Refugee & Migrant Health in Medical Education | WHO Competency Standards

მიერ

აპრილი 24, 2025

One Curriculum, Many Cultures: Embedding Refugee and Migrant Health in Medical Education

By Professor Giorgi Pkhakadze
Chair, Public Health Institute of Georgia (PHIG); Professor at David Tvildiani Medical University (DTMU)

Introduction

In an era marked by escalating conflict, climate-related displacement, and socioeconomic instability, medical education must evolve to meet the needs of an increasingly diverse patient population. According to the International Organization for Migration (IOM), over 281 million people were international migrants in 2022, and the United Nations High Commissioner for Refugees (UNHCR) projects that by mid-2024, over 117 million individuals will be forcibly displaced due to war, persecution, and disasters.

Migrants and refugees face disproportionately high burdens of infectious diseases, untreated chronic conditions, mental health disorders, and maternal health complications. Many lack legal access to care, face linguistic and cultural barriers, or experience discrimination. Despite this, most health education systems globally do not prepare students to serve these populations.

The WHO Global Competency Standards for Health Workers emphasize the need to embed migration-sensitive competencies into health training. These standards define the skills and attitudes required for trauma-informed, rights-based care. Similarly, ASPHER has advocated for integrating migration health into public health education across Europe.

Medical and nursing schools are not just academic spaces—they are incubators of the next generation of health leaders. As one European dean remarked, “No student should graduate without knowing how to serve the displaced.”

This article explores how universities and training institutions can align their curricula with WHO’s Global Competency Standards. Drawing on global models, policy frameworks, and Georgia’s pioneering efforts through DTMU and PHIG, we propose a structured path for embedding migration health into medical education.

International Models and Policy Guidance

Institutions worldwide have started aligning with the WHO’s standards. In Sweden, Karolinska Institutet includes refugee health in its global health curriculum. The Netherlands integrates migrant care into its CME platform, and Germany’s Charité Berlin includes it in public health training. These models emphasize case-based learning and active inclusion of migrants in education design.

At the regional level, ASPHER and WHO Europe co-developed model syllabi and hosted faculty workshops to mainstream migration health. In Lebanon and Jordan—where refugees comprise over 25% of the population—WHO and UNHCR partnered with universities to implement pilot curricula aligned with the Global Competency Standards.

The standards align with global frameworks like the
Universal Health Coverage (UHC), the Sustainable Development Goals (SDGs)—especially SDG 3 (health), SDG 4 (education), SDG 10 (reduced inequalities), and SDG 16 (strong institutions)—and the Global Compact for Safe, Orderly and Regular Migration.

These examples show that embedding refugee and migrant health into education is not only feasible—it is already happening. The next step is scaling up, linking it to national accreditation and licensing systems, and fostering government–university–civil society partnerships.

Georgia’s Leadership and Academic Vision

In Georgia, David Tvildiani Medical University (DTMU) and the Public Health Institute of Georgia (PHIG) were the first to pilot the WHO Global Competency Standards (GCS) in a university setting. In 2024, DTMU integrated the GCS into its undergraduate medical education. Over 200 students participated in dedicated modules on communication, ethics, and migrant-centered care. Post-course evaluations showed a 47% increase in confidence and 33% higher scores in knowledge assessments.

DTMU also launched faculty development workshops in partnership with PHIG and local NGOs. Based on the success of this model, DTMU and PHIG are now proposing a National Academic Framework that will:

Establish GCS-aligned competencies across all accredited programs.
Translate and adapt the WHO standards to the Georgian context.
Introduce a national training-of-trainers (ToT) program for faculty.
Link GCS training to medical licensing and re-certification.

This vision aligns with Georgia’s goals under the WHO European Programme of Work and EU health integration pathways. It offers a replicable model for small and mid-sized countries aiming to reform medical education through migration-sensitive equity standards.

Recommendations for Academic Institutions

Mandate GCS-Based Content: Make migration health a required part of all medical, nursing, and public health programs.
Train Faculty: Invest in faculty development, incentives, and exchange programs to boost institutional capacity.
Integrate Real-World Experience: Partner with NGOs and clinics serving refugees for hands-on student learning.
Include Refugee Voices: Collaborate with migrant communities to co-design course content and assessments.
License-Linked Competency: Include GCS-based training in medical licensing and CME re-certification frameworks.
Join Academic Networks: Link with ASPHER, TropEd, and the IOM networks to share knowledge.
Use SDG Language: Align proposals with SDG 3, SDG 4, SDG 10, and SDG 16 to attract support and funding.

Conclusion

The 21st century will be defined by human movement. Medical and nursing schools must rise to the challenge of preparing health workers who can provide equitable, dignified care to refugees and migrants. From Karolinska Institutet to DTMU, forward-thinking institutions are embedding the WHO Global Competency Standards into education and policy.

