1Foundational International Frameworks
RHWCO draws on an established international competency architecture built over two decades. The frameworks below constitute the primary normative reference layer for RHWCO’s work. Inclusion identifies source materials; it does not imply institutional endorsement of RHWCO by the issuing organizations.
|
World Health Organization · Geneva · 2022
Global Competency and Outcomes Framework for Universal Health Coverage
116 pages · 6 domains · 24 competencies · 35 practice activities · ISBN 978-92-4-003466-2
The principal conceptual reference for all RHWCO work. Developed through the WHO Global Health Workforce Network Education Hub with more than 200 contributors across professions and countries, this framework provides a common competency language applicable across all health occupations. It directly connects population health needs to practice activities to competencies to behaviours to learning outcomes to curriculum — the same chain RHWCO adopts as its conceptual spine. The six domains (People-centredness; Decision-making and problem-solving; Communication; Collaboration and teamwork; Evidence-informed practice and learning; Personal and professional conduct) are designed to be contextualised nationally and by profession. RHWCO uses this framework as the common reference point across all country profiles, thematic analyses and comparative studies.
|
World Health Organization · Geneva · 2024
Global Competency and Outcomes Framework for the Essential Public Health Functions
Second major RHWCO pillar · WHO National Workforce Capacity for EPHFs Collection · 2024
Extends the UHC competency architecture specifically to the public-health workforce delivering Essential Public Health Functions — epidemiology, surveillance, health promotion, health protection, emergency preparedness, environmental health and leadership. Particularly important for RHWCO because the Caucasus and Central Asia still maintain large public-health institute systems inherited from the Soviet sanitary-epidemiological service. The EPHF framework maps competencies across: workforce functions → competency domains → behaviours → educational outcomes → capacity requirements. Part of the broader WHO EPHF Workforce Capacity Collection which includes an operational handbook and workforce enumeration guidance. RHWCO uses this as the core reference for Programme 3 — Public Health Workforce.
Collection includes: EPHF operational handbook · workforce enumeration guidance · implementation case studies
|
|
WHO Regional Office for Europe · ASPHER · 2020
Competency Framework for the Public Health Workforce in the European Region
Developed with the Association of Schools of Public Health in the European Region
Critically important for RHWCO: the geographic scope of the WHO European Region encompasses 53 member states including Georgia, Armenia, Azerbaijan, Ukraine, Moldova, Kazakhstan and Kyrgyzstan. This framework was explicitly designed as a starting point for context-specific competency development — precisely the function RHWCO supports at national level. It covers nine competency areas: public health sciences; methods and tools; assessment of population health needs and determinants; policy formulation; communication; leadership and management; partnerships; equity and ethics; public-health specialisation. The framework addresses workforce planning, continuing professional development, recruitment, accreditation, credentialing and quality assurance. Authors: Czabanowska, Shickle, Burazeri, Gershuni, Otok, Azzopardi-Muscat — many of whom are central figures in ASPHER and WHO/Europe workforce development.
|
WHO Regional Office for Europe · ASPHER · 2022
Roadmap to Professionalizing the Public Health Workforce in the European Region
Moves beyond competency frameworks to professional system architecture
Competency frameworks do not self-implement. This roadmap addresses the regulatory, institutional and systemic mechanisms required to make competency-based approaches operational: professional identity and registration; credentialing and certification systems; career pathway structures; CPD requirements; regulation and governance frameworks; workforce planning methodology. RHWCO uses this as the conceptual basis for Programme 6 (Assessment Research) and Programme 5 (Competency-Based Education) — because the evidence is clear that competency standards achieve sustained workforce improvement only when embedded in functioning professional and regulatory systems. Produced by WHO/Europe and ASPHER, it is directed at governments, ministries of health, health authorities, public-health institutes, education institutions, professional bodies and employers across the region.
