7International Ecosystem — Organisations & Frameworks RHWCO Monitors
RHWCO monitors three distinct layers of institutional architecture: the global normative layer (WHO), the European regulatory and policy layer (EU institutions, Council of Europe), and the professional and academic layer (UEMS, ASPHER, AMEE and discipline-specific bodies). The frameworks and actions listed here are the primary sources of competency standards, professional regulation and workforce intelligence relevant to the RHWCO region. Listings do not imply partnership with RHWCO or PHIG.
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WHO — Global & European Layer
WHO Health Workforce Department — principal global normative body; produces UHC (2022), EPHF (2024) and thematic competency frameworks
WHO Global Health Workforce Network — multi-stakeholder platform; Education Hub; produced UHC 2022 framework with 200+ contributors WHO Academy (Lyon) — education, training and implementation arm of WHO; delivers competency-based training at scale WHO Global Health Observatory — Health Workforce — primary source for regional workforce density and distribution data WHO Regional Office for Europe — regional normative authority for 53 member states; produced WHO-ASPHER frameworks; covers all RHWCO countries WHO/Europe Publications — health system reviews, policy briefs, workforce reports for the European Region European Observatory on Health Systems and Policies — HiT country reviews; workforce intelligence; policy synthesis for Europe and RHWCO region |
European Union — Regulatory & Policy Layer
European Commission — Health Workforce — EU policy on health workforce planning, mobility and skills; Joint Actions on HWF; directly relevant to EU candidate RHWCO countries (Ukraine, Moldova, Georgia)
EU4Health Programme 2021–2027 — €5.1B EU health programme; funds workforce resilience, crisis response, health promotion and cancer; RHWCO region EU candidates eligible European Health Union — strategic EU framework; health security, resilience and cross-border cooperation; sets workforce standards for EU alignment Directive 2013/55/EU — Professional Qualifications — regulates mutual recognition of professional qualifications across EU; defines minimum training requirements for 7 regulated health professions (doctor, nurse, dentist, pharmacist, midwife, physiotherapist, veterinarian); critical reference for RHWCO countries pursuing EU alignment European Qualifications Framework (EQF) — 8-level framework for recognition and comparison of qualifications across Europe; reference point for RHWCO countries standardising health education credentials EU Skills Agenda & Green / Digital Transitions — European skills policy; includes health sector upskilling; relevant to digital health and climate competencies tracked by RHWCO Programme 7 |
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Council of Europe — Rights & Ethics Layer
46 member states — includes all RHWCO countries
Council of Europe — 46 member states; human rights framework underpinning health worker obligations; all RHWCO countries are members Oviedo Convention (1997) — Convention on Human Rights and Biomedicine; sets ethical standards for medical practice, research and consent across all CoE states; binding framework for health professional conduct European Social Charter (1961/1996) — guarantees the right to health protection (Article 11) and the right to safe and healthy working conditions (Article 3) for health workers; applies across RHWCO region European Medicines Agency (EMA) — pharmaceutical regulation; pharmacovigilance competencies; directly relevant to pharmacy workforce training standards in RHWCO region Bologna Process — European Higher Education Area; three-cycle degree system; competency-based curricula reform; all RHWCO countries are Bologna signatories — the primary structural lever for CBE reform in the region Europass Framework — CV, diploma supplement, skills passport; credential recognition infrastructure; RHWCO countries use Europass as the practical mechanism for qualifications portability |
EU Agencies — Health Security & Surveillance
ECDC — EPIET/EUPHEM Programmes — European Programme for Intervention Epidemiology Training and European Public Health Microbiology; two-year competency-based fellowship programmes; direct relevance to public health workforce competencies in RHWCO countries seeking EU alignment
ECDC — European Centre for Disease Prevention and Control — field epidemiology training; IPC competencies; emergency preparedness workforce; covers EU and partner countries including Georgia and Ukraine through joint programmes European Medicines Agency (EMA) — regulatory science competencies; pharmacovigilance; Good Clinical Practice training; regulatory workforce development relevant to RHWCO countries seeking EU market alignment European Association of Hospital Pharmacists (EAHP) — competency framework for hospital pharmacy; statements on hospital pharmacy practice; relevant to pharmaceutical workforce development across RHWCO region EU Health Security Committee — coordinates cross-border health security; IHR implementation at EU level; emergency health workforce competencies; relevant to Ukraine and Moldova (EU candidates) and Georgia (EU associate) |
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ASPHER · EUPHA · EPHA — Public Health Layer