Georgia’s leadership, through DTMU and PHIG, demonstrates how academic transformation can drive national reform. Their model is a blueprint for countries across the WHO European Region and beyond.

Now is the time to act. If we believe in health for all, then education for all must include training for all. The future of healthcare belongs to those who are prepared to serve humanity in all its complexity.

“No student should graduate without knowing how to serve the displaced.”

📌 About the Author

Professor Giorgi Pkhakadze, MD, MPH, PhD
Professor and Head of Department at David Tvildiani Medical University (DTMU), Chair of the Public Health Institute of Georgia (PHIG), and Official Representative of Accreditation Canada in Georgia. He is a WHO consultant on health and migration, a former Member of the UN Secretary-General’s Independent Accountability Panel, and a current Technical Advisor to Gavi and former expert for the Global Fund to Fight AIDS, Tuberculosis and Malaria (GFTAM).

📬 Contact: info@accreditation.ge
📱 #drpkhakadze #გიორგიფხაკაძე #MigrationHealth #MedicalEducation #HealthForAll #GlobalStandards

Health for All: WHO Competency Standards for Migrants

მიერ

აპრილი 24, 2025

Global-Competency-and-Outcomes-Framework-for-Universal-Health-Coverage

By Professor Giorgi Pkhakadze
Chair, Public Health Institute of Georgia (PHIG)

Introduction

We are living through one of the most defining humanitarian and public health crises of our time. As conflict, climate change, and socioeconomic instability displace millions, the burden falls heavily on national health systems that are often unprepared to meet the needs of increasingly diverse populations. According to the International Organization for Migration (IOM), there were over 281 million international migrants in 2022, with more than 36 million refugees and asylum seekers. By mid-2024, the United Nations High Commissioner for Refugees (UNHCR) estimates that over 117 million individuals will be forcibly displaced—an alarming figure that underscores both a humanitarian emergency and a global policy failure.

This mass movement of people presents both an obligation and an opportunity: to build stronger, fairer, and more inclusive healthcare systems. Refugees and migrants bring with them a wealth of resilience and potential, but also face deep-seated barriers to accessing care, from legal exclusion to linguistic and cultural divides. The gaps are most evident in frontline service delivery, where health workers are often left without the training or tools to respond effectively to the unique health profiles and rights of displaced populations.

At the same time, governments around the world are struggling to maintain equity and quality in health service provision, even for their own citizens. In this context, ensuring that health professionals are equipped to serve everyone—not just those who fall within traditional citizenship models—is not only a matter of ethics, but a strategic necessity.

It is within this complex, high-stakes environment that the World Health Organization (WHO) launched the Global Competency Standards for Refugee and Migrant Health (GCS). The GCS are designed to close the knowledge and skills gap in healthcare delivery to refugees and migrants. More importantly, they provide a structured framework that governments can use to regulate training, licensing, and professional development in alignment with equity-focused international goals such as the Sustainable Development Goals (SDGs) and Universal Health Coverage (UHC).

This article outlines why the adoption of the GCS should be seen not just as an educational initiative but as a legal and policy imperative. By showcasing real-world implementation models—from Canada and Kenya to the European Union and Georgia—it makes the case for urgent and systemic reform to embed the GCS into national legislation, accreditation systems, and public health strategies.

Migration, whether voluntary or forced, intersects with all aspects of health—from access and quality of care to the social determinants that shape well-being. Refugees and migrants often face disproportionate health risks, including poor access to healthcare, language and cultural barriers, mental health burdens, and heightened exposure to infectious diseases. Structural exclusion from national health plans, fragmented services, and a lack of trained providers exacerbate these disparities and violate basic human rights.

Despite international commitments to Universal Health Coverage (UHC) and the Sustainable Development Goals (SDGs), many national health systems remain ill-prepared to deliver inclusive, high-quality, and culturally responsive services to mobile and displaced populations. These vulnerabilities are not limited to low-income countries. In high-income regions such as Europe and North America, the absence of migration-competent training is still a barrier to equitable care.

The situation calls for urgent, coordinated, and legally grounded action. The World Health Organization (WHO) responded with the introduction of the Global Competency Standards for Refugee and Migrant Health (GCS)—a transformative policy and education framework designed to equip all health workers with the knowledge, skills, and attitudes required to deliver inclusive and rights-based care.

More than a guideline, the GCS represent a paradigm shift. They call for health worker regulation, institutional policy reform, and multi-level governance to embed equity into every level of care. For the GCS to be impactful, they must become a legal and policy imperative—not merely a best practice. This article presents an evidence-based argument for the integration of competency standards into national laws and professional licensing, using global, regional, and national examples to show how it can be done—and why it must be done now.

