Facilitators and barriers to health professionals' competence in delivering quality primary health care in the digital era in Amhara region, Ethiopia: an exploratory qualitative study.

Background: Despite the critical role of professional competence in providing quality primary health care, evidence on the facilitators and barriers to health professionals' competence is limited. Therefore, we explored factors influencing health professionals' competence in delivering quality primary health care in Amhara region, Ethiopia.

Methods: A qualitative case study was conducted in Amhara region from November 1 to December 30/2023. We conducted key informant interviews with five faculty members from training institutions, five health service or facility managers, and five study participants from non-governmental organizations. Additionally, we conducted in-depth interviews with twelve health professionals. The number of participants was determined based on information saturation, and purposive heterogeneous sampling was used. A thematic analysis was conducted to analyze the data. The Standards for Reporting Qualitative Research (SRQR) were used to report findings.

Results: Factors influencing the competence of health professionals in providing quality primary health care were divided into two main categories: facilitators and barriers. The presence of educational technologies, advanced instructional methods, educational design, the education-for-life model, universities, colleges, CPD centers, and NGOs working on health workforce capacity development in the region were facilitators of health professionals' competence to provide quality primary health care. On the other hand, identified barriers include poorly prepared and demotivated students, the rapid expansion of universities and colleges with inadequate infrastructure, weak external quality assurance systems, poor collaboration between education and health systems, and the impacts of conflict and COVID-19.

Conclusion: Although facilitators exist to enhance health professionals' competence in the region, higher education institutions have not effectively produced the competent professionals necessary for quality primary health care. Factors such as poor-quality pre-service education, inconsistent and poorly implemented CPD initiatives, and limited NGO-funded training have all contributed to the subpar competence of health professionals. There is an urgent need for collaboration between the Ministry of Health and the Ministry of Education to plan, revise, and implement health professional training, improve the quality of pre-service education, and optimize in-service training and CPD efforts.