|
Thematic Competency Frameworks — Active RHWCO Tracks
|
WHO · 2021 · Refugee & Migrant Health · Active RHWCO track
Global Competency Standards for Health Workers Working with Refugees and Migrants
Nine global competency standards covering: health systems and migrants; communication and language; culturally sensitive care; mental health; infectious diseases; sexual and reproductive health; non-communicable diseases; emergency and humanitarian care; advocacy and ethics. Full implementation package: Standards document → Knowledge Guide → Curriculum Guide → Training. PHIG and DTMU delivered the WHO Competency Standards training in Riga, September 2024 as part of a WHO/IOM/EU project covering 10 European countries and training Ukrainian refugee health mediators. This is an active RHWCO implementation track under Programme 4.
|
WHO · 2023 · Self-Care
Self-care Competency Framework: Global Competency Standards
Ten competency standards structured around: self-care concepts and evidence; enabling environments; communication; counselling; support and follow-up; equity and ethics. Full implementation package: Standards → Knowledge Guide → Curriculum Guide. Critical RHWCO reference model: the Self-Care CS family is among the most operationally complete WHO competency packages available — it demonstrates precisely how global competency standards translate into teachable, assessable educational programmes with standardised learning outcomes. RHWCO uses this as a case study in the operationalization pathway: standard → knowledge → curriculum → delivery → assessment → practice change.
|
|
WHO · 2022 · HIV Module — Adaptation methodology
HIV Module: Global Competency and Outcomes Framework for UHC
Maps HIV prevention, treatment, care and support services onto the practice activities of the parent UHC Competency Framework — a Type C thematic adaptation: specific health services are mapped onto existing cross-cutting competency architecture rather than creating a parallel, disconnected system. This modular approach — anchoring thematic expansions to the UHC framework — is the methodology RHWCO will use for future thematic adaptations including Patient Safety, Emergency Preparedness, NCDs and Mental Health. Related: WHO HIV Knowledge Guide and Curriculum Guide.
|
WHO · June 2026 · Digital Health — Emerging competency stream
Competency Frameworks and Standards for Digital Health: A Landscape Analysis
The most recent major WHO competency publication. Synthesises the rapidly evolving landscape of digital health competency frameworks across six recurring areas: patient care and clinical informatics; data management and governance; communication and digital health literacy; technical proficiency; digital professionalism; and leadership in digital transformation. Produced as part of the WHO Global Initiative on Digital Health (GIDH). RHWCO has designated Digital Health & AI as a dedicated emerging competency stream under Programme 7, noting that the field is developing rapidly and monitoring must precede standard-setting.
|
ILO & UNESCO Instruments — Labour, Education and Qualifications Perspective
|
International Labour Organization · 1977 · Convention C149
Nursing Personnel Convention and Recommendation R157
Only binding international treaty specifically on health workforce · Complements WHO competency standards with labour rights
ILO Convention C149 on Nursing Personnel (1977) and its accompanying Recommendation R157 are the sole binding international instruments devoted specifically to health workforce standards — predating all WHO competency frameworks. C149 requires ratifying states to adopt policies for nursing education and training that meet the needs of the population, and working conditions enabling nurses to carry out their professional responsibilities. Recommendation R157 elaborates on: entry requirements; duration and curriculum of nursing education; practical training; continuing education; career structures; and working conditions. RHWCO treats C149 ratification status and implementation as a baseline indicator in country profiles for the regulatory and rights environment of the nursing workforce — the single largest health worker cadre in every RHWCO country. Complementary instruments: ILO Labour Standards on occupational safety, working hours and social protection applicable to all health workers.