The COVID-19 pandemic underscored these challenges. Displaced populations were often left out of national vaccination and response plans, while front-line healthcare workers reported uncertainty and discomfort in treating patients from unfamiliar backgrounds. These experiences exposed an urgent need to equip health professionals with the knowledge, skills, and values necessary to provide equitable, culturally responsive, and trauma-informed care.

In response, the World Health Organization (WHO) developed the Global Competency Standards for Refugee and Migrant Health (GCS)—a framework that outlines core competencies for all health workers interacting with these populations. These standards aim to institutionalize person-centered, rights-based, and inclusive care into health systems worldwide. However, for the GCS to make a lasting impact, they must be integrated into national policies, legislation, and professional regulation frameworks.

This article argues that training for all health workers must be recognized not just as good practice—but as a legal and policy imperative. By analyzing case studies from Canada, Kenya, the European Union, and Georgia, it presents a roadmap for turning competency standards into enforceable tools that strengthen equity and accountability in healthcare systems.

Health worker training on WHO Global Competency Standards

Global Precedents: Canada and Kenya

Global implementation of the Global Competency Standards (GCS) is gaining momentum, with Canada and Kenya standing out as frontrunners in translating policy into action. These countries have demonstrated that integrating GCS into health licensing and training structures is not only feasible but also impactful.

In Canada, provinces such as Ontario and British Columbia are incorporating migration-sensitive competencies into licensing requirements and Continuing Medical Education (CME) criteria. A 2023 policy review from the Canadian Medical Association found that over 60% of surveyed healthcare providers supported mandatory training in refugee and migrant health, particularly in urban centers where 35% of the population consists of first-generation immigrants. In Ontario alone, more than 250,000 healthcare workers now have access to GCS-aligned training through provincial CME platforms.

Kenya provides another compelling example. The Ministry of Health, in collaboration with WHO and IOM, has piloted GCS-based training modules in five counties that host large refugee populations, including Turkana, Garissa, and Nairobi. According to a 2022 report from Kenya’s Department of Health Workforce Development, over 12,000 health workers received competency-based training between 2021 and 2023. Furthermore, the Kenya Medical Practitioners and Dentists Council is reviewing amendments that would make refugee health competencies a requirement for license renewal in selected regions.

These efforts are grounded in national health workforce strategies that recognize the increasing demands placed on front-line providers. Both countries have integrated GCS training into professional development pathways and linked them to measurable performance indicators such as patient satisfaction, service equity scores, and treatment adherence rates.

By embedding GCS into licensing, CME, and curriculum requirements, Canada and Kenya show how structural change can support both professional growth and health equity. Their experiences offer clear lessons for other nations looking to institutionalize migration health competencies within national regulatory systems.

European Union and WHO Europe: From Policy to Law

Across the European Union, the drive to institutionalize the Global Competency Standards (GCS) is gaining traction. The need is urgent: according to Eurostat, over 2.9 million people sought asylum in EU+ countries between 2021 and 2023, while millions more migrated for economic or humanitarian reasons. Despite this, a 2022 European Public Health Alliance report found that only 38% of frontline healthcare providers had received any form of migration health training.

Several Member States have taken bold steps toward rectifying this. In Germany, state governments are integrating cultural and linguistic competency modules aligned with the GCS into public health postgraduate programs. In Sweden, the National Board of Health and Welfare has made cultural competence training a core component of nurse licensing renewal. The Netherlands has launched a national platform that incorporates GCS principles into continuing professional development (CPD) for primary care physicians, with 8,200 registrants in its first year.

Beyond country-level efforts, the European Commission is enabling large-scale harmonization. The European Skills Agenda explicitly supports lifelong learning and cross-border recognition of healthcare training—creating a pathway to embed GCS into regional qualification frameworks. Meanwhile, the EU4Health Programme has allocated over €5.3 billion through 2027, part of which supports training programs for inclusive health access, including migrant populations.

The WHO Regional Office for Europe has complemented these policy shifts by developing implementation guidance for ministries and academic institutions, and by establishing regional benchmarks to track the uptake of migration-sensitive competencies.

As a senior health official from Romania noted during the 2024 WHO Europe Migration Health Forum: “The GCS are not just a technical tool—they are a human rights framework. Embedding them in law is about fulfilling our ethical and legal commitments to all who reside in Europe.”

To accelerate progress, it is time for the European Commission to consider a directive mandating the integration of GCS within national accreditation and licensing bodies. Such harmonization would ensure consistency across health systems while upholding the rights and dignity of displaced persons throughout the region.

Georgia: A Strategic Legal Recommendation

In Georgia, the case for institutionalizing the Global Competency Standards (GCS) has become increasingly urgent. As the country progresses toward integration with the European Union and continues to navigate domestic health system reforms, aligning with international human rights and health equity frameworks is both strategic and essential.

