2021 - WHO Benchmarks For The Training of ACUPUNCTURE
2021 - WHO Benchmarks For The Training of ACUPUNCTURE
2021 - WHO Benchmarks For The Training of ACUPUNCTURE
THE TRAINING
OF ACUPUNCTURE
WHO BENCHMARKS FOR
THE TRAINING
OF ACUPUNCTURE
WHO benchmarks for the training of acupuncture
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Contents
Foreword iv
Preface v
Acknowledgements vi
Glossary vii
1. Introduction 1
2. Categories of training 3
3 . Levels of training 5
References 10
iii
Foreword
The World Health Organization (WHO) is currently implementing its 13th General Programme of Work
(GPW13) to support countries in reaching all health-related Sustainable Development Goals (SDGs).
GPW13 is structured around three interconnected strategic priorities: achieving universal health coverage;
addressing health emergencies; and promoting healthier populations. These strategic priorities are
supported by three strategic shifts: stepping up leadership; driving public health impacts in every country;
and focusing global public goods on impact.
Traditional medicine has always had a role in this collective endeavour. The Declaration of Astana, renewed
from the Declaration of Alma-Ata towards universal health coverage and the SDGs, reaffirms the role of
traditional medicine in strengthening primary health care, a cornerstone of health systems, in pursuit of
health for all. This has also been reflected in the WHO global report on traditional and complementary
medicine 2019, in which 88% of WHO Member States acknowledge the use of traditional and
complementary medicine in health care.
Taking note of the growing importance of traditional medicine in the provision of health care nationally
and globally, WHO and its Member States have strived to explore ways to integrate, as appropriate, safe
and evidence-based traditional and complementary medicine services within national or subnational
health systems, as committed to in the Political Declaration of the High-level Meeting on Universal Health
Coverage.
WHO aims to provide policy and technical guidance to Member States; promote the safe and effective
use of traditional and complementary medicine through appropriate regulation of products, practices and
practitioners; and support Member States in harnessing the contribution of traditional and complementary
medicine to people-centred health care in implementing the WHO Traditional Medicine Strategy
2014–2023.
Setting norms and standards is a unique function of WHO. The normative work is driven by needs and
could be translated into real impact in relevant countries through appropriate policy options. This series
of benchmarks, covering various systems and interventions of traditional, complementary and integrative
medicine, aims to provide a reference point to which actual practice and practitioners can be evaluated.
I am very pleased to introduce this series to policy-makers, health workers and the general public, and I
firmly believe it will serve its purpose.
Zsuzsanna Jakab
Deputy Director-General
World Health Organization
iv
Preface
Integrated health services are essential for the World Health Organization (WHO) in the implementation
of its 13th General Programme of Work, which aims to support countries in achieving universal health
coverage and the health-related Sustainable Development Goals. The overarching mission for the
Department of Integrated Health Services is to accelerate equitable access to quality health services that
are integrated and people-centred, and that can be monitored and evaluated.
WHO is unique in its mandate to provide independent normative guidance. Its normative products
encompass a wide range of global public health goods, including norms and standards. It is therefore
the primary role of the Department of Integrated Health Services to generate and produce relevant global
goods. Key to improving its work in this area is ensuring global public health goods are driven by country
needs and can deliver tangible impacts at the country level.
As of 2018, when 88% of WHO Member States acknowledged the use of traditional and complementary
medicine, WHO’s support in evaluating the safety, quality and effectiveness of traditional and complementary
medicine has continuously ranked in the top areas of need, according to the WHO global report on
traditional and complementary medicine 2019.
WHO prioritizes normative products based on an assessment of demands. To address increasing needs
and to drive impact in countries, this series of benchmarks captures the main systems and interventions
of traditional, complementary and integrative medicine by setting up required norms and standards on
training and practice.
WHO’s guiding principles and quality assurance procedures have been strictly followed in designing and
formulating these benchmarks. WHO will not only assess the quality of these normative products but
also streamline systems and plans for monitoring and evaluation.
I am pleased to present this series of benchmarks and invite you to join us in measuring and documenting
their impact.
Edward Kelley
Director
Department of Integrated Health Services
World Health Organization
v
Acknowledgements
The World Health Organization (WHO) acknowledges the technical support of the National Administration
of Traditional Chinese Medicine, China, without which the production of this document would not have
been possible.
Thanks are due to the China Association of Acupuncture-Moxibustion and Hubei University of Chinese
Medicine, China, which kindly provided logistic support to the WHO working group meeting on this
document.
Special thanks go to Baoyan Liu, Hua Wang, Fengxia Liang and Nicola Robinson, who have actively and
diligently contributed to the drafting and editing of this document. WHO is indebted to all experts who
have provided their inputs to the WHO working group meeting and the peer review process.
Qi Zhang and Qin Liu undertook revision work under the guidance of Edward Kelley. Colleagues within
the WHO headquarters team for traditional, complementary and integrative medicine provided secretarial
support.
vi
Glossary
Basic requirements
The fundamental level of knowledge and skills needed for people with various backgrounds who are
aiming to provide a limited acupuncture service, which will be combined as part of their treatment options.
