National Reporting Instrument 2018

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Background

Hide [iBG] Adopted in 2010 at the 63rd World Health Assembly (WHA Res 63.16), the WHO Global Code of Practice on the International Recruitment of Health Personnel (“the Code”) seeks to strengthen the understanding and ethical management of international health personnel recruitment through improved data, information, and international cooperation.

Article 7 of the Code encourages WHO Member States to exchange information on the international recruitment and migration of health personnel. The WHO Director General is additionally mandated to report to the World Health Assembly every 3 years. WHO Member States completed the 2nd Round of National Reporting on Code implementation in March 2016. The WHO Director General reported progress on implementation to the 69th World Health Assembly in May 2016 (A 69/37 and A 69/37 Add.1). During the 2nd Round of National Reporting, seventy-four countries submitted complete national reports: an increase in over 30% from the first round, with improvement in the quality and the geographic diversity of reporting.

The National Reporting Instrument (NRI) is a country-based, self-assessment tool for information exchange and Code monitoring. The NRI enables WHO to collect and share current evidence and information on the international recruitment and migration of health personnel. The NRI (2018) has been considerably shortened, while retaining key elements. It now comprises 18 questions. The common use of the instrument will promote improved comparability of data and regularity of information flows. The findings from the 3rd Round of National Reporting are to be presented at the 72nd World Health Assembly, in May 2019.

The deadline for submitting reports is 15 August 2018.

Should technical difficulties prevent national authorities from filling in the online questionnaire, it is also possible to download the NRI via the link: http://www.who.int/hrh/migration/code/code_nri/en/. Please complete the NRI and submit it, electronically or in hard copy, to the following address:

Health Workforce Department
Universal Health Coverage and Health Systems
World Health Organization
20 Avenue Appia, 1211 Geneva 27
Switzerland
hrhinfo@who.int

The data and information collected through the National Reporting Instrument will be made publicly available via the WHO web-site following the proceedings of the 72nd World Health Assembly. The quantitative data collected will be updated on and available through the National Health Workforce Accounts online platform (http://www.who.int/hrh/statistics/nhwa/en/).
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Disclaimer

Hide [disclaim]
 For more information on WHO Data Policy kindly refer to http://www.who.int/publishing/datapolicy/en/
I have read and understood the WHO policy on the use and sharing of data collected by WHO in Member States outside the context of public health emergencies
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Designated National Authority Contact Details

Hide [q01a] Name of Member State:
Malaysia
Hide [q01b] Contact information:
Full name of institution:
MINISTRY OF HEALTH
Name of designated national authority:
Ms KAREN ANG HUAY MEIN
Title of designated national authority:
SENIOR PRINCIPAL ASSISTANT SECRETARY, POLICY AND INTERNATIONAL RELATIONS DIVISION, MINISTRY OF HEALTH MALAYSIA
Telephone number:
+603-888832828 / +6016-5213517
Email:
karen_ang@moh.gov.my
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Implementation of the Code

Hide [q1] 1. Has your country taken steps to implement the Code?
Yes
Hide [q2] 2. To describe the steps taken to implement the Code, please tick all items that may apply from the list below
2.a Actions have been taken to communicate and share information across sectors on the international recruitment and migration of health personnel, as well as to publicize the Code, among relevant ministries, departments and agencies, nationally and/or sub-nationally.
Yes
2.b Measures have been taken or are being considered to introduce changes to laws or policies consistent with the recommendations of the Code.
The legal framework for the recruitment of foreign health personnel is consistent with recommendation of the code.
2.c Records are maintained on all recruiters authorized by competent authorities to operate within their jurisdiction.
Incoming • Employment of foreign doctors/dentist/pharmacist/allied health personnel is directly managed by the prospective employer (private sectors), not by recruiters/agents. • Records of the incoming health personnel are maintain by councils (competent authorities) namely: i. Malaysia Medical Council (MMC) ii. Malaysia Dental Council (MDC) iii. Nursing Board of Malaysia (LJM) iv. Pharmacy Board of Malaysia (PBM) Outgoing/deployment • For doctors, MMC does not keep a record of these doctors. There is no requirement for outgoing doctors to inform the MMC at this point of time. Doctors do request a Letter of Good Standing (LOGS) if the target country requires it. However the LOGS requested is not only limited to the purpose of employment. • For dentist, MDC does not control the outgoing dentist. • For pharmacist, PBM works together with Pharmaceutical Services Division and Human Resources Division, MOH. • For nurses, deployment of local trained nurses are through recruitment agency which governed by Ministry of Human Resources e.g. Melorita Healthcare, Firestar Service Sdn Bhd, Dataflow Group, Agensi Pekerjaan Starmag Sdn Bhd, W.A Gloserve, Akma Service, Crest Synergy Global, Procare Care Center, Across the Globe and I care Home Health Service.
2.d Good practices, as called for by the Code, are encouraged and promoted among recruitment agencies.
Good practices are expected to be practiced by the respective ministry that governs the recruitment agency.
2.e Measures have been taken to consult stakeholders in decision-making processes and/or involve them in activities related to the international recruitment of health personnel.
Yes
2.f Other steps:
Hide [q3] 3. Is there specific support you require to strengthen implementation of the Code?
3.a Support to strengthen data and information
3.b Support for policy dialogue and development
3.c Support for the development of bilateral agreements
3.d Other areas of support:
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Data on International Health Personnel Recruitment & Migration