Georgia is a transit and host country for thousands of refugees, asylum seekers, migrants, and ethnic minorities. According to data from the Public Service Development Agency, over 35,000 foreign nationals were residing in Georgia with temporary or permanent status as of 2023, including displaced individuals from Ukraine, Afghanistan, and neighboring regions. The Ministry of Internally Displaced Persons also supports over 280,000 internally displaced people (IDPs) from previous conflicts. These populations have unique healthcare needs—needs that cannot be addressed without specific, structured training for frontline providers.

The Public Health Institute of Georgia (PHIG), in partnership with David Tvildiani Medical University (DTMU), has initiated a nationwide advocacy and technical assistance campaign to promote GCS uptake. These efforts include faculty development workshops, public health forums, academic curriculum reforms, and pilot GCS-aligned modules across undergraduate and postgraduate programs.

To achieve systematic integration, PHIG and DTMU jointly recommend that the Ministry of Health of Georgia undertake the following legal and institutional actions:

– Enact a ministerial decree mandating that all healthcare providers complete a certified GCS training module during license renewal cycles.
– Integrate GCS into CME accreditation frameworks, making it a requirement for re-licensure and career progression within the public health system.
– Revise national curriculum standards for medical and health sciences universities to include compulsory modules on refugee and migrant health, in collaboration with the National Center for Educational Quality Enhancement.
– Establish a national taskforce led by the Ministry of Health, with technical support from PHIG and WHO Georgia, to coordinate the monitoring, evaluation, and continuous improvement of GCS implementation.

Early results from PHIG’s pilot workshops are promising. In 2024 alone, over 420 healthcare professionals from 3 regions (Tbilisi, Adjara, and Imereti) participated in introductory training, with 92% reporting increased confidence in addressing migration-related health challenges. Further, several university departments have formally requested PHIG’s support in integrating GCS modules into upcoming academic years.

Legal codification of these standards would also support Georgia’s compliance with global and regional commitments—including the Global Compact for Migration, the WHO European Programme of Work, and EU-aligned human rights frameworks.

Making GCS implementation mandatory is not only a technical upgrade—it is a moral and strategic investment in a just, responsive, and inclusive health system that leaves no one behind.

Leveraging the SDGs for Policy Advocacy

Advancing the legal and policy integration of the Global Competency Standards (GCS) can be strategically reinforced through the Sustainable Development Goals (SDGs)—a globally endorsed framework with universal appeal and accountability. By aligning advocacy for GCS with national and international SDG commitments, stakeholders can increase political will, attract donor support, and mobilise cross-sectoral action.

Several SDGs directly support the integration of GCS:

– SDG 3.8 calls for Universal Health Coverage (UHC), emphasising access to quality essential health services for all, including migrants and refugees. GCS enable health workers to meet this target by strengthening skills in culturally appropriate, non-discriminatory care.
– SDG 4.7 promotes inclusive, equitable education and lifelong learning. Integrating GCS into pre-service and in-service health training ensures that the health workforce is prepared from the start.
– SDG 10.2 calls for the social, economic, and political inclusion of all, regardless of status. Competency-based approaches directly address systemic barriers that marginalise migrants in healthcare systems.
– SDG 16.6 aims to develop effective, accountable, and transparent institutions. Making GCS mandatory through professional regulation strengthens institutional performance and public trust.

This alignment is not abstract. In fact, countries such as Portugal and Slovenia have successfully linked health equity initiatives—including GCS-based education pilots—to their national SDG implementation strategies. In Portugal, health authorities use SDG 3 and 10 indicators to justify inclusive health education reforms to the Ministry of Finance. Similarly, Slovenia’s National Development Strategy cross-references SDG indicators to prioritise workforce training for migrant-inclusive services.

International platforms also reinforce this approach. The WHO SDG Partnership Platform and the EU4Health Programme provide not only funding but technical guidance to embed SDG-aligned health strategies—including GCS—in national plans.

Policymakers and advocates should frame legislative proposals around SDG indicators. For example:

– “Mandating GCS in licensing aligns with SDG 3.8 to ensure quality healthcare access for all.”
– “Including migration health in university curricula supports SDG 4.7 for inclusive education.”

By anchoring GCS within this universally accepted development framework, countries not only ensure policy coherence but also elevate the legitimacy and urgency of inclusive health reform.

Conclusion

The institutionalisation of the Global Competency Standards (GCS) is no longer a matter of preference or policy aspiration—it is a necessary evolution in global health governance. As nations confront the realities of record displacement, systemic inequities, and workforce challenges, the GCS provide a concrete, adaptable framework to ensure that no one is excluded from high-quality, respectful care.