Advanced requirements
The higher level of knowledge and skills (in addition to that under the basic requirements) needed for
people with various backgrounds who are aiming to provide a comprehensive acupuncture service, which
will enable them to become a specialized acupuncture practitioner.
Full training
The acupuncture training programme designed for people without a previous medical background. It
includes complete learning modules for acupuncture, traditional Chinese medicine, conventional medical
knowledge and other relevant areas to satisfy both basic and advanced requirements.
Adapted training
The acupuncture training programme designed for people with a traditional or conventional medical
background. It includes adjusted learning modules for acupuncture, traditional Chinese medicine,
conventional medical knowledge and other relevant areas to satisfy both basic and advanced requirements.
vii
Executive summary
Various backgrounds of acupuncture service providers were addressed inadequately in this document,
however, and there is a lack of a defined career pathway for acupuncture providers.
Based on the needs of Member States, the updated benchmarks aim to reduce the gaps by setting up
required leaning modules for each category of acupuncture service providers at different levels, so that
individual practices and practitioners can be compared, evaluated and accredited.
This document will join the benchmarks for the practice of acupuncture to form an integral part of the
serial benchmarks, targeting key modalities of traditional medicine intervention and contributing to the
establishment of a reference toolkit for countries.
In line with WHO established principles and processes for benchmark development, the WHO Secretariat
made the planning proposal and clarified the scope of work. The first draft was prepared by selected
leading experts based on the framework provided by WHO. This draft was presented to the working
group meeting for discussion.
Twenty-nine experts from 12 countries across the WHO regions joined the working group meeting. After
two days of intensive discussion on the scope, structure and content of the draft document, the meeting
was concluded with consensus and advice on further improvement, which guided production of the
second draft. This draft was then ready for online consultation.
Seventeen experts from nine countries across the WHO regions joined the next consultation, reviewed the
progress made since the last working group meeting, and contributed to the development of the third
draft. This draft marked the conclusion of the consulting process and became the last technical version
of the benchmark before formatting and printing.
1
See: https://apps.who.int/iris/bitstream/handle/10665/66007/WHO_EDM_TRM_99.1.pdf
viii
What does this benchmark cover?
This document is structured in five parts:
Introduction: gives a short briefing on the background and objectives of the document.
Categories of training: provides training options applicable for a wide range of acupuncture service
providers.
Levels of training: defines general expertise and possible career pathways for acupuncture service
providers.
Components and requirements for full training: presents learning modules at different levels for people
without a medical background.
Components and requirements for adapted training: presents principles of adaptation in terms of
learning modules for people with a traditional or conventional medical background.
These five parts constitute a complete set of benchmarks for the training of acupuncture.
Qi Zhang
Head
Unit of Traditional, Complementary and Integrative Medicine
Department of Integrated Health Services
World Health Organization
ix
x
1 Introduction
With its use acknowledged in 113 Member States, acupuncture remains the most common form of
traditional medicine practice according to the WHO global report on traditional and complementary
medicine 2019 (1). With the growing popularity of acupuncture worldwide, there has been a need for
more countries to regulate its practice and practitioners for appropriate integration into health systems.
In 1999, the World Health Organization (WHO) published the Guidelines on basic training and safety in
acupuncture (2). These guidelines presented what professional experts and health regulators considered
to be appropriate training programmes for acupuncture practitioners, as well as physicians and primary
health personnel who wish to provide acupuncture treatment.
Various backgrounds of acupuncture service providers were inadequately addressed in this document,
however, and there is a lack of defined career pathways for acupuncture providers.
Based on the needs of Member States, these updated benchmarks try to reduce the gaps by setting up
required learning modules for each category of acupuncture service providers at different levels, so that
individual practices and practitioners can be compared, evaluated and accredited.
In addition to the introduction, this document incorporates four essential components – categories
of training, levels of training, components and requirements for full training, and components and
requirements for adapted training – to constitute a complete set of benchmarks for the training of
acupuncture.
1
2
2 Categories of training
3
4
3
Levels of training
5
6
4 Learning modules
for full training
7
4.1.4 Other learning modules
Ability to recognize and comply with laws and regulations related to an acupuncture service.
Ability to recognize and comply with principles of medical ethics and professionalism.
8
5 Learning modules
for adapted training
9
References
1. WHO global report on traditional and complementary medicine 2019. Geneva: World Health
Organization; 2019 (https://apps.who.int/iris/bitstream/handle/10665/312342/9789241515436-eng.
pdf, accessed 28 July 2020).
2. Guidelines on basic training and safety in acupuncture. Geneva: World Health Organization; 1999 (https://
apps.who.int/iris/bitstream/handle/10665/66007/WHO_EDM_TRM_99.1.pdf, accessed 28 July 2020).
3. Standard acupuncture nomenclature: a brief explanation of 361 classical acupuncture point names
and their multilingual comparative list. Manila: World Health Organization; 1993 (https://apps.who.
int/iris/bitstream/handle/10665/207716/9290611057_eng.pdf, accessed 28 July 2020).
