Most of our readers will realise that on May 19th we celebratedWorld
Family Doctor Day (WFDD) and this year all theme was Healthy Planet HealthyPeople.
I have watched World Family Doctor Daygrowfromitsbeginningsin2010 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 betteroutcomesforourpatients
SUCCESS
Our main promotional video was produced by Young Doctors and WorkingPartyonPlanetaryHealth
Prof Sir Andy Haines, WONCA life Direct member and eminent international leader on Planetary healthandamemberofourWONCA 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”chatsessionsrecorded Iamtakingthisopportunitytoshow a random selection of some of the many fantastic activities that were held. Congratulations to all who participated in a WFDD event and thankyouallformakingthisdaythe huge success it has become. My apologies in advance that I can’t feature every country or every activity.Thatindeedwouldfillavery largebook!
background to celebrate the event WONCA.TheseincludedWONCAEast Mediterranean President elect, Prof Faisal Alnasir (pictured) who was alsoinvolvedinmakingavideo.
The Bangladesh Academy of FamilyPhysiciansobservedtheday for the first time in Bangladesh in 2014. The Board of Governors of the Academy has held a program at its headofficeinsideDhaka.Arallywas organized at Dhaka. (pictured) After theRallyasumptuousbreakfastwas 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 thesignificanceoftheday.
Bahrain Family Physicians Association (BFPA) used WONCA’s excellentsocialmediatoolkittopost key messages to support the global campaign through its official Instagram and WhatsApp. WONCA pagesandhashtagswerementioned withtheposts. Organizationleaders changed their social media profile picturesusingthe WONCA
The Hong Kong College Family Physicians (HKCFP) issued a Press Release on World Family Doctor Day 2024: Healthy Planet, Healthy People,ACalltoActionforHealthier CommunitiesinHongKong Overahundredrepresentativesfrom public and private healthcare sectors, patient groups leaders, etc, celebrated the WFDD 2024 together and what an amazing sight in the photoabove.
AssociationofFamilyPhysiciansof
India (AFPI) are hosting our 2025 WONCA South Asia Region conference. Watch the promotional video about next year’s conference inBangalore.
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 sustainablepractices
The event reiterated the importance of "Healthy People, Healthy Planet" and encouraged the community to take active steps towards a sustainablefuture.
Slovak Society of General Practice celebratedwithgeneralpractitioners in their communities organising a series of "Stepwalking" events. By literally “stepping out” of their practices, family doctors invited patientsandmembersofcommunity to walk and join them in honouring their special day Why? To show by example that walking is a great preventive measure against a number of serious diseases at zero financialandecologicalcost
"Stepwalks" were held across Slovakia – in the lowlands and mountains, in towns and small villages,aswellasinthecapitalcity. The first walk began on 11 May in Veľký Biel, a little village in Western Slovakia, and the final walk closed thisgreatseriesofeventson30May in Prešov, a small town in Eastern Slovakia.
WONCA Africa Region Conference in Abuja, Nigeria
Taiwan Association of Family Medicine took the initiative to organize a hiking event up the Jiantan Mountain on May 19th to promotehealthylifestyles
The group is photographed high up the mountain with a specially designedWFDDpromotionalbanner.
The Venezuelan Society of Family Medicine (SOVEMEFA), held a workshoponMay3withleadersand 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 withthecommitmentofthedifferent institutionsinvolved.
OnMay18,acomprehensivemedical 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 withgreatneedforassistance
It’s not surprising that many of our WFDD events have significant community impact and are reported inthepress–twoexamplesfollow
The Caribbean College of Family Physicians - Jamaica Chapter were reported in local newspaper “The Gleaner” and parts of the article are repeatedabove.
The 2024 celebration was a two-day functiontohonourfamilyphysicians 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 communitywork.
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 medicalpractice.
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 FamilyDoctorDay.
Finally our South Asia Region (SAR) reportedonawebinar.
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 healthinequalities.Ilovedthepoints made on this slide (pictured). The speakers, all family physicians/ general practitioners from South Asian countries, presented data and evidence-based information related totheircountries.
I found the content of this slide particularly shocking and worth sharingaswidelyaswecan.
I thank all colleagues who take the time to make OUR day a special day intheirpartoftheworld.Wedeserve theaccolades!
ASSOC PROF KAREN FLEGG
GENEVA, JUNE 2024
This past week at the World Health Organization headquartersin
Genevatheatmospherewaselectric as health leaders from around the world gathered for the 77th World HealthAssembly
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-communicablediseases,
AT THE 77TH WORLD HEALTH ASSEMBLY
DR ANNA STAVDAL
W H O L I A I S O N
ASSOC PROF MARIA PILAR ASTIER PEÑA
M E M B E R A T L A R G E
DR HARRIS LYGIDAKIS
W O N C A C E O
and addressing the urgent threats posedbyclimatechange.
Concurrently WONCA has finalized its WHO triennial collaborative plan andisconsideringnewprojectswith WHO for the 2025-2027 period aiming to continue and expand its influenceinglobalhealthinitiatives.