Evidence from Canada, Kenya, the European Union, and Georgia shows that embedding GCS into legal and professional frameworks has a multiplier effect. It not only raises standards of care but fosters a workforce that is ethically grounded, clinically competent, and socially responsive. Countries that institutionalize GCS benefit from stronger health outcomes, improved public trust, and greater alignment with international health and human rights obligations.

Georgia’s leadership, particularly through the collaborative efforts of PHIG and David Tvildiani Medical University, demonstrates that national institutions can catalyze regional transformation. These localized, evidence-driven approaches serve as blueprints for broader WHO European Region implementation and offer replicable models for middle-income countries globally.

Legislative integration of GCS also ensures sustainability. When tied to licensing, accreditation, and monitoring systems, competency becomes a permanent pillar—not a pilot project. Furthermore, aligning legal reforms with the Sustainable Development Goals (SDGs) enhances legitimacy, encourages multisectoral partnerships, and opens doors to strategic funding.

The pathway forward is clear:

GCS must be codified in professional licensing and training.
Ministries of Health must champion legal reform and interministerial collaboration.
Donors and technical partners must align funding to support GCS implementation.
Academic institutions must drive innovation in curriculum and assessment.

This is not just about training healthcare providers—it is about embedding dignity, empathy, and equity into the fabric of public health.

As the world strives toward Universal Health Coverage and global equity, GCS stand as a moral, strategic, and professional imperative.

The time to legislate for inclusion is now. The time to build systems that heal without exclusion is now.

Competency is not just a qualification—it is a reflection of our shared humanity.

About the Author

Professor Giorgi Pkhakadze, MD, MPH, PhD
Professor and Head of Department at David Tvildiani Medical University (DTMU), Chair of the Public Health Institute of Georgia (PHIG), and Official Representative of Accreditation Canada in Georgia. He is a World Health Organization (WHO) consultant on health and migration, former Member of the UN Secretary-General’s Independent Accountability Panel for Women’s, Children’s and Adolescents’ Health, and a current Technical Advisor to Gavi, the Vaccine Alliance, and former technical expert of the Global Fund to Fight AIDS, Tuberculosis and Malaria (GFTAM).

With over 25 years of experience in global and national public health systems, Professor Pkhakadze is a leading advocate for advancing equity, accountability, and quality of care, particularly for refugees, migrants, and vulnerable populations worldwide.

🔗 More at: www.asf-france.fr
📬 Contact: info@accreditation.ge
📱 #drpkhakadze #გიორგიფხაკაძე #HealthForAll #MigrationHealth #AccountabilityMatters

References

1. World Health Organization. Refugee and Migrant Health: Global Competency Standards for Health Workers. Geneva: WHO; 2021. Available from: [https://www.who.int/publications/i/item/9789240030626] (Accessed: 23 April 2025)
2. International Organization for Migration. World Migration Report 2022. Geneva: IOM; 2022. Available from: [https://worldmigrationreport.iom.int/wmr-2022] (Accessed: 23 April 2025)
3. United Nations High Commissioner for Refugees (UNHCR). Global Trends: Forced Displacement in 2023. Geneva: UNHCR; 2024. Available from: [https://www.unhcr.org/statistics/unhcrstats/667e2e7e4/global-trends-forced-displacement-2023.html] (Accessed: 23 April 2025)
4. Organisation for Economic Co-operation and Development (OECD). Health of Migrants: Access and Outcomes in OECD Countries. Paris: OECD Publishing; 2021. Available from: [https://www.oecd.org/migration/health-of-migrants-report-2021.htm] (Accessed: 23 April 2025)
5. European Commission. European Skills Agenda for Sustainable Competitiveness, Social Fairness and Resilience. Brussels: European Commission; 2020. Available from: [https://ec.europa.eu/social/main.jsp?catId=1223] (Accessed: 23 April 2025)
6. European Commission. EU4Health Programme 2021–2027. Brussels: European Commission; 2021. Available from: [https://health.ec.europa.eu/funding/eu4health-programme-2021-2027\_en] (Accessed: 23 April 2025)
7. World Health Organization. European Programme of Work, 2020–2025 – United Action for Better Health. Copenhagen: WHO Regional Office for Europe; 2020. Available from: [https://www.who.int/europe/publications/i/item/WHO-EURO-2020-1437-41173-56444] (Accessed: 23 April 2025)
8. Ministry of Internally Displaced Persons from the Occupied Territories, Labour, Health and Social Affairs of Georgia. Georgia Health Sector Reform Strategy 2024–2028. Tbilisi: Ministry of Health; 2024. [Internal policy draft – citation pending public release]

Global Competency Standards for Refugee and Migrant Healthcare | Prof. Giorgi Pkhakadze

მიერ

აპრილი 24, 2025

Global Competency Standards for Refugee and Migrant Healthcare Prof — #post_seo_title

Building Skills for Humanity: How Global Competency Standards Are Transforming Refugee and Migrant Healthcare

By Professor Giorgi Pkhakadze
Chair, Public Health Institute of Georgia (PHIG)

Introduction

In an age of unprecedented global displacement, the delivery of equitable and culturally competent healthcare to refugees and migrants has become a public health imperative. According to the International Organization for Migration (IOM), more than 281 million people were international migrants in 2022, including over 36 million refugees and asylum seekers (IOM, 2022). The UNHCR adds that 117.2 million people will be forcibly displaced by mid-2024, a record high (UNHCR, 2024).

