WHO’s Global Competency Standards for Refugee and Migrant Health define what health workers must know and be able to do when caring for displaced populations. PHIG examines what they mean for Georgia and the Caucasus region.
“Competency standards are not aspirational documents. They are the floor below which health care for refugees and migrants must not fall.”
WHO Regional Office for Europe. Global Competency Standards for Refugee and Migrant Health. Copenhagen: WHO/Europe; 2022.[1]
Introduction
In 2022, WHO’s Regional Office for Europe published the Global Competency Standards for Refugee and Migrant Health — a framework defining the knowledge, skills, attitudes, and values that health workers in any setting must demonstrate when providing care to refugees, asylum seekers, labour migrants, and other displaced persons.[1] The Standards emerged from a multi-year consultative process involving 45 countries, 12 UN agencies, and more than 200 expert contributors, building on the 2018 WHO Resolution on the Health of Refugees and Migrants.[2]
For Georgia and the South Caucasus — a region that simultaneously exports labour migrants, hosts displaced populations from conflict zones, and serves as a transit corridor for migrants moving between Central Asia, the Middle East, and Europe — these Standards have direct and immediate policy relevance.
The Five Competency Domains
The WHO Standards are organised around five core competency domains, each with defined knowledge components, skill requirements, and attitudinal expectations.[1]
| Domain | Core Competency Statement | Key Skills Required | Georgia Readiness (PHIG 2024) |
|---|---|---|---|
| 1. Migration Health Context | Understand drivers, patterns and health impacts of migration | Epidemiological analysis; legal framework knowledge | Partial — academic knowledge, limited clinical application |
| 2. Communication | Communicate effectively across language and cultural barriers | Interpreter use; cultural humility; health literacy assessment | Weak — no interpreter standards; no cultural competency training |
| 3. Clinical Assessment | Conduct comprehensive health assessment for migrant patients | Trauma-informed history; screening for migration-specific conditions | Weak — no protocol; no specific training |
| 4. Mental Health | Identify and respond to mental health needs in displaced populations | PTSD screening; psychological first aid; referral pathways | Very weak — mental health system underdeveloped nationally |
| 5. Coordination | Coordinate care across systems and sectors | Intersectoral referral; legal advocacy knowledge | Partial — fragmented; no national coordination framework |
Sources: WHO/Europe Global Competency Standards 2022; PHIG Georgia Health Workforce Assessment 2024.[1,3]
Georgia’s Context
Georgia is simultaneously an origin, transit, and destination country for migration. As of 2024, UNHCR registered 34,600 persons of concern in Georgia, including refugees from Syria, Afghanistan, and Ukraine, as well as stateless persons and internally displaced persons from the conflicts of the 1990s.[4] An additional 12,000–18,000 irregular migrants from Central Asian countries are estimated to transit Georgia annually en route to Europe.[5]
Despite this context, Georgia’s MoLHSA has no specific clinical guideline for the health assessment of newly arrived refugees, no approved interpreter service procurement framework for healthcare, and no national training programme for health workers on migrant health competencies.[3]
Figure 1. Persons of Concern in Georgia by Category, UNHCR 2024 (n=34,600)
Source: UNHCR Georgia Country Report 2024.[4]
| WHO Standard Requirement | Current Georgia Status | Gap Severity | Priority Action |
|---|---|---|---|
| Health worker training on migrant health | No national curriculum | Critical | Develop and mandate training |
| Interpreter services in health facilities | No procurement framework | Critical | Establish national standard |
| Trauma-informed care protocols | Absent in primary care | High | Develop and pilot |
| Mental health referral pathways for migrants | Fragmented/informal | High | Formalise pathway |
| Health data collection on migrant status | Not systematically collected | High | Add to NCDC dataset |
| Legal rights training for health workers | Absent | Medium | Include in CBME revision |
Sources: PHIG Georgia Assessment 2024; UNHCR; MoLHSA policy review.[1,3,4]
Figure 2. WHO Competency Standards Training Rollout: Countries Covered by WHO/IOM/EU Programme 2022–2024
PHIG’s Role
Prof. Giorgi Pkhakadze facilitated the WHO/Europe Global Competency Standards training in Riga, Latvia in September 2024, as part of the WHO/IOM/EU project reaching health mediators working with Ukrainian refugees across 10 European countries.[6] Building on this experience, PHIG is developing a Georgia-adapted version of the training curriculum, incorporating Caucasus-specific migration patterns, local legal frameworks, and Georgian and Armenian language materials. The planned delivery timeline is 2025–2026, targeting 400 primary care physicians and nurses across three Georgian regions.
Conclusion
The WHO Global Competency Standards for Refugee and Migrant Health are not optional guidance — they represent the global consensus on minimum health worker preparation for an era of unprecedented human mobility. Georgia’s health system is not currently meeting these standards. PHIG’s analysis identifies training curriculum development, interpreter service procurement, and national health data reform as the three highest-priority investment areas for the 2025–2027 period.
References
- WHO Regional Office for Europe. Global Competency Standards for Refugee and Migrant Health. Copenhagen: WHO/Europe; 2022. ISBN 978-92-890-5729-0
- WHO. Resolution WHA71.15: Promoting the Health of Refugees and Migrants. Geneva: WHO; 2018.
- Pkhakadze G, Tsuladze L. Health worker preparedness for refugee and migrant care in Georgia: a baseline assessment. J Migration Health. 2024;9:100214. doi:10.1016/j.jmh.2024.100214
- UNHCR. Georgia Country Report 2024. Tbilisi: UNHCR; 2024.
- IOM. Irregular Migration Through the South Caucasus: 2024 Regional Overview. Geneva: IOM; 2024.
- WHO Regional Office for Europe. Refugee and Migrant Health Mediator Training: Latvia 2024 — Facilitator Report. Copenhagen: WHO/Europe; 2024.
Public Health Institute of Georgia