ASPHER — Association of Schools of Public Health in the European Region; produced WHO-ASPHER competency frameworks (2020) and Professionalization Roadmap (2022); accreditation programme for schools of public health; core curriculum; central to RHWCO’s competency architecture
EUPHA — European Public Health Association; annual European Public Health Conference; workforce section; policy advocacy; publishes European Journal of Public Health EPHA — European Public Health Alliance; advocacy and civil society voice on health workforce and public health policy at EU level TEPHINET — Training Programmes in Epidemiology and Public Health Interventions Network; global network of FETPs; competency-based epidemiology training; RHWCO region countries have FETP programmes (Georgia, Ukraine, Kazakhstan, Kyrgyzstan) IANPHI — International Association of National Public Health Institutes; institutional model; PHIG is a member; framework for EPHI functions and capacity; connects RHWCO’s institutional base to the global PHI network |
UEMS & European Professional Bodies
UEMS — Union Européenne des Médecins Spécialistes — European medical specialists; sets postgraduate medical training standards across 47 member organisations; Prof. Pkhakadze is Secretary/Treasurer of the UEMS Section of Public Health; European Training Requirements (ETRs) for each specialty define minimum competency standards for specialist recognition
UEMS Section of Public Health — European training requirements for public health medicine specialists; competency standards for PH physicians; directly linked to RHWCO through Prof. Pkhakadze’s role WONCA Europe — World Organisation of Family Doctors European Region; European Definition of General Practice/Family Medicine; competency framework for GPs; highly relevant to PHC reform across RHWCO region PGEU — Pharmaceutical Group of the European Union — community pharmacy competencies and professional standards; relevant to pharmacy workforce development HOPE — European Hospital and Healthcare Federation — hospital management and leadership competencies; Exchange Programme; connects hospital managers across Europe including RHWCO region countries European Nursing Organisations (EFN, ENA) — nursing competency standards; Directive 2013/55/EU nursing minimum training requirements; critical reference for nursing workforce reform in RHWCO countries |
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Health Professions Education & Training
AMEE — Association for Medical Education in Europe — leading international medical education organisation; AMEE Guides on CBE methodology; ESME courses; Medical Teacher journal; principal methodology reference for RHWCO Programmes 5 and 6
European Training Foundation (ETF) — EU agency for human capital development in partner countries; directly active in Caucasus and Central Asia; skills and qualifications systems reform; workforce intelligence for RHWCO non-EU countries WFME — World Federation for Medical Education — global standards for basic, postgraduate and CPD medical education; WFME recognition of medical schools; accreditation framework; reference for medical education reform across RHWCO region CanMEDS Framework (Royal College of Canada) — physician competency framework widely adopted internationally; 7 roles (Medical Expert, Communicator, Collaborator, Leader, Health Advocate, Scholar, Professional); methodology reference for RHWCO competency architecture ACGME Milestones — competency-based postgraduate medical education; milestone-based developmental assessment; reference for RHWCO Programme 6 (Assessment Research) Maastricht University — FHML/CAPHRI — academic home of WHO-ASPHER framework team (Czabanowska, Otok et al.); problem-based learning origin; health professions education research |
Workforce Intelligence, Financing & Research
OECD Health — Health at a Glance series; Health Working Papers; comparative workforce data for OECD countries; policy recommendations on supply, training and international mobility
World Bank Health Workforce — Human Capital Index; workforce financing; reform lending programmes active in Kazakhstan, Uzbekistan, Ukraine and Georgia EU Joint Action on Health Workforce — joint actions on HWF planning, forecasting and needs assessment; methodology applicable to RHWCO EU candidate countries ILO — International Labour Organization — Decent Work Agenda in health sector; Care Economy framework (health and care as employment sector); skills and lifelong learning policy; Nursing Personnel Convention C149 (minimum standards for nursing workforce); active in Central Asia through country programmes Public Health Reviews (BioMed Central) — open-access journal; workforce and public health systems research; RHWCO region authors regularly published Human Resources for Health (BioMed Central) — leading peer-reviewed journal on HWF policy, planning and development; primary publication target for RHWCO outputs Faculty of Public Health (UK) — professionalization reference; competency curriculum; membership examination; CPD framework; professional standards for public health practitioners |
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ILO — Health Workforce: Labour, Rights and Skills
The ILO frames health workforce from a labour market perspective — complementary to WHO’s competency and public health lens. Together they form the two principal international bodies for workforce development; the combined view (competency + labour conditions + skills) is essential for RHWCO country profiles.