Migration—whether forced or voluntary—presents both challenges and opportunities for global health systems. While health disparities widen at the margins of society, the capacity of health workers to bridge these divides remains uneven. Refugees and migrants are more likely to encounter health systems that are unprepared to meet their needs, leading to fragmented care, miscommunication, and institutional distrust. These challenges are further intensified by limited legal access, cultural and linguistic barriers, and the psychological toll of displacement.

The COVID-19 pandemic exposed and exacerbated these structural weaknesses. Displaced populations were often excluded from national response plans, and front-line health workers reported significant gaps in preparedness to serve linguistically and culturally diverse groups. The consequence is not only diminished health outcomes but a failure of systems to uphold the principle of health equity.

In response to these realities, the World Health Organization (WHO) introduced the Refugee and Migrant Health: Global Competency Standards for Health Workers (GCS)—a transformative educational and ethical framework. The GCS defines the knowledge, skills, and attitudes essential for inclusive, high-quality, and rights-based care. By adopting and institutionalizing these standards, governments and health systems can move toward a more resilient, just, and people-centered approach to healthcare for all.

The Rationale for Competency-Based Standards

Displaced populations face a multitude of interlinked health risks that are often poorly addressed by conventional healthcare education and systems. These include untreated chronic diseases, high rates of maternal and child mortality, mental health disorders related to trauma and violence, and barriers to preventive services such as immunization. Migrants and refugees are also disproportionately affected by conditions such as tuberculosis, hepatitis, and malnutrition—yet few frontline providers are trained to address these vulnerabilities in a culturally competent manner.

Studies conducted by the WHO and IOM reveal that the lack of adequate training for healthcare workers contributes to delayed diagnoses, mismanagement of care, and even discrimination within service delivery. For example, in a 2022 survey of European primary care providers, over 40% reported uncertainty in communicating with migrant patients, while 30% expressed discomfort in dealing with mental health needs in displaced populations.

The WHO GCS framework is a direct response to these challenges. By focusing on five core domains—people-centeredness, communication, collaboration, evidence-informed practice, and personal conduct—it equips health workers with the tools they need to respond not only clinically, but ethically and compassionately. These domains reflect a shift from disease-centered to human-centered care.

Importantly, the competency standards are not limited to medical skills alone. They encompass attitudes and behaviors that support dignity, inclusivity, and non-discrimination. This approach aligns with the principles of Universal Health Coverage (UHC) and international human rights frameworks, particularly the International Covenant on Economic, Social and Cultural Rights, which affirms the right of everyone to the highest attainable standard of physical and mental health.

For health systems, the adoption of GCS facilitates better health outcomes, enhances trust among vulnerable populations, and increases the efficiency of service delivery by reducing fragmentation and duplication. For individuals, it creates an environment where they are more likely to seek care, adhere to treatment, and participate in public health programs.

Thus, competency-based standards are not only a professional necessity—they are a cornerstone of public health justice. They represent a shared global responsibility to protect the health of the most vulnerable, through care that is skilled, respectful, and informed by the realities of human displacement.

Global Momentum and Policy Integration

The Global Competency Standards have generated momentum at international and national levels, providing a policy framework that bridges education, service delivery, and workforce development. Numerous global health bodies, including WHO, IOM, UNHCR, and the OECD, have emphasized that building the competencies of frontline health workers is crucial not only for refugee and migrant health outcomes but also for broader public health system resilience.

The OECD has noted that countries investing in migrant-sensitive training experience measurable benefits, such as reduced hospitalization costs, improved patient satisfaction, and fewer delays in care access (OECD, 2021). Similarly, UNHCR data from 2023 shows that only 45% of forcibly displaced persons have unrestricted access to national health systems, underscoring the need for competency-based reforms that promote inclusion (UNHCR, 2023).

Policy integration of the GCS can take multiple forms. At the global level, WHO has aligned the standards with its Thirteenth General Programme of Work and the Global Action Plan for Healthy Lives and Well-being. In doing so, the GCS provides a technical entry point for countries aiming to achieve SDG 3 (health) and SDG 10 (reducing inequalities). For example, countries can incorporate GCS into national health workforce strategies, professional licensing frameworks, and quality assurance mechanisms.