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 regionsworldwide. WONCA’scollaborationwithWHOon refiningclinicalalgorithmsusingthe International Classification of Primary Care version 3 (ICPC-3) is critical for enhancing global health responses and underscores the importanceofthisclassification.
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 geriatriccaretrainingrepresentinga forward-thinking approach to global healtheducation.
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 publichealthadvocacy.Readthefull report on this transformative event here.
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 forMaternalNewborn&ChildHealth (PMNCH), and the World Federation of Public Health Associations (WFPHA) to explore synergies and collaborativeopportunities.
Spanish Minister for Health, Dr Monica Garcia, WHO Liaison for WONCA, Anna Stavdal, and WONCA Member at Large, Maria Pilar Astier-Peña
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 highlightedthepivotalroleofPHCin managing these health crises The new statement advocated for an integrated care model that emphasizes preventive care and robustcommunitypartnerships
A STRONG VOICE ON CLIMATE CHANGE LOOKING AHEAD
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 healthcallingforimmediateaction.
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
STATEMENT ON PREVENTION AND CONTROL OF NCDS WONCA STATEMENTS AT WHA77
STATEMENT ON CLIMATE AND HEALTH
STATEMENT ON REDUCING MATERNAL, NEWBORN AND CHILD MORTALITY
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
8 REASONS WHY FAMILY PHYSICIANS ARE THE ACTUAL STARS OF MEDICINE
titioner and primary care researcher, it was always fascinatingformetodelveintothescientificlitera-tureto investigatethisissue Herearethekeyresults
DR FLORIAN STIGLER, MPH
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 withfootnotesandreferences.
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
My journey was long and unusual... I’ve had a deep passion for medicine, research and organizing projects for a long time, but these interests never seemed to fit together. Also, although I love to write and was even published in The Lancet and NEJM,
I felt my work was just sitting on the shelf Determined to find a solution, I decided to ‘invent’ my own dream job. And here it is! This Newsletter & Blog unite my life passions and I’m excited to share them with you. I truly hope you will find them engaging and useful!
2. More GPs = Higher Life Expectancy
Did you know that people in areas with more GPs live longer? Studies from the USA showed that adding one GP per 10,000 inhabitants was associated with 2-5 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
prevented 127,617 deaths per year in the USA.² This graph shows the association between prima- ry care physician density and life expectancy among US states:
3. Having Your Own LongTerm GP Can Save Your Life
Patients who choose a GP rather than a specialist as their primary care provider have a 19% lower mortality and produce 22%-33% lower healthcare spending. Also, systematic reviews on ‘continuity’ found mortality reductions in most included studies In other words, having your own GP and contacting him or her first (rather than a specialist), might just save your life and save us money A fantastic study from Norway12 (based on 4.5 million people in 2018), shows that the longer you know your GP, the better off you are Patients who know their GP for over 15 years decrease acute hospital ad- missions by 28%, out-of-hours services by 30%, and even 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):
•
Why do long-term GP-patient relationships improve health and reduce costs?11,13
Over time, GPs come to know their patients well. You no longer need to review all medical records or repeat the whole medical and personal history. Over time, GPs put their patients into context. You know your patients’ evolving story as well as their family, friends, coworkers, and the peculiarities of their local community.
Over time, more trust develops Adherence to medical advice improves and unnecessary self-referrals to other doctors decrease.
Over time, communication improves. Patients share personal issues more easily and medical errors are more easily avoided.
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
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.
We live in a world of aging populations, with rising chronic diseases, multimorbidity, and polypharmacy. Family medicine today is therefore more import- ant than ever Why? Because chronic diseases are largely managed in primary care and are therefore the GPs’ daily business:
Patients with multimorbidity account for 78% of GP appointments (based on 100,000 UK patients). More than 45% of primary care patients have multi- morbidity (based on 700,000 US patients) Family physicians are the sole care providers for 86% of hypertensive patients and for 71% of dia- betics (based on 2.7 million Canadian patients) Patients with multimorbidity who usually visit pri- mary care rather than specialists showed 2% lower mortality, 6% less hospitalizations, and 9% lower healthcare costs (based on 4 million US patients)
Ehent Quam, Ea Volupta Temporeptas Quas Quiaero
5. GPs Improve Chronic Disease Management
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:
7. GPs Save Money
GPs can save money by:
• Improving prevention and chronic disease management Avoiding potentially harmful di- agnostic and therapeutic proce- dures Reducing unnecessary specialist visits and hospitalizations
• • That’s why a recent study of 5 million US patients showed that the first primary care visit saves $3,976
Source:
Continelli
and each additional visit saves $721 per year. A further study of 6 million veteran patients showed, as mentioned previously, that having your own primary care provider reduced healthcare costs by 22% (another study showed a 33% reduction) Also, healthcare systems with stronger fo- cus on primary care might be associ- ated with lower costs or at least with slower growth in costs. In Europe,
countries with stronger primary care had less unnecessary hospitalizations, especially concerning Asthma, COPD, and diabetes. This is a remark- able statistic, especially as GP visits are relatively inexpensive. As shown in the following graph, primary care services amount for only 8 1% of healthcare costs in the EU 2018
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 deprived populations, it offers more comprehensive services, and GPs know their patients longer and better. In other words, patients can get more services, more easily, more appropriately All of that is especially important for disadvan-
Mechanisms
taged individuals with more risk factors, more chronic diseases, more medications, and lower health literacy. Last year, I was honored to interview Sir Michael Marmot, former Chair of the WHO Commission on Social Determinants of Health and former President of the World Medical Association, about his perspectives on primary care and health inequalities.
