How Exeter is helping to strengthen primary care expertise globally

The COVID-19 pandemic has placed the importance of public health and primary care into sharp focus – not only in treating people with Covid, but to facilitate vaccine distribution. Managing the impact of the virus is carried out in community settings, and the World Health Organisation has increasingly highlighted the importance of primary care as the most cost-effective way of improving health.

Yet many countries around the world are struggling with inadequate primary care systems, hampering not only their response to the pandemic, but to other chronic conditions such as obesity and diabetes. There is often a disconnect between public health policy and primary care practice – with primary care training and continuing development remaining beyond the reach of many practitioners.

To help address this issue, Professor Alex Harding and his colleagues at the College of Medicine and Health have joined forces with medical professionals, commercial providers of primary care software systems and NGOs to run a new online course: Principles of Primary Care International CPD.

The inaugural course in January attracted 20 health practitioners from across the world, including GPs, nurses, project managers and recently graduated medical students from Africa, Asia, Europe and North America. Many of these participants from low and middle-income countries were supported by the generous donations of supporters through a philanthropic scholarship fund.

The course aims to help health professionals strengthen primary care in their own countries, building their ability to make a meaningful, practical impact in their communities. It gives them the opportunity to:

• Explore the core concepts of both public health and primary care to provide an integrated approach.
• Take away a toolkit of practical skills to help them put learning into practice: with ongoing mentorship from the faculty, participants design a project that can improve primary care provision in their area.
• Participate in an ongoing ‘knowledge exchange’, where participants and alumni from across the globe support each other and share solutions to common problems.

Dr Adam Bitunguramye, a GP at Munini Hospital, Republic of Rwanda, was one of the participants. He said: “I want to acquire more knowledge and skills to be able to improve the health of the population, especially in the remote area of Rwanda where infrastructure usually hinders the effective delivery of primary care services.”

According to Dr Bitunguramye, poor antenatal care is a particular issue that contributes to increased deaths among mothers. “The majority of these deaths are preventable, and might be linked to inadequate antenatal care,” he said. “Upon completing this module, I will be in the position to undertake research on how to increase antenatal care, especially in the rural community.”

Another participant commented: “The course was helpful as a whole because it brought into sharper focus the importance of primary care. The knowledge exchange sessions were particularly helpful as we got the chance to exchange and share ideas from different countries.”

The course has recently been endorsed by Wendy Morton, MP and Minister for Global Health at the UK Foreign, Commonwealth and Development Office, and by the World Health Organisation.

Following its early success, Professor Harding is aiming to run it at least every six months. He said:

Our ambition is to offer the course to a growing number of health professionals from low and middle-income countries to continue to support capacity building in primary care to improve health care outcomes. Our next virtual course will run in November, and we’ve also just won a grant to deliver the course in Nepal.

Anyone wanting to support the next cohort of practitioners can do so through the Scholarship Fund.

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