LESSONS LEARNED DURING THE WONCA AFRICA REGION CONFERENCE Attending the WONCA Conference in Kenya was a transformative experience. It provided a platform to learn from global experts in family medicine and primary health care.

One of the key lessons I learned was the importance of community involvement in healthcare delivery.

Engaging local communities in health initiatives fosters trust, encourages healthy behaviors, and ensures interventions are culturally appropriate and sustainable.

Another valuable takeaway was the significance of continuous professional development and education for healthcare providers.

Keeping abreast of the latest medical advancements and best practices is crucial for delivering high-quality care.

Working in diverse settings, from rural clinics to urban hospitals, has enriched my understanding and commitment to family medicine. I experienced firsthand the profound impact of preventive care, early diagnosis, and ongoing patient education. The versatility and breadth of family medicine allowed me to appreciate the importance of continuous and comprehensive care, a hallmark of this field.

EXPERIENCE FROM THE CUBAN HEALTH SYSTEM My training as a resident in family medicine allowed me to acquire a sea of knowledge and practical skills from one of the best-organized healthcare systems in the world.

WONCA NEWS

The Cuban health system, with its strong primary health care basis, applies principles of decentralization, multisectoral engagements, and active community participation in health decisionmaking. This approach has led to significant positive impacts on Cuban health indicators. Family physicians in community clinics serve as the entry point to their health system, allowing appropriate linkage to care at all tiers. Health prioritization of community needs, with a focus on prevention, early diagnosis, treatment, and continuous health promotion activities, has significant economic value for the country.

Despite these challenges, there are numerous opportunities to strengthen primary health care in Kenya. Leveraging technology to enhance health services presents a major opportunity. Telemedicine, mobile health applications, and electronic health records, as observed in the establishment of the electronic community health system (eCHIS), can greatly improve access to care. Furthermore, community health worker programs have shown great promise in extending the reach of primary health care services.

MY INTERESTS AND PASSION My interests and passions are deeply rooted in improving health outcomes and ensuring equitable access to quality care for all. I am also keenly interested in health systems strengthening and policy advocacy. I believe that systemic changes and effective health policies are essential for creating sustainable improvements in health care delivery.

42

In my personal time, I enjoy participating in community health outreach programs and mentoring young healthcare professionals.

These activities allow me to give back to the community.

CONCLUSION My journey in family medicine has been shaped by a passion for holistic care and a commitment to improving health outcomes. As the Primary Health Care Network Coordinator in Nairobi County, I strive to enhance the quality and accessibility of primary health care services. Despite the challenges faced by the healthcare system in Kenya, there are significant opportunities for improvement through technology, community involvement, and robust health policies. The lessons learned from the WONCA Conference have further reinforced the importance of community engagement and continuous professional development. My dedication to preventive medicine, health education, and systemic change drives my work and fuels my passion for making a difference in the lives of individuals and communities.

W O N C A

C O N F E R E N C E S

WONCA NEWS

WELCOME

IMPORTANT DATES

VENUE

As the President of The Wonca EMR Organization, it is my great honor and pleasure to welcome you to the Wonca East Mediterranean Region Family Medicine Congress 2024, which will be held on 3rd October 2024 in Jordan.

This year’s conference has been designed to provide an innovative and comprehensive overview of the latest research developments in Family Medicine and Primary Health Care.

Over the course of three days, the conference will feature symposia, keynote sessions, parallel workshops and abstract presentations.

Aug 15 - Early Bird Registration Close Sep 7 - CME Announced Oct 3 - WONCA EMR 2024 goes live!

Fairmont Amman CONFERENCE WEBSITE https://www.woncaemr2024.com/ THEME This year's theme is "Towards Resilient Sustainable Primary Health Care." Expect a comprehensive overview of the latest advancements in Family Medicine and Primary Health Care, including symposia, keynote sessions, workshops, and the presentation of research papers.

We hereby invite you all to share the results of your scientific research with us by submitting an abstract of your work, and by joining us in sharing our vision of Wonca EMR Family Medicine Congress 2024: Towards Resilience Sustainable Primary Health Care.

We welcome you to the beautiful country of Jordan, and wish you three days of education, knowledge sharing and unforgettable experiences.

Venue: Fairmont Amman.

I look forward to meeting you at Wonca EMR 2024!

ABDULAZIZ AL-MAHREZI

President, WONCA East Mediterranean

43

W O N C A

C O N F E R E N C E S

WONCA NEWS

WONCA RURAL CONFERENCE

UBUNTU 2024

REGISTER NOW!

CAPE TOWN, SOUTH AFRICA: 10 - 14 SEPTEMBER 2024.

Ubuntu 2024 is a joint conference between The Network: Towards Unity for Health (TUFH) and Rural WONCA (The Working Party on Rural Practice).