ILO International Labour Standards — Nursing Personnel Convention C149 (1977): the only binding international treaty specifically on health workforce; minimum standards for nursing education, training, working conditions and employment; ratification status assessed in every RHWCO country profile |
UNESCO — Education, Classification and Qualifications Architecture
UNESCO provides the global education and qualifications architecture within which health workforce competency frameworks are implemented. Where WHO defines what competencies health workers need and ILO defines their labour conditions, UNESCO defines how education systems classify, deliver and certify those competencies.
ISCED — International Standard Classification of Education — the universal standard for classifying education programmes; Health and Welfare at Field 09 covers all health workforce education; ISCED levels (5–8) structure all comparative health education data across RHWCO countries; without ISCED literacy, health workforce competency data across the region is incomparable |
11Key References
Core academic and institutional literature informing RHWCO’s conceptual framework and methodology. Vancouver citation style.
Foundational theory
- Frenk J, Chen L, Bhutta ZA, et al. Health professionals for a new century: transforming education to strengthen health systems in an interdependent world. Lancet. 2010;376(9756):1923–58. doi:10.1016/S0140-6736(10)61854-5
- Frank JR, Snell L, Ten Cate O, et al. Competency-based medical education: theory to practice. Med Teach. 2010;32(8):638–45. AMEE
- Ten Cate O. Entrustability of professional activities and competency-based training. Med Educ. 2005;39(12):1176–7.
- World Health Organization. Transforming and scaling up health professionals’ education and training. Geneva: WHO; 2013. WHO guidelines
WHO normative frameworks
- World Health Organization. Global competency and outcomes framework for universal health coverage. Geneva: WHO; 2022. ISBN 978-92-4-003466-2. who.int
- World Health Organization. Global competency and outcomes framework for the essential public health functions. Geneva: WHO; 2024. who.int
- World Health Organization. Global competency standards for health workers working with refugees and migrants. Geneva: WHO; 2021. who.int
- World Health Organization. Competency frameworks and standards for digital health: a landscape analysis. Geneva: WHO; 2026. who.int
- World Health Organization. Self-care competency framework: global competency standards. Geneva: WHO; 2023. who.int
European & regional frameworks
- Czabanowska K, Shickle D, Burazeri G, et al. Competency framework for the public health workforce in the European Region. Copenhagen: WHO/Europe & ASPHER; 2020. who.int/europe
- WHO Regional Office for Europe, ASPHER. Roadmap to professionalizing the public health workforce in the European Region. Copenhagen: WHO/Europe; 2022. who.int/europe
- Burazeri G, Czabanowska K, Laaser U, Kark JD. Postgraduate public health education in South-East Europe—heads of schools’ perspectives. Public Health Rev. 2014;35(2). doi:10.1007/BF03391706
Workforce intelligence & assessment
- Frank JR, Mungroo R, Ahmad Y, Wang M, De Rossi S, Horsley T. Toward a definition of competency-based education in medicine: a systematic review of published definitions. Med Teach. 2010;32(8):631–7.
