The Future of Work in Primary Health Care (PHC): Emerging Roles and Skillsets
The Future of Work in Primary Health Care (PHC): Emerging Roles and Skillsets Primary Health Care (PHC) remains the foundational pillar for strengthening health systems, including progress towards the achievement of Universal Health Coverage (UHC). For this to be realised, PHC must be redesigned to strengthen the health workforce to be resilient, responsive, inclusive, and digitally enabled. It is on this premise that Amref International University and its partners convened the 2nd Primary Health Care Congress under the theme: Redesigning Primary Health Care: Building Resilience Amid Global Uncertainty. Among the most compelling discussions was a plenary session hosted by the Africa Health Collaborative (AHC). The programme convened partners, policymakers, and practitioners for a timely discussion on “The Future of Work in Primary Health Care: Emerging Roles and Skillsets.” At the centre of the conversation was a stark reality. Africa is projected to face a shortage of 6.1 million health workers by 2030. This is not a distant concern, as it is already visible in overstretched health systems, long patient queues, and health workers managing overwhelming workloads, as elaborated by Timothy Kinoti, Learning Facilitator, Africa Health Collaborative (University of Toronto). Yet the conversation did not dwell on deficits alone; it also highlighted solutions. What unfolded was not just another panel. It was a grounded and comprehensive reflection on what it will take to build a health workforce that can truly meet Africa’s health service delivery needs. The conversation shifted from workforce shortages to the skills health workers need today and in the future. Discussions highlighted a critical gap between training and workforce needs, calling for curricula alignment with evolving health systems. Speakers emphasised a new skills mix combining clinical expertise, digital literacy, soft skills, and human-centred approaches to service delivery. Entrepreneurship emerged as a pathway for young professionals to shape their own opportunities, create employment, and provide solutions to PHC challenges. Employee retention strategies remain essential to curb labour migration. A workforce challenge shaped by change Primary health care systems across the continent are evolving under increasing pressure. The continent bears approximately 25% of the global disease burden while facing a projected shortage of 6.1 million health workers by 2030. The population in Africa is experiencing a youth bulge and is expected to become even younger. Non-communicable diseases are rising alongside infectious diseases. These demographic and epidemiological shifts, changing political and fiscal landscapes, digital tools, and artificial intelligence continue to reshape how health care is delivered, managed, and measured. These shifts are redefining what it means to be a fit-for-purpose health care worker. Speakers returned to a central question: are current training curricula and delivery models preparing graduates adequately for these changing landscapes? For many, the answer is no. The Vice Chancellor, Amref International University, Prof. Joachim Osur, spoke to a persistent disconnect between training and labour market needs: “Each year, millions of young people graduate across Africa, yet only a fraction secure jobs.” In the health sector, this mismatch is even more concerning because it exists alongside severe workforce shortages. The challenge is not only about the numbers of the health workforce, but whether they possess the right set of skills for the needs of the health system. Rethinking what health workers need to know A central theme emerging from the discussion was the concept of a new “skills stack” for health workers delivering primary health care, as described by Dr. Meshack Ndirangu, Country Director, Amref Health Africa Kenya. Though clinical competence remains essential, it should be complemented by a strong sense of purpose that grounds practitioners in their work. In addition, health workers need to understand the job market, acquire relevant and in-demand skills, and cultivate both technical and soft skills that enhance their employability. With technological advancements, health workers are expected to be competent in utilising data for decision-making, navigating digital tools, and adapting to new technologies, including artificial intelligence. At the same time, a human-centred approach to the delivery of health care has become even more important. Therefore, communication, cultural awareness, and the ability to work across teams are no longer optional but core skills that health workers should acquire. This combination reflects the reality of modern care. Patients are not just cases; they are individuals shaped by social, cultural, and economic contexts. Health systems are not just facilities; they are networks that require coordination, empathy, and trust for quality service provision. From job seekers to job creators A notable perspective in the discussion was the repositioning of young professionals, not just as job seekers but as innovators and job creators. Through the Africa Health Collaborative and partners such as the Mastercard Foundation, young people are gaining access to training, mentorship, seed funding, and platforms that enable them to develop and scale solutions to address PHC challenges, as highlighted by Emanuella Alimlim, Lead for the Africa Health Collaborative, Mastercard Foundation. This investment approach to strengthening the health workforce recognises a fundamental reality: the future of health care will not be built only within existing systems. It will also emerge from ventures and innovative ideas to deliver health care. For many young health professionals, this opens new pathways. Not only finding a job within the PHC system but shaping it by becoming job creators and PHC problem solvers. This in turn is being realised through AHC capacity building interventions that equip the health workforce with a redesigned skill set for the health workforce that goes beyond clinical training to include adaptability, digital literacy, contemporary life and soft skills, entrepreneurship, and systems thinking. Holding on to talent While training more health workers and innovation are critical, retaining them in the health system remains a key priority. Labour migration continues to pull skilled professionals away from the continent, often in pursuit of better pay and working conditions. Retention requires deliberate, strategic, and sustained efforts. Incentives for rural service, clearer career pathways that allow for progression, and improved working environments are all critical factors in promoting retention. Without these measures, investments in training risk benefiting other health systems more than local communities, as emphasised by the Acting County Director of Health Administration and Planning, Nakuru County, Dr. Joy Mugambi and Dr. Diallo Malick, Director of Human Resources, Ministry of Health and Public Hygiene Senegal. A collaborative model The Africa Health Collaborative is a strong example of how partnerships can drive meaningful transformation in addressing health workforce challenges. The Collaborative is built on a multi-partner network that fosters co-creation of solutions, with strong alignment to national health system priorities,