It’s bringing together the TUFH 2024 Annual Conference for TUFH, which is celebrating it’s 45th anniversary in 2024, and the 20th WONCA World Rural Health Conference!

This conference is being co-hosted by 5 partners in Cape Town, South Africa: University of the Western Cape; University of Cape Town; Stellenbosch University; Cape Peninsula University of Technology, and the Department of Health and Wellness – Western Cape Government.

This joint conference has been named Ubuntu 2024; referring to the meaning of Ubuntu “I am, because you are”.

Ubuntu 2024 conference.

will

be

a

fully

hybrid

The Post Conference Tour is only available for physical attendees who have a fully paid physical registration. There are ONLY 50 places, and it’s on a first come basis. So the first 50 individuals who pay for postconference and are eligible will have the places.

POST CONFERENCE TOUR Embark on a breathtaking Four-day Tour from Cape Town to the Garden Route, exploring some of the most picturesque regions in South Africa.

The tour will showcase the natural beauty of the Western and Southern Cape regions, including the iconic Garden Route, along with clinical training sites of Stellenbosch University and the University of Cape Town. The tour will provide an immersive experience, highlighting the natural wonders and cultural heritage of the region, as well as health professional training in these areas.

44

W O N C A

C O N F E R E N C E S

WONCA NEWS

WONCA ASIA PACIFIC CONFERENCE 2024 SINGAPORE FIND OUT MORE

WONCA EUROPE CONFERENCE More key note speakers have just been announced including Tomas Zapata (Spain), Ana Luisa Neves (Portugal), Alexandre Gouveia (Portugal), Niels H. Chavannes (Netherlands), Eva Kozub (France), Mercy Nafula Wanjala (Kenya)

SEE ALL KEYNOTE SPEAKERS

For more information visit: www.woncaeurope2024.org 25 - 28 SEPTEMBER 2024.

DUBLIN, IRELAND.

45

W O N C A

C O N F E R E N C E S

SOUTH ASIA REGION CONFERENCE 2025

WONCA NEWS

BENGALURU, INDIA. Bengaluru, often referred to as the "Silicon Valley of India" and the IT hub of the country, has established itself as a prominent destination for various conferences and events, including those in the medical field.

Hosting the WONCA South Asia Regional Conference in Bengaluru (4-6th April 2025) holds several advantages and reflects the city's unique strengths.

IT AND HEALTHCARE INTEGRATION Bengaluru's reputation as the IT hub of India ensures excellent infrastructure and technological support. This integration of IT with healthcare can enhance the conference experience through advanced communication tools, telemedicine demonstrations, and discussions on the role of technology in family medicine.

GLOBAL CONNECTIVITY Bengaluru is well-connected globally, with an international airport that facilitates easy access for participants from across South Asia and around the world. This connectivity is crucial for a conference that brings together professionals from different countries to share knowledge and experiences in family medicine.

The city is home to a diverse and well-established medical community, including renowned hospitals, medical colleges, and research institutions. This provides an ideal environment for fostering collaboration and the exchange of ideas among family doctors from South Asia.

DR. ROSHNI JHAN GANGULY

ACADEMIC AND RESEARCH OPPORTUNITIES Bengaluru's academic and research institutions offer a conducive environment for hosting conferences that aim to promote the latest advancements in family medicine. The city's commitment to medical education and research aligns with the goals of WONCA conferences.

CULTURAL AND RECREATIONAL ATTRACTIONS Bengaluru's vibrant culture and recreational attractions provide participants with opportunities to unwind and engage in networking activities outside of the conference sessions. This contributes to a more enriching and enjoyable overall experience for attendees.

DIVERSE MEDICAL COMMUNITY

46

WATCH THE PROMOTIONAL VIDEO FOR WONCA SAR 2025

W O N C A

C O N F E R E N C E S

INNOVATION ECOSYSTEM The city's thriving innovation ecosystem, fueled by the presence of numerous tech companies and startups, can inspire discussions on innovative approaches to healthcare delivery and family medicine practice. This aligns with WONCA's focus on promoting excellence and innovation in family medicine.

WONCA NEWS

In summary, hosting the WONCA South Asia Regional Conference in Bengaluru from 4-6th April 2025 leverages the city's strengths in IT, global connectivity, diverse medical community, academic resources, cultural attractions, and innovation ecosystem.

47

These factors collectively contribute to creating a dynamic and enriching environment for the conference, facilitating the exchange of knowledge, fostering collaborations, and promoting advancements in family medicine.

W O N C A

W E B I N A R S

WONCA NEWS

WEBINAR: CYBERXFM Throughout the webinar, Dr. Neves, Mr. Au Yeung, and Dr. Thompson shared their expertise on the integration of telemedicine in primary healthcare and the various cybersecurity challenges that accompany this digital transformation. The event provided valuable insights into how healthcare professionals can safeguard telemedicine practices from cyber threats, ensuring the protection of patient data and the integrity of healthcare services.