In many regions, cross-ministerial collaboration is key. Ministries of health, education, and social welfare must coordinate to align curricula, accreditation standards, and in-service training pathways. Some countries are using GCS as a foundation for curriculum reviews in medical schools and integrating it into national continuing professional development (CPD) systems.

Despite this progress, several obstacles remain. Many low- and middle-income countries lack resources to fully implement new training systems. Health professionals may face disincentives such as time constraints, lack of accreditation, or limited awareness about the relevance of refugee and migrant health. Moreover, implementation requires strong monitoring systems, political commitment, and investment in faculty development.

The GCS, however, is designed to be adaptable. Its flexibility allows countries to apply it in ways that reflect local needs, whether through e-learning modules, community-based training, or formal inclusion in national health strategies. As such, it serves as a global public good—openly accessible and shaped by the principle of solidarity.

The next step lies in translating political endorsements into operational tools. Countries must create measurable action plans, assign institutional responsibilities, and secure budget lines to scale up competency-based healthcare delivery. This is not only a technical process—it is a strategic act of inclusion and justice.

Academic Institutions as Catalysts for Change

Academic institutions play an essential role in turning policy into practice. They are uniquely positioned to bridge the gap between international frameworks and local implementation by embedding the Global Competency Standards (GCS) into the formal education of future healthcare providers. This ensures that health professionals are equipped with relevant, context-sensitive competencies from the very beginning of their careers.

Globally, leading public health and medical schools are reviewing and revising their curricula to include migration-sensitive health modules. For example, in the WHO European Region, initiatives supported by the Association of Schools of Public Health in the European Region (ASPHER) have begun to pilot curriculum reform aligned with the GCS. These initiatives stress the importance of interdisciplinary training, which brings together students of medicine, public health, social work, and nursing to tackle the complexities of displacement in a holistic manner.

In Georgia, David Tvildiani Medical University (DTMU) has emerged as a regional leader by voluntarily promoting the GCS among its faculty and initiating curriculum reforms to incorporate these standards into undergraduate and postgraduate medical education. These efforts are aligned with the strategic objectives of the Public Health Institute of Georgia (PHIG), which is working to facilitate GCS uptake across academic institutions in the country. This model demonstrates how leadership from within the academic sector can accelerate national adoption and sustainability.

To support institutional transformation, WHO and its partners should invest in faculty development programs, including training-of-trainers, online resources, and mentorship exchanges. These capacity-building strategies will help academic institutions overcome common barriers such as limited teaching expertise, lack of standardized resources, and administrative resistance to curriculum reform.

Moreover, accreditation agencies should recognize and reward institutions that integrate GCS-aligned content. Linking GCS implementation with institutional performance indicators, academic rankings, and professional recognition can provide powerful incentives for schools and training centers.

Ultimately, educational institutions are not only engines of knowledge—they are engines of social change. Their leadership is critical to ensuring that refugee and migrant health is no longer treated as a niche topic, but rather as a core component of professional competency and public health excellence.

Strategic Recommendations

To ensure the long-term success of the Global Competency Standards, actionable strategies must be implemented at all levels—global, regional, and national. These strategies should not only promote the standards but also embed them into the fabric of health systems, professional development, and institutional culture.

Global Level:

WHO should formally integrate the GCS into the upcoming Global Health Workforce Strategy 2024–2030, establishing them as a core benchmark.
International agencies such as UNHCR and IOM should require GCS-aligned training as part of deployment for health workers in emergency or displacement settings.
Global financing mechanisms—such as the Global Fund, Gavi, and the World Bank—should earmark funding for competency-based training in migration-affected contexts.

Regional Level (WHO Europe):

Establish a Regional Competency Hub to provide technical assistance, training-of-trainers, and peer exchange among member states.
Embed GCS into EU-supported CPD programs, academic accreditation frameworks, and cross-border collaboration initiatives.
Promote the use of regional monitoring indicators to assess the effectiveness and reach of competency-based programs.

National Level (Georgia):

The Ministry of Health should adopt a national directive mandating GCS integration across all medical, nursing, and public health training programs.
PHIG and DTMU should co-lead a taskforce on GCS implementation and develop pilot programs in urban and rural settings.
Allocate national budget lines to support translation, dissemination, and capacity-building for GCS.
Develop national monitoring and evaluation tools to assess competency uptake and patient impact.

These recommendations are not merely administrative suggestions—they are a call to action for transforming healthcare delivery in a way that respects the dignity, complexity, and humanity of displaced populations.

Conclusion

The Global Competency Standards represent a bold and necessary shift in the way healthcare systems prepare, support, and evaluate their workforce in the context of growing global displacement. They offer a roadmap not only for improving service quality but also for safeguarding the dignity and rights of refugees and migrants who face compounding vulnerabilities in their quest for health and stability.