- World Health Organization. Health workforce 2030: towards a global strategy on human resources for health. Geneva: WHO; 2016. who.int
- OECD. Health at a Glance 2023: OECD Indicators. Paris: OECD Publishing; 2023. oecd.org
- Royal College of Physicians and Surgeons of Canada. CanMEDS 2015 Physician Competency Framework. Ottawa: Royal College; 2015. royalcollege.ca
ILO & UNESCO — Labour and Education Instruments
- International Labour Organization. Nursing Personnel Convention (C149). Geneva: ILO; 1977. ilo.org/international-labour-standards
- International Labour Organization. Nursing Personnel Recommendation (R157). Geneva: ILO; 1977. Companion instrument to C149.
- International Labour Organization. Care work and care jobs for the future of decent work. Geneva: ILO; 2018. ILO Care Economy
- UNESCO. Global Convention on the Recognition of Qualifications Concerning Higher Education. Paris: UNESCO; 2019. unesco.org
- UNESCO Institute for Statistics. International Standard Classification of Education: ISCED 2011. Montreal: UIS; 2012. uis.unesco.org
- UNESCO-UNEVOC. Skills Development in the Health Sector. Bonn: UNESCO-UNEVOC; 2023. unevoc.unesco.org
This reference list covers the primary academic and institutional sources underlying RHWCO’s work. The full RHWCO knowledge base, including annotated framework records with complete bibliographic data, is maintained in the RHWCO Competency Intelligence Hub (Programme 1). Additional references appear inline throughout this page.
Regional Health Workforce Competency Observatory (RHWCO) · An initiative of the Public Health Institute of Georgia (PHIG) · Established 2025 · Based in Tbilisi, Georgia
Scientific Director: Prof. Giorgi Pkhakadze, MD, MPH, PhD · ORCID 0000-0001-7609-4515 · Chair, PHIG · Head, School of Public Health, David Tvildiani Medical University · WHO Consultant, Special Initiative for Health and Migration, Geneva · Secretary/Treasurer, UEMS Section of Public Health
Geographic scope: Caucasus · Eastern Europe · Central Asia · Türkiye
Related PHIG observatories: Health & Migration Observatory · Country Assessment Tool · Georgian Medical Journal
Scientific independence: RHWCO is an independent PHIG initiative. References to WHO, EU institutions, ASPHER, professional organisations and other bodies identify relevant source materials and do not imply institutional endorsement of RHWCO or partnership with PHIG unless explicitly stated. Inclusion in the RHWCO knowledge base does not imply endorsement, affiliation or partnership.
Scientific Director: Prof. Giorgi Pkhakadze, MD, MPH, PhD · ORCID 0000-0001-7609-4515 · Chair, PHIG · Head, School of Public Health, David Tvildiani Medical University · WHO Consultant, Special Initiative for Health and Migration, Geneva · Secretary/Treasurer, UEMS Section of Public Health
Geographic scope: Caucasus · Eastern Europe · Central Asia · Türkiye
Related PHIG observatories: Health & Migration Observatory · Country Assessment Tool · Georgian Medical Journal
Scientific independence: RHWCO is an independent PHIG initiative. References to WHO, EU institutions, ASPHER, professional organisations and other bodies identify relevant source materials and do not imply institutional endorsement of RHWCO or partnership with PHIG unless explicitly stated. Inclusion in the RHWCO knowledge base does not imply endorsement, affiliation or partnership.
Cite this page: Public Health Institute of Georgia, Regional Health Workforce Competency Observatory. Ecosystem. Version 5.1, 6 October 2026. https://publichealth.ge/rhwco/ecosystem/ (accessed: add date). Licence CC BY 4.0. Data from WHO NHWA/World Bank WDI are CC BY 4.0 and cited at source.