Watch this insightful webinar on identifying intimate partner violence (IPV) in primary care, hosted by the WONCA Special Interest Group on Family Violence. Learn from leading experts and gain practical skills to support IPV survivors in your medical practice.

48

WONCA NEWS

CRISP REPORTING CHECKLIST HELPS ADVANCE PRIMARY CARE RESEARCH Comprehensive generalist medical care (family medicine general practice and primary care) is a global enterprise devoted to providing patientcentered evidence-based care to patients families and communities. It has its own caring perspective clinical methods and foundation of knowledge. With WONCA support, primary care research is growing to inform clinical primary care and primary healthcare at the foundation of our healthcare systems.

REPORTING RESEARCH The new CRISP (Consensus Reporting Items for Studies in Primary Care) Checklist is a tool for planning reporting and applying primary care research. The CRISP Checklist was built by and for primary care to meet the needs of our clinical practitioners academic investigators patients and communities.

Across biomedical and health sciences there is growing recognition of the need to improve the information investigators deliver in their research reports. This need has led to the development of research reporting guidelines.

CRISP WEBSITE HTTPS://CRISP-PC.ORG/ Improving the reporting of primary care research: Consensus Reporting Items for Studies in Primary Care—the CRISP Statement.

Annals of Family Medicine 2023.

Improving the reporting of primary care research: An international survey of researchers.

J Am Board Fam Med 2021.

Key items for reports of primary care research: an international Delphi study.

BMJ Open 2022.

By William R. Phillips MD MPH FAAFP University of Washington Seattle WA. USA Liz Sturgiss BMed PhD FRACGP MPH MForensMed FHEA Monash University Melbourne Victoria Australia .

Well-known examples include CONSORT for reporting randomized clinical trials and PRISMA for systematic reviews. The EQUATOR Network catalogs over 450 research reporting guidelines but none address the needs of family medicine/general practice.

Early CRISP studies documented that family physicians and general practitioners frequently read original research reports but usually find them inadequate to apply the study findings to patient care in their practice settings. The CRISP initiative set out to fill that gap.

CRISP PROCESS A rigorous five-year program of research and development engaged diverse voices across 29 nations. This work was conducted by the international CRISP Working Group including Drs. Paul Glasziou Pallavi Prathivadi and Grant Russell (Australia); Aaron Orkin (Canada); Tim olde Hartman and Chris van Weel (Netherlands); and Joanne Reeve (UK).

CRISP pioneered a new approach to developing research reporting guidelines based on the values of family medicine/general practice. Rather than relying on a small group of expert methodologists CRISP regarded the experts as the users of research. CRISP actively engaged the worldwide primary care community including practicing clinicians researchers patients community representatives educators policymakers journal editors and reviewers. All nominated items needed in research reports and a Delphi study identified the essential elements and refined the final CRISP Checklist.

49

WONCA NEWS

CRISP CHECKLIST The CRISP checklist identifies 24 items in ten themes to include in research reports. Each item is on the list because it was identified by our worldwide community producers and users of primary care research. The CRISP Checklist and full CRISP Statement were published in the Annals of Family Medicine in 2023 along with a full explanation and examples for each item.

Overall the CRISP Checklist suggests richer context in research reports. Readers need to understand the context of the researchers patients populations health problems clinical encounters patient care teams study interventions and research measures. The breadth depth and wide variety of practice settings in primary care mean that research reports need context to help readers understand the studies and how they might apply to their own practice settings and healthcare systems.

The CRISP Checklist is a tool for investigators and authors to improve the dissemination and application of their research. It is flexible to accommodate the variety of research methods study designs patient populations topics and systems of care. Not all items apply to all study reports. Authors and editors will still make final decisions on content and form.

The WONCA Executive endorsed the CRISP Checklist in August 2023.

NAPCRG - the North American Primary Care Research Group – has also endorsed the Checklist. The CRISP Checklist is now registered with the EQUATOR Network.

The Checklist and all materials can be downloaded from the CRISP website.

CRISP DISSEMINATION AND USE The CRISP checklist is included in the “Information for Authors” along with other major research report guidelines by a growing number of journals around the world. A network of colleagues is translating the Checklist to serve researchers working in a variety of languages.

The CRISP Checklist can apply to all primary care research. This includes research done by primary care investigators and studies by others in primary care settings patients and problems and all studies intended to influence the practice and organization of primary care. CRISP can be a tool to help others understand the complexities of family medicine/general practice the information we need and the research we do.

CRISP users have reported the Checklist helps them craft their research reports and can also help in reviewing and editing reports planning studies and teaching research methods with a focus on primary care.

The Working Group considers the CRISP Checklist to be a living document ready for application testing and improvement. We welcome all comments and suggestions.

50