Hide [iq4] Improving the availability and international comparability of data is essential to understanding and addressing the global dynamic of health worker migration.
Hide [q4] 4. Does your country have any mechanism(s) or entity(ies) to maintain statistical records of foreign-born and foreign-trained health personnel?
Yes
Hide [q4x1] Please describe:
Refer to Item 10.1.
Hide [iQ5] For the latest year available, consistent with the National Health Workforce Accounts (NHWA) Indicators 1-07 and 1-08, please provide information on the total stock of health personnel in your country (preferably the active workforce), disaggregated by the country of training (foreign-trained) and the country of birth (foreign-born). Please consult with your NHWA focal point, if available, to ensure that data reported below is consistent with NHWA reporting.
Hide [q5x1] 5. Data on the stock of health personnel, disaggregated by country of training and birth

5.1 Consolidated stock of health personnel
Total Domestically Trained Foreign Trained Unknown Place of Training National Born Foreign Born Source* Additional Comments#
Medical Doctors 10517 6348 4169 0 9966 551 MMC Register -
Nurses 5605 5543 62 0 0 0 Nursing Board Register -
Midwives 1037 1037 0 0 0 0 Nursing Board Register -
Dentists 1258 660 598 0 1254 4 Malaysia Dental Council -
Pharmacists 1293 1190 103 0 1290 3 Pharmacy Board of Malaysia -
Hide [iq5x2] 5.2 Country of training for foreign-trained health personnel

Please provide detailed data on foreign-trained health personnel by their country of training, as consistent with NHWA Indicator 1-08. This information can be provided by one of the following two options:
Hide [q5x2x1] Option A: Completion of the template in Excel
Download and Upload
Please upload file
Hide [q5x2x2] Option B: Uploading any format of documentation providing such information (e.g. pdf, excel, word).
Please upload file
Hide [Q5fn] *e.g. professional register, census data, national survey, other
#e.g. active stock, cumulative stock, public employees only etc.
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Partnerships, Technical Collaboration and Financial Support 1/2

Hide [q6] 6. Has your country provided technical or financial assistance to one or more WHO Member States, particularly developing countries, or other stakeholders to support the implementation of the Code?
6.a Specific support for implementation of the Code
6.b Support for health system strengthening
6.c Support for health personnel development
6.d Other areas of support:
MOH Malaysia shares best practices with the neighbouring WHO members states on the regulations of health personnel.
Hide [q7] 7. Has your country received technical or financial assistance from one or more WHO Member States, the WHO secretariat, or other stakeholders to support the implementation of the Code?
7.a Specific support for implementation of the Code
-
7.b Support for health system strengthening
-
7.c Support for health personnel development
-
7.d Other areas of support:
-
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Partnerships, Technical Collaboration and Financial Support 2/2

Hide [q8] 8. Has your country or its sub-national governments entered into bilateral, multilateral, or regional agreements and/or arrangements to promote international cooperation and coordination in relation to the international recruitment and migration of health personnel?
Yes
Hide [q8x1] 8.1 Please provide the text and/or web-links to the agreements or arrangements
Please upload file
Hide [q8x1wl] Web-links:
http://www.miti.gov.my/index.php/pages/view/2109
Hide [q8x2] 8.2 If documentation is unavailable, please use Table A on next screen to describe the bilateral, regional or multilateral agreements or arrangements:

Table A Description of bilateral, multilateral, regional agreements or arrangements
1.
2.
3.
4.
5.
Hide [q8x2fx1] Title of Agreement
ASEAN Framewok Agreement on Services
Hide [q8x2ax1] Type of Agreement
Multilateral
Hide [q8x2bx1] Countries Involved
ASEAN Countries
Hide [q8x2cx1] Coverage
National
Hide [q8x2dx1] Main content of agreements (Include all that apply)
Education and training
Institutional capacity building
Promotion of circular migration
Retention strategies
Recognition of health personnel
Recruitment of health personnel
Twinning of health care facilities
Other mechanism (include details if possible)
Hide [q8x2ex1] Categories of Health Personnel (Include all that apply)
Doctors
Nurses
Midwives
Dentists
Pharmacists
Other (include details as necessary)
Hide [q8x2gx1] Validity period
Since 1997
Hide [q8x2fx2] Title of Agreement

Hide [q8x2ax2] Type of Agreement
Hide [q8x2bx2] Countries Involved

Hide [q8x2cx2] Coverage
Hide [q8x2dx2] Main content of agreements (Include all that apply)
Education and training
Institutional capacity building
Promotion of circular migration
Retention strategies
Recognition of health personnel
Recruitment of health personnel
Twinning of health care facilities
Other mechanism (include details if possible)
Hide [q8x2ex2] Categories of Health Personnel (Include all that apply)
Doctors
Nurses
Midwives
Dentists
Pharmacists
Other (include details as necessary)
Hide [q8x2gx2] Validity period

Hide [q8x2fx3] Title of Agreement

Hide [q8x2ax3] Type of Agreement
Hide [q8x2bx3] Countries Involved

Hide [q8x2cx3] Coverage
Hide [q8x2dx3] Main content of agreements (Include all that apply)
Education and training
Institutional capacity building
Promotion of circular migration
Retention strategies
Recognition of health personnel
Recruitment of health personnel
Twinning of health care facilities
Other mechanism (include details if possible)
Hide [q8x2ex3] Categories of Health Personnel (Include all that apply)
Doctors
Nurses
Midwives
Dentists
Pharmacists
Other (include details as necessary)
Hide [q8x2gx3] Validity period

Hide [q8x2fx4] Title of Agreement

Hide [q8x2ax4] Type of Agreement
Hide [q8x2bx4] Countries Involved

Hide [q8x2cx4] Coverage
Hide [q8x2dx4] Main content of agreements (Include all that apply)
Education and training
Institutional capacity building
Promotion of circular migration
Retention strategies
Recognition of health personnel
Recruitment of health personnel
Twinning of health care facilities
Other mechanism (include details if possible)
Hide [q8x2ex4] Categories of Health Personnel (Include all that apply)
Doctors
Nurses
Midwives
Dentists
Pharmacists
Other (include details as necessary)
Hide [q8x2gx4] Validity period

Hide [q8x2fx5] Title of Agreement

Hide [q8x2ax5] Type of Agreement
Hide [q8x2bx5] Countries Involved

Hide [q8x2cx5] Coverage
Hide [q8x2dx5] Main content of agreements (Include all that apply)
Education and training
Institutional capacity building
Promotion of circular migration
Retention strategies
Recognition of health personnel
Recruitment of health personnel
Twinning of health care facilities
Other mechanism (include details if possible)
Hide [q8x2ex5] Categories of Health Personnel (Include all that apply)
Doctors
Nurses
Midwives
Dentists
Pharmacists
Other (include details as necessary)
Hide [q8x2gx5] Validity period

Hide [q8x3] 8.3 Are recommendations of the WHO Global Code reflected in the agreements (e.g. taking into account the needs of developing countries)?
Yes/Partly
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Health Workforce Development and Health System Sustainability

