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The primary care medical workforce crisis in the European region: a call for evidence and analysis papers on causes, impacts, and solutions

Edited by:
Giuliano Russo: Queen Mary University of London, UK
Julian PerelmanNOVA University Lisbon, Portugal
Tomas ZapataWHO Regional Office for Europe, Denmark
Milena Šantrić-MilićevićUniversity of Belgrade, Serbia

Submission Status: Open   |   Submission Deadline: 31 March 2024


Human Resources for Health is calling for submissions to our Collection on The primary care medical workforce crisis in the European region: a call for evidence and analysis papers on causes, impacts, and solutions.

This Collection aims at pulling together the evidence from the particularly affected European countries on root causes of a crisis in the medical workforce, its impacts on population health and access to services, as well as on the effectiveness of existing policies and interventions. 

This Collection supports and amplifies research related to the following Sustainable Development Goals: 3 – Good Health and Well-being, 10 – Reduced Inequalities, and 16 – Peace, Justice and Strong Institutions.

Image credit: © sudok1 / Stock.adobe.com

Meet the Guest Editors

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Giuliano Russo: Queen Mary University of London, UK

Giuliano Russo is a senior lecturer in global health at Queen Mary University of London and associate editor for the journal Human Resources for Health. Giuliano has over 25 years of professional experience in academia, public and private sector, having worked in the past for the University of Lisbon (Portugal), the World Bank, the Overseas Development Institute (UK), the Government of Mozambique, the Instituto Nacional de Salud Publica (Mexico), as well as for SmithKline Beecham Pharmaceuticals (Spain and European Headquarters). A health economist by training, his recent work has focused on pharmaceutical policies and markets in low- and middle-income countries, the economics of human resources for health, health systems in low-income settings, and on the global aid architecture for the health sector.

Julian PerelmanNOVA University Lisbon, Portugal

Julian Perelman holds a PhD in Economics from Université Catholique de Louvain, Belgium, currently associate professor at the Nova National School of Public Health (NOVA University Lisbon), and Vice-President of the Portuguese Commission for Health Technology Assessment (CATS), at the Drugs and Health Products National Authority (Infarmed, IP). He coordinated the Mission Framework for the Sustainability of the Health Budget Program (under supervision by the Ministry of Health and the Ministry of Finance), from 2018 to 2020. He authored more than 90 publications in indexed scientific journals and one book; he was the first author of the 2019 Portuguese guidelines for economic evaluation of health technologies. His research is mainly related to economic evaluation in health, socioeconomic determinants of health, and payment systems and incentives.

Tomas ZapataWHO Regional Office for Europe, Denmark

Tomas Zapata is a medical doctor specialised in Family Medicine. Dr Zapata is a health services and health workforce expert with more than 13 years of experience in policy advice, research and programme implementation, including long term international work with WHO, UNFPA and Doctors of the World based in Mozambique, Angola, Namibia, Bangladesh and India. He has conducted several analyses focusing on integration of services, primary health care, health workforce policy and health labour market analysis among others in African, Asian and European settings. Currently, Dr Zapata leads the Health Workforce and Service Delivery Unit in the WHO Regional Office for Europe based in Copenhagen.

Milena Šantrić-MilićevićUniversity of Belgrade, Serbia

Dr Milena Šantrić-Milićević is professor in social medicine, public health and health management at the Faculty of Medicine, University of Belgrade, and Visiting Professor at Al-⁠Farabi Kazakh National University, Faculty of Medicine and Health Care, Almaty, Kazakhstan. As a human resources for health expert, Dr Šantrić-Milićević was member of the European committees developing the methodology for health workforce planning (EU/JAHWPF), policy options addressing the medical deserts (EU/AHEAD), and health workforce policies (WHO GHWN TG). She acted as an expert on migrations/mobility in EU/JAHEE and in Pillars of Health (WEMOS). For the last 25 years she has been health workforce planning, management and policy adviser to the Serbian Ministry of Health, as well as to the European Commission, World Health Organization, and World Bank.

About the Collection

Primary care services are key to population health and for the efficient and equitable organisation of national health systems; this is why they are often financed through public funds. Primary care doctors (also known as General Practitioners – GPs - or family doctors) are instrumental for the delivery of preventive services, continuity of care, and for the referral of patients through the system. These doctors are also the single largest health expenditure at the core of such services.

Although recruitment and retention of primary care doctors have historically been challenging, shortages are now exacerbated by higher demand of services from aging populations and increased burden of chronic diseases. Concurrently, the supply of GPs is constrained by rising retirement rates, in connection with internal and external migration, worsening working conditions, and budget cuts. Misalignment between national education sectors and labour markets is becoming apparent, compounding existing shortages of such critical and in-high-demand resources. With their predominantly publicly funded health systems and in the aftermath of COVID-19, European countries appear to be on the cusp of a long-burning primary care crisis, with almost every country reporting shortage in GPs workforces, long waiting lists for doctor appointments, unfilled vacancies in the medical labour market, and additional pressures on other parts of national health systems.

This Collection aims at pulling together the evidence from the particularly affected European countries on root causes of such a workforce crisis, its impacts on population health and access to services, as well as on the effectiveness of existing policies and interventions.

Original research papers are invited documenting the state of the primary care medical workforce in the European region, the impact of shortages on population health and access to services, as well as the effectiveness of reforms, policies and interventions aimed at mitigating the effects of the crisis. Only articles will be considered presenting primary or original analysis of secondary qualitative, quantitative or mixed methods evidence from the World Health Organization’s European region[1]. Commentaries or opinion pieces will not be included in this Collection.

Ultimately, the aim of this article Collection is to contribute to the achievement of Sustainable Development Goals 3, 10 and 16, and provide an evidence basis for the identification of policy solutions to present and future primary care crises in higher and lower-income countries.

[1] See a list of the WHO Euro region countries at: https://www.who.int/europe/about-us/about-who-europe#:~:text=The%20WHO%20Regional%20Office%20for,Atlantic%20to%20the%20Pacific%20oceans.


  1. International mobility of health workforce affects the performance of health systems and has major relevance in human resources for health policy and planning. To date, there has been little research exploring...

    Authors: Sara Calderón-Larrañaga, Ángel González-De-La-Fuente, Ana Belén Espinosa-González, Verónica Casado-Vicente, Óscar Brito-Fernandes, Niek Klazinga and Dionne Kringos
    Citation: Human Resources for Health 2024 22:9
  2. Primary care services are key to population health and for the efficient and equitable organisation of national health systems. This is why they are often financed through public funds. Primary care doctors ar...

    Authors: Giuliano Russo, Julian Perelman, Tomas Zapata and Milena Šantrić-Milićević
    Citation: Human Resources for Health 2023 21:55

Submission Guidelines

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This Collection welcomes submission of original research articles. Commentaries or opinion pieces will not be included in this Collection.

Should you wish to submit a different article type, please read our submission guidelines to confirm that type is accepted by the journal. Articles for this Collection should be submitted via our submission system, Editorial Manager. During the submission process you will be asked whether you are submitting to a Collection, please select "The primary care medical workforce crisis in the European region: a call for evidence and analysis papers on causes, impacts, and solutions" from the dropdown menu.

Articles will undergo the journal’s standard peer-review process and are subject to all of the journal’s standard policies. Articles will be added to the Collection as they are published.

The Guest Editors have no competing interests with the submissions which they handle through the peer-review process. The peer-review of any submissions for which the Guest Editors have competing interests is handled by another Editorial Board Member who has no competing interests.