So, in a nutshell, WHY are GPs so important and HOW do they improve health and save money?
• GPs know their patients well, which improves diagnostic accuracy
GPs are highly trusted, which encourages adherence to medical advice
GPs improve prevention, which avoids diseases
GPs improve early detection, which improves treatment outcomes.
GPs improve chronic disease management, which prevents complications.
GPs avoid unnecessary duplications of diagnostic procedures
GPs avoid unnecessary and potentially harmful medications.
GPs prevent unnecessary specialist visits and hospitalizations
GPs offer the same services more affordably than specialists or hospitals.
GPs offer guidance and coordination within a complex system.
Conclusion
Healthcare systems which focus on family medicine and patients who have their own long-term GP enjoy many benefits. GPs know their patients best and are highly trusted, which results in better outcomes. They are easily accessible and offer more affordable services. Also, because by far most healthcare happens in primary care offices (rather than in hospitals), that is where the quality of prevention and chronic disease management is really determined 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.
Subscribe to “Golden Nuggets of Family Medi- cine” (Newsletter by & for GPs).
MY FIRST RURAL HEALTH CONFERENCE
I attended my first rural health conference in my second year of medical school and I am incredibly gratefulthatIdid.Thiswasthe2022 WONCA World Rural Health ConferenceheldinLimerick,Ireland I played a role in organizing the conference,anopportunityprovided tomebymyschoolandmyroleasa 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 midstofmymedicaltraininganddid not personally know anyone else attending Nevertheless, I made the decision to attend and had an incredibleexperience.
Each day was filled with delightful conversation with individuals from allovertheworldinvariousstagesof their careers, including medical studentslikemyself.
Thisexperiencenotonlysignificantly 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 innovativesolutionstotheinequities faced by rural communities. Being from a rural town, it is easy to feel likeasmallfishinabigpond
However,atthisconference,Ifeltas though I was part of a very large community working towards the samegoals.
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 reconnectwithpeers,mentorothers, and continue my journey of lifelong learning. My current interest lies in the upcoming Ubuntu conference in CapeTown,SouthAfrica,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 theconferencewebsite.
Rural Seeds and WONCA Rural Conference, Limerick 2022
ALEXANDRA FERRARA
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,evenifyoufindyourself a bit hesitant like I once was. I also encourageyoutoexplorethevarious 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 participatinginconferences,youcan stay updated on the latest advancements in medicine, build a supportive network of peers and mentors, and gain insights that can shapeyourfuturepractice
Rural health conferences provide a unique opportunity to gain insight into rural health inequities and understand how to advocate for underservedpopulations.
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,andcommunityisatthe 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 fieldofmedicine!
ALEXANDRA FERRARA
NAIROBI, KENYA
AFRIWON ACTIVITIES AT WONCA AFRICA CONFERENCE
Onthemorningofthe4thofJune,a team of international delegates embarked on a visit to Makadara, a vibrant health centre offering primary care services to an underservedcommunity
in the lower wealth quantiles in Nairobi County This visit was not justatourbutanimmersionintothe 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 networkwithahubandspokemodel connecting level 2 and 3 facilities referredtoasspokestoalevel4.
Our first stop was the Makadara HealthCentre,thehub-abeaconof hope and wellness for the local community As we entered the facility,weweregreetedbyavibrant muraldepictingscenesofhealthand vitality, a testament to the community's commitment to wellness.
We began with a presentation and discussionwiththemultidisciplinary team, gaining an understanding of the organization functions and activitiesaswellassuccessstoriesof the Primary Care Network. The bustling corridors echoed with the sounds of healthcare in action nursesattendingtopatients,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 incredibleworktheydo.Thesedesks serve as the frontline of health education, providing vital information on disease prevention, maternal and child health, and chronicdiseasemanagement
Jericho Health Centre: The Spoke ofSupport
OurjourneycontinuedtotheJericho 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.
Visit to Makadara Health Centre
Dr Elena Klusova leads a workshop on ‘Most Threatening Rhythms for the Family Doctor’
AHomeVisit:CompassioninAction
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 underscoredtheholisticapproachof 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 hostingthislearningexchange
Successful Second International AfriWon Preconference/2nd International WONCA Emergency Medicine SIG Workshop: A Milestone in Emergency Medicine TrainingforYoungFamilyDoctors
The 2nd International AfriWon Preconference/2nd International WONCA Emergency Medicine SIG Workshop,heldonJune5th,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 urgentcaresituationseffectively.
AboutAfriWonRenaissance
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 promotingleadershipdevelopment.
