Training needs and service capacity gaps among primary healthcare workers in Henan Province, China: a large cross-sectional study

BACKGROUND: Primary care training is a key strategy for strengthening healthcare services in China. This study aimed to systematically assess the training needs and service capacity improvement demands among primary healthcare workers in Henan Province, and to examine regional and role-specific variations, providing evidence for optimizing primary care workforce development. METHODS: A cross-sectional online survey was conducted between April 11 and April 22, 2024, among 136,040 primary healthcare workers registered on the "Huayi Mobile Medical Education" training platform across 18 cities in Henan Province. A self-designed questionnaire assessed demographic characteristics, training needs, and service capacity enhancement. Descriptive statistics and chi-square tests were used to explore differences across regions and professional roles. Multivariable logistic regression models were constructed to examine associations between professional role and high training demand for selected core competencies, adjusting for institution type, professional title, and job position. RESULTS: Overall, primary healthcare workers reported high demand (>75%) for training in the diagnosis and treatment of common diseases, rational drug use, and emergency response skills. Significant regional differences were observed, with certain areas showing higher demand for training in Traditional Chinese Medicine techniques, infectious disease control, or rehabilitation services. Training needs also varied by professional role: clinical staff emphasized clinical knowledge and Traditional Chinese Medicine, public health workers prioritized essential public health services, and nursing and technical personnel focused on first aid and emergency response. CONCLUSIONS: Training needs among primary healthcare workers in Henan Province are urgent and diverse, with clear regional and role-specific variations. These findings highlight the need for a competency-oriented, context-specific training system that improves relevance and practical applicability, thereby enhancing primary care service capacity and supporting the efficient allocation of health resources.