Bridging the Gaps: Strengthening Health Practitioner Regulation for Safer Healthcare

The World Health Organization’s Health Practitioner Regulation: Design, Reform, and Implementation Guidance emphasizes the need for flexible, context-specific regulatory frameworks for health practitioners. It highlights the gaps between policy and practice in many countries and calls for a risk-based, right-touch approach to regulation. The report also shares lessons from the COVID-19 pandemic and offers recommendations for countries to build resilient and effective regulatory systems that support broader health goals.

Ensuring patient safety and quality healthcare is a priority for every health system worldwide. However, achieving this requires a robust and effective regulatory framework for health practitioners—a system that not only establishes clear standards but also adapts to the changing needs of healthcare services. The World Health Organization’s (WHO) recent report, Health Practitioner Regulation: Design, Reform, and Implementation Guidance, aims to guide countries through the process of designing, reforming, and implementing these critical regulatory systems. The report is a response to the pressing need for stronger regulatory oversight, especially in low- and middle-income countries where such systems are often fragmented or underdeveloped.

Addressing the Regulatory Gaps

The WHO report emphasizes that health practitioner regulation is not a one-size-fits-all solution. Regulatory systems vary widely depending on the country’s legal, educational, and health service frameworks. Yet, despite the diversity, many nations face similar issues: weak governance, resource constraints, and a disconnect between regulatory goals and actual health outcomes. This mismatch creates what the report terms a “regulatory practice gap,” where the policies on paper do not translate into effective regulation on the ground.

One common problem is that health regulation tends to be overly rigid, with an excessive focus on protecting the profession rather than the public. This can lead to regulatory capture, where the interests of the health professionals take precedence over those of patients. In other cases, the standards may be set too high, creating unnecessary barriers to practice, particularly in low-resource settings. To counter this, the WHO proposes a “right-touch” regulatory approach—one that is proportionate, risk-based, and flexible enough to respond to the specific needs of the health system.

Building a Framework for Reform

The Health Practitioner Regulation Guidance provides a detailed framework for countries looking to reform their health practitioner regulation. It outlines eight key steps, beginning with understanding the local context, identifying the regulatory gaps, and assessing the risk of patient harm. The ultimate goal is to create a regulatory system that not only ensures the safety of healthcare services but also supports broader health policy objectives such as workforce availability, equitable access, and improved service quality.

To achieve this, the report highlights the importance of stakeholder engagement at every stage—from policy-makers and regulators to practitioners and the wider health community. Only by working together can countries build regulatory systems that are both effective and sustainable.

Learning from the Pandemic

The COVID-19 pandemic brought unprecedented challenges to health systems worldwide, putting regulatory frameworks to the test. The WHO report reflects on these experiences, noting that countries with flexible, adaptable regulatory systems were able to respond more effectively to the crisis. Temporary licensing, expanded telehealth provisions, and fast-tracked recognition of foreign qualifications were just some of the emergency measures that helped maintain health service delivery during the pandemic.

These temporary flexibilities, however, have also raised questions about the long-term resilience of regulatory systems. As health systems recover from the pandemic, there is an opportunity to incorporate some of these innovations into permanent policy. The WHO guidance suggests that regulators should evaluate the impact of these measures and consider reforms that allow for greater adaptability in future crises.

Moving Forward: Recommendations for Reform

The WHO report does not prescribe a single model for health practitioner regulation but instead offers a set of principles and policy considerations that can be adapted to local contexts. Among the key recommendations are:

Establishing Proportional Regulation: Regulation should be tailored to the specific risks associated with different health professions. For example, more stringent standards may be necessary for high-risk professions, while lower-risk roles can be regulated through simpler mechanisms such as voluntary certification.

Creating Unified Regulatory Frameworks: In countries with fragmented systems, integrating various health professions under a single regulatory body can improve efficiency and reduce inconsistencies.

Enhancing Transparency and Public Trust: Regulatory bodies should adopt transparent practices and engage more actively with the public to build trust and ensure accountability.

Strengthening Capacity in Low-Resource Settings: For low- and middle-income countries, the focus should be on building the capacity of regulators, ensuring they have the resources and expertise needed to enforce standards effectively.

Ultimately, the WHO’s Health Practitioner Regulation: Design, Reform, and Implementation Guidance calls for a dynamic and agile approach to health regulation—one that is responsive to both current and future challenges. By bridging the regulatory practice gaps and aligning health practitioner regulation with national health priorities, countries can ensure safer, more accessible healthcare for all.