ILO International Labour Standards → Related: ILO Care Economy framework · Decent Work Agenda for health workers · ILO-WHO joint statement on health worker safety
|
UNESCO · 2019 · Global Convention · ISCED 2013
UNESCO Global Convention on Recognition of Qualifications in Higher Education & ISCED
Global Convention: 113 signatories · Only global binding treaty on qualifications recognition · ISCED: universal education classification system
Two UNESCO instruments are directly operative across all RHWCO countries and essential for understanding health workforce education systems. The UNESCO Global Convention on Recognition of Qualifications (2019) — the first global legally binding treaty on mutual recognition of higher education qualifications — directly enables cross-border recognition of health professional credentials. For RHWCO countries where diploma non-recognition is a primary driver of brain drain and a barrier to managed migration, this Convention provides the legal framework for remediation. ISCED 2013 (International Standard Classification of Education) is the universal standard for classifying education programmes; Health and Welfare at Field 09 is the classification covering all health workforce education globally. ISCED levels (5–8) and fields structure all comparative health education data across RHWCO countries. Without ISCED literacy, health workforce competency data across the region is incomparable. Related: IIEP Paris — health workforce education planning methodology; UNESCO-UNEVOC health sector skills — mid-level and allied health training.
|
These frameworks are produced by their respective issuing organisations. Inclusion in the RHWCO knowledge base identifies source materials and does not imply institutional endorsement of RHWCO or partnership with PHIG unless explicitly stated elsewhere.
2bEU & European Regulatory Framework Architecture
The European regulatory layer operates through legally binding instruments, recognition directives and funding programmes distinct from WHO normative frameworks. For the RHWCO region — Georgia, Ukraine and Moldova are EU candidates or associates; all 12 RHWCO countries are Council of Europe members — this architecture is directly operative or a proximate policy target for national health workforce reform.
|
European Union · Directive 2013/55/EU
Professional Qualifications Directive — Minimum Training Requirements for Health Professions
Binding across 27 EU member states · Reference standard for EU candidate countries including Georgia, Ukraine, Moldova
The EU’s primary instrument for mutual recognition of health professional qualifications. Sets legally binding minimum training requirements for seven health professions: doctors (general and specialist), nurses, dental practitioners, pharmacists, midwives and physiotherapists. These EU minimums are de facto competency standards — any professional trained to Directive requirements is recognised across all 27 member states. For Georgia, Ukraine and Moldova, aligning national training to Directive 2013/55/EU standards is a precondition for professional mobility within the EU. RHWCO maps national training requirements against these EU minimums in country profiles.
Automatic recognition for: Doctor · Nurse (general care) · Dental practitioner · Pharmacist · Midwife · Physiotherapist · Veterinarian
|
Bologna Process · 1999 · All 12 RHWCO countries are signatories
European Higher Education Area — Three-Cycle System and Learning Outcomes Framework
49 signatory countries · ECTS credit system · Diploma Supplement · Qualifications Frameworks
The most significant structural lever for competency-based education reform available in the RHWCO region. All 12 RHWCO countries are Bologna signatories. The three-cycle system (Bachelor / Master / Doctoral), European Credit Transfer System, learning outcomes framework and Diploma Supplement create the infrastructure within which health education competency reforms are implemented. The shift from input-based (years of study) to outcome-based (what the graduate can do) curricula — the Bologna reform’s core contribution — is the mechanism through which WHO competency frameworks become operational in health education programmes. RHWCO’s Programme 5 (Competency-Based Education) works explicitly within the Bologna architecture.
EHEA — European Higher Education Area → Related: European Qualifications Framework (EQF) · National Qualifications Frameworks · Europass Diploma Supplement
|
|
Council of Europe · 1997 · ETS No. 164
Oviedo Convention on Human Rights and Biomedicine
Only legally binding international bioethics treaty · All RHWCO countries are CoE members · Ratification varies
The Council of Europe’s foundational bioethics instrument and the only legally binding international treaty on biomedicine. Sets the ethical framework for health professional practice: primacy of the individual, informed consent, privacy, equitable access, and prohibition of financial gain from the human body. Directly relevant to RHWCO because professional ethics is a competency domain — the WHO UHC Framework includes Personal and Professional Conduct as one of its six core domains. RHWCO tracks Oviedo ratification and implementation as a component of the ethics and regulatory environment in each country profile. Related: European Social Charter guarantees the right to health (Art. 11) and safe working conditions (Art. 3) for health workers across all CoE member states.