PreconferenceHighlights
The preconference featured three intensive workshops, each meticulously designed to equip participants with critical emergency medicalskills:
Point of Care Ultrasound (POCUS) ECHOModules:
This workshop provided hands-on training in point-of-care ultrasound, focusing on echocardiography modules. Participants learned to rapidlyassessanddiagnosepatients using POCUS, an invaluable skill in emergencysettings.
ECG: Most Threatening Rhythms for theFamilyDoctor:
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 lifethreateningcardiacrhythmsthrough a live, practical, timed session. The workshop empowered family doctorstoactswiftlyandaccurately incriticalsituations
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 responsecoordination,andeffective management strategies. Through fun-filled tabletop simulations, participants practiced handling various disaster scenarios, enhancing their readiness for reallifeemergencies.
AfriWon Preconference Attendees at Aga Khan University
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
ImpactandFutureDirections
The preconference successfully providedadynamicandinformative session, offering young doctors the opportunitytoenhancetheirskillsin 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 participantshighlightedthepractical value of the workshops and the immediate applicability of the skills learned, with discussions on collaboration for ongoing trainings ofthisnature.
AsAfriWonRenaissancecontinuesto grow,futureeventswillbuildonthis foundation, expanding the scope and reach of training programs to further empower young doctors acrossthecontinent
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 needtohaveastakeinit,thatsenseofownership thatcomesfromhavingwonitforthemselves.”
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,withinoursharedprofession”
Background
Understanding, developing and defining family medicine is not something we do once and then we’vegotit It’sanongoingprocess;professional development is a core activity for family doctors, integrating research, experiential knowledge, reflection and implementation in a dynamic circularreciprocity.
Ourvaluesareourguidingprinciples.Atthesame 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 communityfinditself.
when we develop training programs, define researchagendas,agreeonadvocacyactionsand planactivitiesthatarewell-dimensioned.
We can recognize our differences better when we’reawareofourcommonground,italsomakes usbetterpreparedtomeetthechallengesweface with shifts in societal trends, which are always reflected in health systems, not least in primary care
Knowledge of our common ground also enables ourcollectiveeffortstobeeffective,suchas
Family medicine has traditionally been defined anddescribedfromWesternHighIncomeCountry (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 ValuesProject.
Howisitorganized?
The project lead group consists of Prof Felicity Goodyear Smith (New Zealand), Prof Johann Sigurdsson (Iceland/Norway), and WONCA Immediate Past President Anna Stavdal. Handpickedregionalleadswereinvitedtorecruit three additional persons each, preferably from different countries in their regions, to share responsibility and facilitate process on country level
Nina Monteiro, liaison person to the WONCA Lisbon Conference 2024, is also part of the core group.TheWONCAPresident,PresidentElect,and CEOareexofficiomembers
Projectgoals
In short, our goal is to encourage and support WONCA member organizations (MOs) to define theirprofessionintheirlocalcontext,andtomap what already exists of definitions, vision and missionstatements.
Thanks to Felicity Goodyear Smith’s extensive efforts, we had a preliminary overview when the projecttookoffforreal:40%ofourmemberMOs donothavelocaldescriptionsofthedisciplineof family medicine available online and/or on their websites/otheronlineentries.
Wearenowworkingonfinalizingthemap,andwe are encouraging development where such documentation doesn’t exist This year, all WONCA regions organize conferences, an opportunity for regional workshops for face-tofacediscussionstohappen.SouthAsiaandAfrica already organized well-attended workshops, and discussions sparked APR is next, followed by Europe,EMR,CIMF,andNorthAmerica.
Whatmightemerge?
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 discussedfurtherinthecoregroup.Abookabstractis accepted by the WONCA publisher Taylor & Francis, describing the state-of-the-art from regional perspectivesandwillbeonthemarketin2026 Inthe course of the project, maybe a manifesto will be drafted for Council handling, a step toward a statementofGlobalFamilyMedicineCoreValuesand Principlesonwhichwecouldagree?
Outcomes will be presented at the WONCA World conferenceinLisboninSeptember2025.
TheCoreValuesprojectwasthetopicoftheworkshop attheannualWONCACouncil,whichtookplaceonline in the end of June. It was met with enthusiasm and theworkshopprovidedfruitfulinput.
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 RATHERTHANHINDEREDBYOURDIFFERENCES.
Doyouwanttotakepart?
Attend the workshops at the regional conferences Contact your regional lead for guidance on how you can contribute. Write to CoreValues@wonca.net and wewillforwardrequests.Usethesamee-mailaddress should you have input or feedback to the project leads
Happybrainstorming!
AllenF.Sha
PROF JOHANN SIGURDSSON
HAIZHU JIANGNANZHONGJIE
COMMUNITY HEALTH CENTRE
WONCA PRACTICE ACCREDITATION
Guangzhou,China,July2,2024
The World Organization of Family Doctors (WONCA) announced the achievement of Practice
Accreditation for the Haizhu Jiangnanzhongjie Community Health Centre. This accreditation highlightstheCentre’sdedicationto delivering high-quality healthcare and aligns it with international standardsofpractice
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 TheChineseUniversityofHongKong (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 inpersonassessmentinMay2024with Prof.Wong.
