Development of the World Health Organization Global competency and outcomes framework for the Essential Public Health Functions

Abstract

Background: Competency-based education has variable uptake in public health, despite calls for effective education-to-employment pathways. A WHO and partners’ Roadmap to strengthen the public health and emergency workforce called for a holistic globally-relevant competency-based framework oriented to practice and delivery of the Essential Public Health Functions (EPHFs). This research answers the question: What are the relevant competencies and practice activities for the breadth of the public health workforce to deliver the 12 globally-relevant EPHFs? Methods: A mixed methods approach was used to build the competency framework, informed by literature review; content analysis of existing frameworks and curricula using the WHO competency model as an organizing framework; and an iterative approach to drafting, consultation and consensus about the framework content. Results: Twenty competencies were identified as relevant to the public health workforce across contexts, geographies and role responsibilities, organized into six domains: community-centeredness; decision-making; communication; collaboration; evidence-informed practice; and personal conduct. Forty practice activities that describe the work required to deliver the EPHFs are organized into five domains: health systems enablers; public health intelligence; public health programs and services; management of resources for public health programs and services; and public health emergency management. Discussion: Whilst the 20 competencies unite the public health workforce, irrespective of occupational group, public health priority or context, practice activities are role-specific and require contextualization. Competencies and practice activities must be interpreted together to provide a holistic approach to competence. The value of the framework is in its contextualization and application. Different components of the framework provide a common language but can be adapted to inform education and employment. Reflections on the methodology and the framework construct and organization are offered, confirming the WHO competency model application as a lens to interpret content from multiple sources to provide clarity about learning and assessment of educational content.