WORKFORCE DEVELOPMENT: GLOBAL COMPETENCY OUTCOMES FRAMEWORK
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Authored by: Ishani Sharma, WHOCC Intern
WHO 2022 Roadmap
In the past 5 years, major events including COVID-19, wildfires, flooding and man-made disasters are but a few of the health challenges that have been brought into the fore of public attention. These have, in turn, underlined a pressing need to upskill public health professionals to increase capacity and resilience.
In response to the rising global challenges within public health, in May 2022, the WHO published a comprehensive roadmap1, detailing key actions and strategies to strengthen the Public Health and Emergency Workforce. This roadmap details three key ‘Action Areas’ based on 12 Essential Public Health Functions (EPHFs)2.
What is the framework?
Members of the team at the WHOCC were involved in developing a ‘Global competency and outcomes framework’3, addressing the key questions under action area 2. This framework outlines competencies and educational outcomes to ensure that current and future public health practitioners are equipped with the fundamental skills required to carry out the 12 EPHFs. The framework itself is split into 3 main sections: Competency Domains, Practice Activities, and Contextualising the Framework.
These define the foundational competencies for public health workforce, explain key practice activities which reflect the demands of public health practice and challenges, and highlight how these elements of the framework can be implemented within the context of different public health roles and curricula.
The framework also recognises and establishes the interplay between services achieving competencies. Practice activities are split into five key domains spanning emergency management to the running and resource allocation to programmes and services. These encompass major facets of public health practice to provide rounded and comprehensive training and are linked to EPHF subfunctions and service delivery through the tasks specified and curricular guides.
These are organised into tiers of experience and responsibility within public health, ensuring that competencies and practice activities are suited to the varying roles within the field. Thus, the aims of the framework can be applied and tailored to fit the nuances of public health practice.
Part of implementation highlighted by the framework includes the delivery of the training and its incorporation into public health training across the globe. This includes how to facilitate learning using different methods of discussion, teaching and assessment, and how to evaluate and improve delivery.
How was the framework developed?
The framework was developed over an 8-month period between November 2022 and June 2023. Combining research and analysis of existing frameworks with peer review and global consultation, a collaborative approach was taken to ensure the framework was applicable to professionals in all WHO regions.
During the first phase of development, a total of 31 frameworks were included in the scoping review and analysed based on their functional, behavioural, knowledge-based, and wider content. These spanned the WHO regions and different occupational groups within the public health workforce. This information was peer reviewed and used to form the basis of this competency framework.
What are the next steps for the GCF?
As part of the wider roadmap1, global implementation of the framework in curricula across different sectors and services will introduce exciting prospects for the future of public health. Alongside this, the evaluation and development of training programs and resources will allow for a more tailored education in public health and emergency preparedness.
For example, a study evaluating an emergency preparedness training course4 delivered by the WHOCC highlighted the importance of clearly defined competencies that can be matched by education and training. The course outlined a list of competencies for emergency planning and preparedness, to which educational activities, resources, virtual learning course modules, and assessments were mapped. The response to this approach by the participants was overwhelmingly positive. All participants passed the final assessment, and of the 55% responding to the end of course survey, all were either somewhat or extremely satisfied by the course.
The evaluation of the course through the study corroborated these findings, emphasising the importance of tailored competency-setting and education, and frequent, up-to-date training, to maintain the skills of the workforce. This is consistent with literature and recommendations on medical education both in public health and emergency preparedness. Similarly, using the global competency and outcomes framework, this integrated approach can be expanded, either as a standalone or in conjunction with the other aspects of the roadmap and will help develop a more coherent and prepared public health workforce ready to face any health challenges ahead.
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Celine Tabche, one of the members of the WHOCC for Public Health Education and Training team who worked on the framework, gives her thoughts on the framework, its development, and its use moving forward:
Where do you see the Global Competency and Outcomes Framework being implemented now?
“The framework should be implemented in various regions globally, especially where there is a focus on strengthening the public health workforce. Regions addressing emerging public health challenges, such as low- and middle-income countries, should actively adopt it to align education and workforce needs with the newly defined 12 essential public health functions.”
How will you incorporate this into your own practice and teaching?
“I usually align all the curricula I develop with the relevant competencies defined by WHO. The ones outlined in this framework, ensure practical, real-world training is central to learning. Additionally, I use competency-based assessments to evaluate learners’ proficiency in meeting public health standards, providing a structured approach to workforce readiness.”
Who do you think would most benefit from this framework?
“The primary beneficiaries are public health professionals needing to update their skills, educational institutions training future health workers, and policymakers designing workforce strategies. The framework supports all stakeholders by ensuring that public health training is current, relevant, and globally applicable.”
What was your experience of developing the framework?
“Looking back, it was such a huge project that involved a lot of learning and implementation from my end. It was definitely a collaborative process involving global health experts and stakeholders that I will never forget. Spending months identifying core competencies from over 100 competency frameworks. Then aligning those to the corresponding public health services for weeks, and then ensuring the final product was adaptable across various practitioners and regional contexts, making it relevant to diverse public health needs. But it was definitely all worth it!”
How could this be used in the future?
“The framework could standardise public health education globally, ensuring a consistent and responsive workforce. It will also support workforce development in emerging health crises and provide a roadmap for continuous professional development in public health.”
What are the next steps for the framework and the roadmap as a whole?
“The next steps include expanding its implementation to more countries, monitoring its impact on public health outcomes, and notifying WHO and relevant stakeholders if the framework needs updating to reflect emerging challenges and innovations in the field.”
Congratulations, and thanks to the WHOCC for Public Health Education and Training team, who worked to help develop and publish the framework. It will be intriguing to see how this shapes and evolves public health training going forward!
To access the full document for the ‘Global Competency and Outcomes Framework for the Essential Public Health Functions’ click here.
For more information about our training programmes please visit: Education & Training
References
1. World Health Organisation: Health Workforce. National Workforce Capacity for essential public health functions: a roadmap. 2024. URL: https://www.who.int/teams/health-workforce/PHEworkforce/1
2. World Health Organisation: Health Workforce. Defining Essential public health functions and services to strengthen national workforce capacity. 2024. URL: https://www.who.int/publications/i/item/9789240091436
3. World Health Organisation: Health Workforce. Global competency and outcomes framework for the essential public health functions. 2024. URL: https://www.who.int/publications/i/item/9789240091214
4. Tabche, C., Atwan, Z., Rawaf, S. Integrating Emergency Preparedness Competency Frameworks in Workforce Development Training. Mass Gathering Medicine. 2024. https://doi.org/10.1016/j.mgmed.2024.100008