The review confirmed that Haizhu Jiangnanzhongjie Community HealthCentre,locatedintheHaizhu District of Guangzhou, meets the stringent WONCA Global Standards, ensuring excellence in all aspects of healthcare delivery The center is staffedby70professionals,including 20 General Practitioners and 23 communitynurses
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.”Headded,“TheCentre’s approach to maintaining patient privacy and implementing a one doctor,onepatient,oneroompolicy isamodelforotherstofollow.”
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 correspondenceensurethatpatients receivetimelyandappropriatecare” Hefurthernoted,“Theintegrationof 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 toourpatients
This recognition motivates us to continueenhancingourservicesand tostriveforexcellenceinallaspects ofcommunityhealthcare”
Harris Lygidakis, CEO of WONCA, added, “The WONCA accreditation program is designed to support and recognizeprimarycarepracticesthat arecommittedtoexcellence.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 helpshealthcarefacilitiesenhance theirservicesthroughastructured supportive framework, ensuring they meet the highest internationalstandards.
Staff of Haizhu Jiangnanzhongjie Community Health Centre with Prof. Samuel Y.S. Wong, WONCA Accreditation Expert
ABOUT HAIZHU JIANGNANZHONGJIE
COMMUNITY HEALTH CENTRE
Haizhu Jiangnanzhongjie CommunityHealthCentre,locatedin Guangzhou, China, is a leading healthcare provider dedicated to offering comprehensive medical servicestothelocalcommunity.The Centre is staffed by a team of experienced General Practitioners and community nurses who are committed to delivering personalized and effective healthcaresolutions.
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
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 healthsystems.
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 effectivecareforourpopulations
Toaddressthesepressingissuesand discusstheimpactsofthisinitiative, 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 theBrazilianEmbassyinWashington D.C. Intentionally timed to take advantage of the presence of Ministers of Health and senior staff fromcountriesacrosstheregion,this event highlighted the Alliance and turnedattentiontothecriticalroleof PHC in building and sustaining robusthealthsystems.
WONCA President-elect Dr. Viviana Martinez-Bianchi attended to ensure that the voices of North American andIberoAmericanFamilyMedicine were heard, crucial contacts across the regional ministries were made, and the prospects for future collaborations between WONCA and PAHOwereadvanced
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), followedwithopeningcommentson the essential role of primary health careintheregion,particularlyinthe aftermathofthepandemic.
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,whicharestillveryimportant forLatinAmericaandtheCaribbean, but “if we want the primary healthcarethatisprovidingeffective care for our population we need to covermuchmorethanjustmaternal andchildhealth,weneedtoprovide 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”.
“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 healthcaretoprovideabetteruseof thelimitedresourcesyouhaveinthe healthsector,andalsotoidentifythe barriers to developing a primary health care strategy and transform universal health coverage into a realityinourregion.”
PRIMARY HEALTH CARE: THE FOUNDATION OF THE BRAZILIAN HEALTH SYSTEM
HE Alexandre Pena Ghisleni, Head oftheSpecialOfficeforInternational 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 evolvingepidemiologicalcontext,an aging population, increased mental health needs, and the impact of climate change. Loyce Pace, Assistant Secretary for Global Affairs attheU.S.DepartmentofHealthand HumanServicesandpastCEOofthe 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.
GUIDED DISCUSSION ON PHC AND RESILIENT HEALTH SYSTEMS
The event featured a guided discussion moderated by Dr. Robert Phillips, Executive Director of the CenterforProfessionalism&Valuein Healthcareandrepresentativeofthe American Board of Family Medicine Foundation
Dr. Phillips emphasized how the COVID-19 pandemic has reinforced the need for robust PHC investments,necessitatingsustained commitment from both countries andtheinternationalcommunity 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 highlightedtheimportanceofPHCin 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 diseaseoutbreaks.
Dr JuanPabloUribe,GlobalDirector 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 qualityinvestmentplans.
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.
COMMENTS AND BROADER DISCUSSION
The comments and discussion segmentbeganwithareactionfrom Mag. Gabriela Gomez Castillo, Director of the Department of External Relations and Cooperation at the Ministry of Health, Uruguay. Shediscussedtheimportanceofthe InitiativesinUruguay,acountrythat 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 citedtheimportanceofinvesting2530% of their federal budget for health into primary health care For comparison,theUS invests5-7%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 andpandemicdemands
Questions and comments from the audiencehighlightedtheimportance 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 summaryofkeytakeawaysfromthe 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 postgraduatetraininginFamilyCare
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 activeinthesecrucialdiscussions.
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.
WONCA PAST PRESIDENT AWARDED HONORARY
DOCTORATE
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 highlightsnotonly of
Anna's personal contributions but also the collective efforts and dedicationoftheWorldOrganization of Family Doctors (WONCA) and its commitment to general medicine overthedecades.
TheeventtookplaceonFriday,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 WONCAfamily.