Additional Protocols: genetic testing · biomedical research · organ transplantation. European Social Charter (1961/1996) — rights of health workers
|
European Commission · EU4Health Programme · 2021–2027
EU4Health — European Health Funding and Health Union Framework
€5.1 billion · Health workforce resilience an explicit priority · EU candidate countries increasingly in scope
The EU’s primary direct health investment instrument, with health workforce resilience as a named priority: shortages, skills, geographic distribution, crisis preparedness. EU4Health directly funds EU member states and shapes the competency standards and workforce expectations that EU candidate countries (Georgia, Ukraine, Moldova) must align with during accession. The European Health Union framework — cross-border health security, resilience, crisis response — sets the European strategic context within which RHWCO countries are expected to develop compatible workforce competencies. HERA (Health Emergency Preparedness and Response Authority), created post-COVID, adds a health security workforce dimension directly relevant to RHWCO Programme 4 (Emergency Preparedness track).
Related: EU Joint Action on Health Workforce · HERA · European Health Union · EU Beating Cancer Plan workforce dimension
|
5Framework Comparison — WHO UHC · WHO EPHF · WHO-ASPHER European
The three foundational frameworks RHWCO uses are complementary, not competing. Understanding their scope, intended audience and architecture is essential before selecting a framework basis for national or institutional work.
| WHO UHC Framework 2022 · Geneva |
WHO EPHF Framework 2024 · Geneva |
WHO-ASPHER European 2020 · Copenhagen/Brussels |
|
| Intended workforce | All health workers across all occupations globally | Public-health workforce delivering Essential Public Health Functions | Public-health workforce in the WHO European Region (53 states) |
| Geographic scope | Global — all countries, all income levels | Global — all countries, all income levels | Regional — WHO European Region; directly applicable to all RHWCO countries |
| Architecture | 6 domains → 24 competencies → 35 practice activities → behaviours → learning outcomes | EPHF functions → workforce roles → competency domains → behaviours → education outcomes | 9 competency areas → sub-competencies → workforce planning, CPD, accreditation links |
| Entry point | Population health needs → health services → practice activities → competencies | Essential Public Health Functions → workforce → competencies | Competency areas defined from public health practice and education |
| Adaptation model | Explicit: Type A (national), Type B (professional), Type C (thematic) | Context-specific adaptation expected; operational handbook provided | Explicitly designed as a starting point for national context-specific development |
| Regulatory link | Links to education and curriculum; regulatory embedding not specified | Links to workforce capacity planning and EPHFs delivery | Explicit regulatory dimension: registration, CPD, credentialing, accreditation |
| Companion professionalization tool | — | EPHF operational handbook + workforce enumeration guidance | WHO-ASPHER Roadmap to Professionalizing the PHW (2022) |
| RHWCO primary use | Common reference language across all country profiles, thematic analyses and cross-country comparisons | Core reference for Programme 3 (Public Health Workforce) and EPHF mapping | Primary reference for European-region countries; contextualisation guidance; professionalization roadmap |
| Key limitation | Global scope requires substantial national contextualisation; no regulatory embedding | Public-health-specific; does not cover clinical or allied-health workforce | European Region scope; predates WHO EPHF 2024 (partial overlap requires reconciliation) |
| Relationship | Complementary: UHC provides the cross-cutting language for all workers; EPHF extends it specifically to public health functions; WHO-ASPHER provides the regional contextualisation and professionalization architecture. RHWCO uses all three in combination. | ||
Cite this page: Public Health Institute of Georgia, Regional Health Workforce Competency Observatory. Frameworks. Version 5.1, 6 October 2026. https://publichealth.ge/rhwco/frameworks/ (accessed: add date). Licence CC BY 4.0. Data from WHO NHWA/World Bank WDI are CC BY 4.0 and cited at source.