4. Guidelines on core components of infection prevention and control programmes at the national and
acute health care facility level. Geneva: World Health Organization; 2016 (https://apps.who.int/iris/
bitstream/handle/10665/251730/9789241549929-eng.pdf, accessed 28 July 2020).
5. Patient safety curriculum guide. Geneva: World Health Organization; 2011 (https://apps.who.int/iris/
bitstream/handle/10665/44641/9789241501958_eng.pdf, accessed 28 July 2020).
6. WHO benchmarks for the practice of acupuncture. Geneva: World Health Organization; 2020 (https://
apps.who.int/iris/bitstream/handle/10665/340838/9789240016880-eng.pdf, accessed 17 May 2021).
7. International classification of diseases, 11th revision. Geneva: World Health Organization; 2018 (https://
icd.who.int/dev11/l-m/en, accessed 28 July 2020).
10
Annex 1. Suggested subjects and learning
hours for full training at basic and
advanced levels
Key subjects for each leaning module are suggested below with corresponding numbers of learning hours
to reflect the components and requirements for full training at basic and advanced levels.
It is recognized that training should be competency-based, and adaptation will be applied in consideration
of the trainee’s individual background and previous knowledge and skills.
Learning modules Key subjects Basic level (hours) Advanced level (hours)
Acupuncture Introduction to acupuncture 16 32
Meridians and acupoints 128 144
Acupuncture skills and techniques 128 144
Acupuncture therapeutics 208 256
Microsystems acupuncture – 48
Special acupuncture techniques – 96
Specialized acupuncture treatment – 144
Subtotal 480 864
Traditional Chinese Basic theory of traditional Chinese 96 128
medicine medicine
Traditional Chinese medicine diagnostics 96 128
Clinical essentials of traditional Chinese – 176
medicine
Subtotal 192 432
Conventional Anatomy 128 144
medical knowledge
Physiology 64 64
Pathology 64 64
Biochemistry 64 64
Diagnostics 96 96
Clinical essentials – 64
First aid – 32
Subtotal 416 528
Other relevant areas Medical laws and regulations 48 48
Medical ethics 32 32
Evidence-based medicine – 32
Research methodology – 32
Subtotal 80 144
Supervised clinical practice 400 500
Total 1568 2468
11
Annex 2. Working group meeting
Participants
WHO African Region
Samuel Osei Kwarteng, Ghana Health Service/Ghana Police Hospital, Ghana
Anastasia Michaelina Yirenkyi, Acting Director, Traditional and Alternative Medicine, Ministry of Health,
Ghana
12
Fengxia Liang, Vice Dean, College of Acupuncture and Orthopedics, Hubei University of Chinese Medicine,
China
Baoyan Liu, President, World Federation of Acupuncture-Moxibustion Societies, China
Mingjun Liu, Dean, College of Acupuncture and Moxibustion, Changchun University of Chinese Medicine,
China
Byung-Cheul Shin, School of Korean Medicine, Pusan National University, Republic of Korea
Hua Wang, Former President, Hubei University of Chinese Medicine, China
Jingui Wang, Vice President, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine,
China
Zhihong Wang, Former President, Changchun University of Chinese Medicine, China
Shan Wu, Director, Department of Tuina, Guangdong Hospital of Traditional Chinese Medicine, China
Christopher Zaslawski, Discipline Leader, Chinese Medicine, School of Life Sciences, University of
Technology Sydney, Australia
Hong Zhao, Vice President, Acupuncture and Moxibustion Hospital, China Academy of Chinese Medical
Sciences, China
Observers
Namwoo Lee, Jaseng Korean Medicine Hospital, Republic of Korea
Salih Mollahaliloglu, Ankara Yildirim Beyazit University, Turkey
WHO Secretariat
Qi Zhang, Coordinator, Traditional, Complementary and Integrative Medicine, Service Delivery and Safety,
WHO, Switzerland
Qin Liu, Technical Officer, Traditional, Complementary and Integrative Medicine, Service Delivery and
Safety, WHO, Switzerland
Local Secretariat
Xin Zhang, Changchun University of Chinese Medicine, China
Jingzhi Wang, Hubei University of Chinese Medicine, China
Xuqiang Wei, China Academy of Chinese Medical Sciences, China
13
Annex 3. Online consultation
Participants
WHO African Region
Anastasia Michaelina Yirenkyi, Acting Director, Traditional and Alternative Medicine, Ministry of Health,
Ghana
14
Observer
Salih Mollahaliloglu, Ankara Yildirim Beyazit University, Turkey
WHO Secretariat
Qi Zhang, Coordinator, Traditional, Complementary and Integrative Medicine, Service Delivery and Safety,
WHO, Switzerland
Qin Liu, Technical Officer, Traditional, Complementary and Integrative Medicine, Service Delivery and
Safety, WHO, Switzerland
15
Department of Integrated Health Services
World Health Organization (WHO)
Avenue Appia 20 – CH-1211 Geneva 27 – Switzerland