"The awarding of this honorary doctorateisnotjustaboutmywork," 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 disciplineisthemainreasonforthis honor"
Stavdal’s career exemplifies these values Havingfirststudiedsociology at the University of Oslo before transitioning to medicine, she graduated as a doctor in 1987 and specialized in general medicine in 1999.Since1989,shehasmaintained her patient list in Oslo, demonstratingthecontinuityofcare 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 generationsofdoctors
Immediate Past President of WONCA
Dr Anna Stavdal
Stavdal’s career exemplifies these values.Havingfirststudiedsociology 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, demonstratingthecontinuityofcare 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 generationsofdoctors.
Throughout her career, Stavdal has been a vocal advocate for the integral role of general practitioners inthehealthcaresystem Hertenure 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 the WHO Europe Pandemic Commission, contributing to global health policy discussions and highlighting the critical role of primaryhealthcareduringcrises.
The honorary doctorate awarded to Stavdal is a prestigious recognition, placingheralongsidenotablefigures such as President of Iceland Guðni Th. Jóhannesson and Nobel Prize Winner Professor William G. Kaelin Jr Thishonoremphasizestheglobal importance of the values upheld by WONCA and celebrated through this award
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 healthsystems.
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 promotingavalue-basedfoundation 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 systemsworldwide.
As Stavdal herself humbly noted, “I was the lucky one to receive the honor on behalf of us all” This accolade is a reminder of the power of collective effort and the enduring impact of shared values in the pursuitofbetterhealthforall
For more information about the honorary doctorate and other honorees, please visit the University ofOulu'shonorarydoctorspage.
The hat and sword are the insignia of a doctor at the University of Oulu
GREEN PRACTICE JAPAN
TAKAFUMI SASAKI JAPAN
In Japan, there had been no activitiesbyhealthcareprofessionals 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 theUK WiththesupportofGreener 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 WorkingGroupattheJapanPrimary CareAssociation,continuingtofocus onworkshopsandsymposia.
GREEN STORIES
ForWorldFamilyDoctorDayonMay19,weinvitedfamilydoctorsto 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 favouritestories.YoucanfindmoreinspiringstoriesontheWONCA website
Health team dislocating in Amazon Image credits: Tarso Sarraf
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 healthnurses
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, PlanetaryHealthAllianceJapanHub, 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 pickedupontheirwork.
Green Practice Japan signed the Planetary Health Party's 'Call to SecureaJust&EquitableTransition to Sustainable Energy & Safeguard Health' at WONCA Sydney in 2023 and 'an Open Letter on fossil fuels from the Global Medical and Health Community'addressedtotheCOP28 President. They were the only Japanese healthcare professional organization to participate in these signings. They also worked toward Japan's membership in the Alliance forTransformativeActiononClimate andHealth
The JPCA Planetary Health Working Group assisted in the declaration of climate emergency in primary care (theHamamatsuDeclaration,below) andthesustainableoperationofthe conference
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,andtheyarecommitted to taking responsibility for its implementation.
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 improvethewell-beingofpeople.
SYNDEMIC
Oneofmypatientswasa16-year-old boy who was obese. He came into myconsultingroomwithhismother, wearing jeans and a school t-shirt. Heclearlywasn’tinterestedinbeing at the doctor's, but his mother was worried because he drank at least 2 litres of Coke and other fizzy drinks daily.
Besidesobesity,hewasontheverge of developing high blood glucose levels, which his mother had been monitoringforawhile.
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 sinceitwasclearhedidnotwantto diet
I introduced the idea of co-benefits of a healthy diet for both his health andtheplanet Iaskedifhehadever thoughtabouttheamountofplastic waste he was generating and discussedtheimpactontheoceans, includingthePacificgarbagepatch.I showed him some images of the consequences of plastic pollution Hewasvisiblyconcerned
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 doneonplasticreductionandtaught me about pollution from clothing andmicroplastics.
Promoting healthy eating without plastics: An ethical practiceinprimarycare
MAYARA FLOSS BRAZIL
DR FATHIA MOHAMED NOUR SOMALILAND - FAMILY PHYSICIAN FEATURED DOCTOR:
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 healthcarelandscapeinhercountry Her journey, marked by resilience andcommitment,isaninspiringtale ofovercomingchallengestoimprove healthcaredelivery.
Born in Hargeisa, Somaliland, Dr. Nour pursued her Bachelor of Science in Medicine (MBBS) from AmoudUniversity,graduatinginJuly 2008.Shewasamongthefirstbatch 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."WiththehelpofAmerican family physicians, the faculty volunteeredselflessly
Now, we have taken over, but they mentored us and stayed with us throughout,"Dr.Nourrecalls.
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 collapsedandstartedfromscratch," Dr. Nour explains. She has been integral to this transformation, witnessing and contributing to the program'sgrowthandsuccess.
Dr Nour's experience as one of the firstbatchofgraduateshasgivenher a unique perspective on the challenges and successes of family medicine in Somaliland She highlighted the community's lack of understandingoffamilymedicineas aspecialtyasasignificantchallenge "The community does not understandusasspecialistswhocan providevariedcare
They often see us as just general practitioners, not recognizing the broadrangeofcareweprovide,"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 intensivecareattheNICU,that’sthe broad range of care that family doctors provide to the people in Somaliland,"Dr.Nouremphasizes.
