Competency mapping of medical officers in charge in Kerala’s family health centers: exploring possibilities and challenges
DOI:
https://doi.org/10.18203/2394-6040.ijcmph20260705Keywords:
Competency mapping, Medical officers, Family health centres, Primary health care, KeralaAbstract
Background: Kerala’s Aardram Mission transformed Primary Health Centres into Family Health Centres (FHCs) to deliver comprehensive primary care. Medical officers in charge (MOICs) are pivotal as clinical leaders and administrators, yet their specific competency requirements in this model remain underexplored. This study, part of a larger competency-mapping initiative by the State Health Systems Resource Centre–Kerala, aimed to identify the roles, responsibilities, and competencies of MOICs to inform targeted capacity-building.
Methods: Competencies were mapped through consultations with health system experts and review of government orders and service delivery frameworks. Using these, in-depth interview guides and observation checklists were developed. Twenty-nine MOICs from randomly selected FHCs across six districts, representing diverse geographic and service contexts, were interviewed. Transcripts were deductively coded against the WHO–ASPHER Competency Framework for the Public Health Workforce in the European Region.
Results: MOICs demonstrated strong competencies in clinical care, disease surveillance, health promotion, and community engagement. They effectively collaborated with local self-governments and other departments, led disaster and outbreak responses, and managed human, financial, and material resources. However, challenges included staff shortages, infrastructure gaps, inconsistent community participation, and limited training in managerial, financial, and administrative skills. Performance appraisal practices were inconsistent, and disaster preparedness knowledge varied. Technology use was growing but constrained by connectivity and equipment gaps.
Conclusion: MOICs in Kerala’s FHCs fulfill multifaceted roles spanning clinical service, leadership, public health, and resource management. Strengthening targeted training particularly in administration, financial management, and disaster preparedness-along with systemic support for staffing and infrastructure, can enhance their capacity to deliver comprehensive primary care.
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Patel V, Kumar A, Paul V, Rao K, Reddy K. Universal health care in India: the time is right. Lancet. 2011;377:448–9. DOI: https://doi.org/10.1016/S0140-6736(10)62044-2
Feroz A. Primary health care: programamtic engine for universal health coverage and sustainable development goals. Health Prim Car. 2021;5:1–2.
Mini GK. Socioeconomic and demographic diversity in the health status of elderly people in a transitional society, Kerala, India. J Biosoc Sci. 2009;41:457–67. DOI: https://doi.org/10.1017/S0021932008003003
Sivasankaran S, Thankappan KR. Prevention of non-communicable diseases requires a life course approach: a case study from Kerala. Indian J Med Res. 2013;137:874–7.
Jayalekshmi P, Gangadharan P, Mani KS. Cancer in women in Kerala--a transition from a less-developed state. Asian Pac J Cancer Prev 2006;7:186–90.
Diallo K, Zurn P, Gupta N, Dal Poz M. Monitoring and evaluation of human resources for health: an international perspective. Human Resources for Health. 2003;1:3. DOI: https://doi.org/10.1186/1478-4491-1-3
Lancet T. The Astana declaration: the future of primary health care. Lancet. 2018;392:1369. DOI: https://doi.org/10.1016/S0140-6736(18)32478-4
Lamberti-Castronuovo A, Valente M, Barone-Adesi F, Hubloue I, Ragazzoni L. Primary health care disaster preparedness: a review of the literature and the proposal of a new framework. Int J Disaster Risk Reduct. 2022;81:103278. DOI: https://doi.org/10.1016/j.ijdrr.2022.103278
World Health Organization and Association of Schools of Public Health in the European Region. WHO-ASPHER Competency Framework for the Public Health Workforce in the European Region. 2020.
Zhao L, Sun T, Sun BZ, Zhao YH, Norcini J, Chen L. Identifying the competencies of doctors in China. BMC Med Edu. 2015;15:207. DOI: https://doi.org/10.1186/s12909-015-0495-y
Hertel-Waszak A, Brouwer B, Schönefeld E, Ahrens H, Hertel G, Marschall B. Medical doctors’ job specification analysis: a qualitative inquiry. GMS J Med Educ. 2017;34:67.
Gulati K, Sarkar C, Verma V, Singh A, Gupta S. Assessment of medical leadership competencies and development needs: first comprehensive study from India. Int J Healthc Manag. 2019;14:1–12. DOI: https://doi.org/10.1080/20479700.2019.1647381
Santric Milicevic MM, Bjegovic-Mikanovic VM, Terzic-Supic ZJ, Vasic V. Competencies gap of management teams in primary health care. Eur J Public Health. 2011;21:247–53. DOI: https://doi.org/10.1093/eurpub/ckq010
Ramokate T, Basu D. Health care waste management at an academic hospital: knowledge and practices of doctors and nurses. S Afr Med J. 2009;99:444–5.
Shoaib M, Ramamohan V. Simulation modeling and analysis of primary health center operations. Simulation. 2022;98:183–208. DOI: https://doi.org/10.1177/00375497211030931
Lall D, Balachandra S, Prabhu P, Kumar D, Mokashi T, Devadasan N. Lessons for the design of comprehensive primary healthcare in India: a qualitative study. J Health Man. 2022;24:31–42. DOI: https://doi.org/10.1177/09720634221076238
Dahrouge S, Muldoon L, Ward N, Hogg W, Russell G, Taylor-Sussex R. Roles of nurse practitioners and family physicians in community health centres. Can Fam Physician. 2014;60:1020–7.
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