By placing the values of person-centeredness, equity, and professionalism at the core of clinical education and practice, the GCS signal a new era in global health—one that is grounded in inclusion, resilience, and responsiveness. For health systems to thrive in the face of increasing migration and diversity, their workforces must be trained not just to treat diseases, but to understand the social and cultural realities that shape health outcomes.

Georgia’s leadership, through the efforts of PHIG and David Tvildiani Medical University, underscores the power of national ownership, academic innovation, and strategic alignment. It is a model that can inspire other countries, especially those in the WHO European Region, to prioritize the health of displaced communities through systemic reform.

As the global community moves toward achieving the 2030 Sustainable Development Goals, the implementation of GCS provides an essential tool for reducing inequalities and ensuring that no one is left behind. But the time to act is now. The future of migration-aware, competency-driven healthcare depends on the commitment of policymakers, educators, institutions, and practitioners worldwide.

Competency is not just a technical skill—it is a reflection of our shared humanity.

References

International Organization for Migration. World Migration Report 2022. Geneva: IOM; 2022. Available from: https://worldmigrationreport.iom.int/wmr-2022 (Accessed: 22 April 2025)
World Health Organization. Refugee and Migrant Health: Global Competency Standards for Health Workers. Geneva: WHO; 2021. Available from: https://www.who.int/publications/i/item/9789240030626 (Accessed: 22 April 2025)
World Health Organization. Thirteenth General Programme of Work 2019–2023. Geneva: WHO; 2018. Available from: https://www.who.int/about/what-we-do/thirteenth-general-programme-of-work-2019—2023 (Accessed: 22 April 2025)
UNHCR. Global Trends: Forced Displacement in 2023. Geneva: UNHCR; 2024. Available from: https://www.unhcr.org/statistics/unhcrstats/667e2e7e4/global-trends-forced-displacement-2023.html (Accessed: 22 April 2025)
OECD. Health of Migrants: Access and Outcomes in OECD Countries. Paris: OECD Publishing; 2021. Available from: https://www.oecd.org/migration/health-of-migrants-report-2021.htm (Accessed: 22 April 2025)

1...351352353...1,040 გვერდი 352 of 1,040

Refugee & Migrant Health in Medical Education | WHO Competency Standards

One Curriculum, Many Cultures: Embedding Refugee and Migrant Health in Medical Education

Introduction

International Models and Policy Guidance

Georgia’s Leadership and Academic Vision

Recommendations for Academic Institutions

Conclusion

📌 About the Author

Health for All: WHO Competency Standards for Migrants

სიმპტომების სწრაფად ამოცნობა და დაუყოვნებლივი რეაგირება გადამწყვეტია სიცოცხლის გადასარჩენად

პინეო სამედიცინო ეკოსისტემა • Pineo Medical Ecosystem

გსურთ დაბერების შენელება?

გსურთ დაბერების შენელება? – NMN და უჯრედული ენერგია Nature-ის ახალი კვლევის მიხედვით

წყლის დალევა – უბრალო ჩვევა თუ ჯანმრთელობის მძლავრი პრევენცია?

წყლის დალევა – უბრალო ჩვევა თუ ჯანმრთელობის მძლავრი პრევენცია?

Global Competency Standards for Refugee and Migrant Healthcare | Prof. Giorgi Pkhakadze

Introduction

The Rationale for Competency-Based Standards

Global Momentum and Policy Integration

Academic Institutions as Catalysts for Change

Strategic Recommendations

Global Level:

Regional Level (WHO Europe):

National Level (Georgia):

Conclusion

References

ცილების მნიშვნელობა მარხვის დროს

რა რისკებია მარხვის შემდეგ?

როგორ გადავიდეთ მარხვიდან ხსნილზე სწორად?

კვების რეჟიმის სწორად დაგეგმვა

და ბოლოს – დღესასწაული არის სიხარულისთვის, არა გადაჭარბებისთვის

ბოლო სიახლეები

„ჰანტავირუსის“ უფრო მასშტაბური აფეთქების ნიშნები არ არსებობს – ჯანმო

ხანგრძლივი სამუშაო საათები და სიმსუქნე — 5-დღიანი სამუშაო კვირა სიმსუქნის რისკს უკავშირდება

პოპულარული ამბები

არ შეიძინოთ ხორცი მსგავს ადგილებში: საქართველოში ტრიქინელოზი დაფიქსირდა

მომაკვდინებელი პარაზიტი, ბავშვი გარდაიცვალა – საქართველოში შოკისმომგვრელი შემთხვევა დაფიქსირდა

კატეგორიები

ჩვენ შესახებ

გამოგვყევი სოციალურ ქსელებში