Dr. Nour's dedication to her profession extends beyond clinical practice to impactful research and leadership.Herstudieshavefocused 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 healthcareinSomaliland.
In her role as an educator, Dr Nour hasbeeninstrumentalintrainingthe nextgenerationoffamilyphysicians.
"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 theirpatients
One of the highlights of the WONCA Africa Conference in Nairobi was Dr. Nour's presentation, where she sharedthesuccessesandchallenges of family medicine in Somaliland. Herstorywasmotivatingtoothersin WONCA who are championing primary health care across the continent.Herpresentationreceived athunderingapplause,reflectingthe 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 regionConferenceandfurtheredher professional development. "I would also like to express my gratitude to the Montegut Scholarship for enabling my participation in this conference,"sheadds
As Dr Nour continues to inspire her peersandstudents,hervisionforthe 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 basedonthat,"shereflects.
Dr Fathia Nour's journey is a remarkableexampleofhowpassion, perseverance, and a commitment to continuous learning can drive significantchangeinhealthcare.Her efforts in building a robust family medicineprogramandherrelentless pursuit of excellence in both clinical practiceandmedicaleducationhave made her a respected figure in the medical community Her story is a shining beacon for all family physicians, illustrating that with dedicationandsupport,itispossible totransformhealthcaresystemsand improve lives, even in the most challengingenvironments
INTERVIEW WITH DR. FATHIA NOUR
Recorded at the WONCA Africa Conference, Nairobi, Kenya. June 2024. With thanks to Prof Bob Mash
MY JOURNEY IN FAMILY MEDICINE
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 spectrumofhealthissues
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 continuousandcomprehensivecare, ahallmarkofthisfield.
FEATURED DOCTOR:
DR ANNE MWIKYA KENYA - FAMILY DOCTOR
MBCHB - UNIVERSITY OF NAIROBI, KENYA
MMED-FP UNIVERSITY OF MEDICAL SCIENCES OF HAVANA, CUBA
MY JOURNEY IN FAMILY MEDICINE
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 establishmentofprimaryhealthcare 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, andtertiaryfacilities.
One of my key tasks is streamlining communication and collaboration among healthcare providers, be it private,faith-basedorganizations,or public sectors, ensuring timeliness and appropriate care provision. This position allows me to advocate for better health policies and resource allocation,aimingtomakeatangible differenceinthehealthoutcomesof thepopulation
THE BIGGEST CHALLENGES AND OPPORTUNITIES FOR PRIMARY HEALTH CARE IN KENYA
Primary health care in Kenya faces significantchallenges Oneofthemis 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 decisionmakingprocesses.
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 observedintheestablishmentofthe electronic community health system (eCHIS), can greatly improve access to care. Furthermore, community healthworkerprogramshaveshown greatpromiseinextendingthereach ofprimaryhealthcareservices.
KEY LESSONS LEARNED
DURING THE WONCA AFRICA REGION CONFERENCE
Attending the WONCA Conference in Kenya was a transformative experience Itprovidedaplatformto learn from global experts in family medicine and primary health care. OneofthekeylessonsIlearnedwas the importance of community involvement in healthcare delivery. Engaging local communities in health initiatives fosters trust, encourages healthy behaviors, and ensures interventions are culturally appropriateandsustainable Another valuable takeaway was the significance of continuous professional development and education for healthcare providers Keepingabreastofthelatestmedical 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 continuousandcomprehensivecare, ahallmarkofthisfield.
EXPERIENCE FROM THE CUBAN HEALTH SYSTEM
My training as a resident in family medicine allowed me to acquire a seaofknowledgeandpracticalskills from one of the best-organized healthcaresystemsintheworld.
The Cuban health system, with its strong primary health care basis, applies principles of decentralization, multisectoral engagements,andactivecommunity 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 valueforthecountry. 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 observedintheestablishmentofthe electronic community health system (eCHIS), can greatly improve access to care. Furthermore, community healthworkerprogramshaveshown greatpromiseinextendingthereach ofprimaryhealthcareservices.
MY INTERESTS AND PASSION
Myinterestsandpassionsaredeeply 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 changesandeffectivehealthpolicies areessentialforcreatingsustainable improvements in health care delivery.
In my personal time, I enjoy participating in community health outreach programs and mentoring young healthcare professionals These activities allow me to give backtothecommunity.
CONCLUSION
My journey in family medicine has beenshapedbyapassionforholistic 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 drivesmyworkandfuelsmypassion formakingadifferenceinthelivesof individualsandcommunities.
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 October2024inJordan
This year’s conference has been designed to provide an innovative and comprehensive overviewofthelatestresearchdevelopments inFamilyMedicineandPrimaryHealthCare Overthecourseofthreedays,theconference will feature symposia, keynote sessions, parallel workshops and abstract presentations.
