Center for International Health Initiatives

The AAFP Center for International Health Initiatives (CIHI) was created in 2000 in response to increased interest in the global development of family medicine. As several countries and institutions requested high quality consultations, the AAFP and its members involved in international consultations recognized the need for a process to respond to these requests. The advisory board they created included nine experienced family medicine international consultants

The AAFP Center for International Health Initiatives was formed in the spirit of the AAFP's strategic directions and in response to two relatively unaddressed needs.

  • First, many countries with an overabundance of specialists are discovering the economic and societal benefits of having family physicians address the primary health care needs of the population. As a result, foreign ministries of health are seeking assistance with the development of new departments and residency programs as well as retraining programs in family medicine.
  • Second, U.S. physicians and educators become involved with health care reform projects often at the invitation of a foreign government or act as a subcontractor to an agency by the U.S. government. These individuals may be highly qualified to provide such assistance or have little or no qualifications.

Plans to create such a consultation service were discussed with a variety of AAFP constituencies, all of whom agreed that concrete steps should be taken to implement the program. In December 1999, eight internationally experienced family medicine educators (now known as the Advisory Board) started developing the concept of an international family medicine consulting corps known as the AAFP Center for International Health Initiatives.

In 2000, Dr. Warren Heffron, a member of the CIHI Advisory Board, was the AAFP’s first international senior scholar-in-residence. During this time, he developed consultation tools which he piloted during consultations in Kyrgyzstan, Mongolia, and Saudi Arabia. In addition, he worked with other CIHI consultants to develop comprehensive materials on the consultation process, curriculum development, and consultant selection and training.

CIHI’s vision is “to assist in the development of deliberately trained, competent, generalist physicians to meet the health needs of the community and country.” The underlying philosophy of this vision is that trained international consultants will provide assistance based on the universal principles of family medicine, tailored to the epidemiology and economy of the country, and using the best practices of family medicine in the United States that are appropriate for the needs of the community.


AAFP Family Medicine Global Health Workshop

The inaugural CIHI workshop in 2003 brought together academic and practicing family physicians to enhance the training of family physicians involved in international family medicine or considering involvement in international activities. Participants were trained in consultation skills, public health principles, representing family medicine to key stakeholders, and retraining versus traditional postsecondary training models. Skipping 2004, the second and third workshops were held in 2005 and 2006 in Portland, Maine. The fourth workshop was held in Tucson, Arizona. In 2008, the workshop was renamed the Family Medicine Global Health Workshop and was held in Denver, Colorado.

ProShëndetit Project: Improving Primary Health Care in Albania

In 2003, the AAFP received a three-year subcontract to provide technical services for a United States Agency for International Development (USAID) project in Albania in cooperation with University Research Corporation, LLC (URC) and Bearing Point. As of mid-2006, 12 CIHI consultants have visited Albania, working with project partners and the Albanian Ministry of Health on issues related to primary health care development, educational training models and certification/accreditation systems. In October 2006, the AAFP was included in a two-year project extension. Six consultation visits have been accomplished since then. The framework for family medicine in Albania and the basic package of services have been developed in collaboration with local stakeholders.

New Opportunities

AAFP Center for International Health Initiatives staff are actively pursuing hosting additional international workshops, and have been approached for assistance with additional health care development projects in Iraq, Jordan, Lesotho, Kazakhstan, Azerbaijan, Armenia and India. CIHI consultants have also conducted consultation assessments of post-graduate training programs in Macao and The Bahamas.