We hereby invite you all to share the results of your scientific research with us by submitting an abstract of your work, and by joiningusinsharingourvisionofWoncaEMR 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 unforgettableexperiences
Ubuntu 2024 is a joint conference between The Network: Towards Unity for Health (TUFH)andRuralWONCA(TheWorkingParty onRuralPractice)
It’s bringing together the TUFH 2024 Annual ConferenceforTUFH,whichiscelebratingit’s 45th anniversary in 2024, and the 20th WONCAWorldRuralHealthConference!
This conference is being co-hosted by 5 partnersinCapeTown,SouthAfrica: UniversityoftheWesternCape; UniversityofCapeTown; StellenboschUniversity; CapePeninsulaUniversityofTechnology, andtheDepartmentofHealthandWellness–WesternCapeGovernment
This joint conference has been named Ubuntu 2024; referring to the meaning of Ubuntu“Iam,becauseyouare”.
Ubuntu 2024 will be a fully hybrid conference
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
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 naturalwondersandculturalheritageoftheregion,aswellashealthprofessionaltrainingintheseareas
More key note speakers have just been announcedincluding TomasZapata(Spain), Ana Luisa Neves (Portugal), Alexandre Gouveia (Portugal), Niels H Chavannes (Netherlands), Eva Kozub (France), Mercy NafulaWanjala(Kenya)
SOUTH ASIA REGION CONFERENCE 2025
BENGALURU, INDIA.
Bengaluru, often referred to as the "Silicon Valley of India" and the IT hub of the country, has established itselfasaprominentdestinationfor various conferences and events, includingthoseinthemedicalfield.
Hosting the WONCA South Asia Regional Conference in Bengaluru (4-6th April 2025) holds several advantages and reflects the city's uniquestrengths
IT AND HEALTHCARE INTEGRATION
Bengaluru'sreputationastheIThub 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 discussionsontheroleoftechnology infamilymedicine.
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 experiencesinfamilymedicine.
DIVERSE MEDICAL COMMUNITY
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 SouthAsia.
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.Thecity'scommitmentto 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.Thiscontributestoamore enriching and enjoyable overall experienceforattendees.
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.
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 innovationecosystem
These factors collectively contribute to creating a dynamic andenrichingenvironmentforthe conference, facilitating the exchange of knowledge, fostering collaborations, and promoting advancementsinfamilymedicine.
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 integrityofhealthcareservices.
Watchthisinsightfulwebinaronidentifyingintimatepartnerviolence(IPV)inprimary 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
CRISP REPORTING CHECKLIST HELPS
ADVANCE
PRIMARY CARE RESEARCH
Comprehensive generalist medical care (family medicinegeneralpracticeandprimarycare)isa 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 careandprimaryhealthcareatthefoundationof ourhealthcaresystems
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 forprimarycaretomeettheneedsofourclinical practitioners academic investigators patients andcommunities.
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 developmentofresearchreportingguidelines
Improving the reporting of primary care research:ConsensusReportingItemsforStudies inPrimaryCare theCRISPStatement Annals of Family Medicine 2023
Improving the reporting of primary care research:Aninternationalsurveyofresearchers. J Am Board Fam Med 2021.
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/generalpractice.
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 initiativesetouttofillthatgap.
CRISP PROCESS
A rigorous five-year program of research and development engaged diverse voices across 29 nations This work was conducted by the internationalCRISPWorkingGroupincludingDrs PaulGlasziouPallaviPrathivadiandGrantRussell (Australia); Aaron Orkin (Canada); Tim olde Hartman and Chris van Weel (Netherlands); and JoanneReeve(UK)
CRISP pioneered a new approach to developing researchreportingguidelinesbasedonthevalues of family medicine/general practice Rather than relyingonasmallgroupofexpertmethodologists 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 finalCRISPChecklist
CRISP CHECKLIST
The CRISP checklist identifies 24 items in ten themestoincludeinresearchreports.Eachitem 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 fullexplanationandexamplesforeachitem.
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 reportsneedcontexttohelpreadersunderstand the studies and how they might apply to their ownpracticesettingsandhealthcaresystems
TheCRISPChecklistisatoolforinvestigatorsand 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 decisionsoncontentandform
The WONCA Executive endorsed the CRISP ChecklistinAugust2023.
NAPCRG - the North American Primary Care Research Group – has also endorsed the Checklist. The CRISP Checklist is now registeredwiththeEQUATORNetwork.
The Checklist and all materials can be downloadedfromtheCRISPwebsite.
CRISP DISSEMINATION AND USE
The CRISP checklist is included in the “InformationforAuthors”alongwithothermajor research report guidelines by a growing number of journals around the world. A network of colleagues is translating the Checklist to serve researchersworkinginavarietyoflanguages.
TheCRISPChecklistcanapplytoallprimarycare research Thisincludesresearchdonebyprimary care investigators and studies by others in primary care settings patients and problems and allstudiesintendedtoinfluencethepracticeand organizationofprimarycare CRISPcanbeatool to help others understand the complexities of family medicine/general practice the information weneedandtheresearchwedo.
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 focusonprimarycare.
TheWorkingGroupconsiderstheCRISPChecklist to be a living document ready for application testing and improvement. We welcome all commentsandsuggestions.