Hide [q9] 9. Does your country strive to meet its health personnel needs with its domestically trained health personnel, including through measures to educate, retain and sustain a health workforce that is appropriate for the specific conditions of your country, including areas of greatest need?
Yes
Hide [q9x1]
9.1 Measures taken to educate the health workforce
1. Continuous Medical Education (CME) 2. Continuous Nursing Education (CNE) 3. Continuous Dental Education (CDE) 4. Post basic programmes 5. Postgraduates programmes and sub-specialties 6. Courses 7. Attachments
9.2 Measures taken to retain the health workforce
In order to retain health work force in public sectors, some of the measures taken are as follows: 1. Offering scholarship to further study with full paid leave and promising career advancement 2. Specialist retention package including flexible working hours, parallel pathway specialization program 3. Post basic training for nurses 4. Allowing the health personnel to work in both sectors e.g. locum, private wing etc. 5. Attractive remuneration package – time-based promotion and salary review
9.3 Measures taken to ensure the sustainability* of the health workforce
In order to ensure the sustainability of the health work force in public sectors, some of the measures taken are as follows: 1. Offering scholarship to further study with full paid leave and promising career advancement 2. Specialist retention package including flexible working hours, parallel pathway specialization program 3. Post basic training for nurses 4. Allowing the health personnel to work in both sectors e.g. locum, private wing etc. 5. Attractive remuneration package – time-based promotion and salary review
9.4 Measures taken to address the geographical mal-distribution of health workers
To address the geographical mal-distribution of health workers at public sectors, Ministry of Health Malaysia has the guidelines in place to ensure that all areas are covered based on the total population. Number of health workers are directly proportional with number of health facilities available in the country.
Hide [q10] 10. Are there specific policies and/or laws, across governmental ministries, for internationally recruited and/or foreign-trained health personnel in your country?
Yes
Hide [q10x1] 10.1 Please provide further information in the box below:
Malaysian Medical Council (MMC) Medical Act 1971 & the MMC’s Registration Procedures & Guidelines Malaysian Dental Council (MDC) Dental Act 1971 & Guidelines for Application for Temporary Practising Certificate (TPC) for Dental Surgeons 2018 Pharmacy Board Malaysia (PBM) According to Section 11A of the Registration of Pharmacist Act 1951, Pharmacy Board Malaysia (PBM) allows a foreign pharmacist to register and practice in Malaysia and shall be given a temporary registration certificate. Nursing Board of Malaysia Nurses Act 1950 & Nurses Registration Regulations 1985: Application for employment shall be made through the employer. The employer must obtain the Temporary Practicing Certificate from Nursing Board Malaysia prior to application for approval of Work Permit and Multiple Entry Visa from the Immigration Department. Malaysian Allied Health Profession Council Allied Health Professions Act 2016 (Act 774): A non-Malaysian citizen who has been practising an Allied Health Profession outside Malaysia may apply to the Council to practice in Malaysia if he fulfils the qualification stated on Section 24 (1): Temporary Practising Certificate.
Hide [q11] 11. Recognizing the role of other parts of government, does the Ministry of Health have processes (e.g. policies, mechanisms, unit) to monitor and coordinate across sectors on issues related to the international recruitment and migration of health personnel?
Yes
Hide [q11x1] 11.1 Please provide further information in the box below:
-
Hide [q12] 12. Has your country established a database or compilation of laws and regulations related to international health personnel recruitment and migration and, as appropriate, information related to their implementation?
Yes
Hide [q12x1] 12.1 Please provide further information in the box below:
-
Hide [q9x3fn] *Health workforce sustainability reflects a dynamic national health labour market where health workforce supply best meets current demands and health needs, and where future health needs are anticipated, adaptively met and viably resourced without threatening the performance of health systems in other countries (ref: Working for Health and Growth, Report of the High-Level Commission on Health Employment and Economic Growth, WHO, 2016, available from http://apps.who.int/iris/bitstream/10665/250047/1/9789241511308-eng.pdf?ua=1 ).
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Responsibilities, Rights and Recruitment Practices

Hide [q13] 13. Which legal safeguards and/or other mechanisms are in place to ensure that migrant health personnel enjoy the same legal rights and responsibilities as the domestically trained health workforce? Please tick all options that apply from the list below:
13.a Migrant health personnel are recruited internationally using mechanisms that allow them to assess the benefits and risk associated with employment positions and to make timely and informed decisions regarding them
13.b Migrant health personnel are hired, promoted and remunerated based on objective criteria such as levels of qualification, years of experience and degrees of professional responsibility on the same basis as the domestically trained health workforce
13.c Migrant health personnel enjoy the same opportunities as the domestically trained health workforce to strengthen their professional education, qualifications and career progression
13.d Other mechanisms, please provide details below if possible:
Hide [q14] 14. Please submit any other comments or information you wish to provide regarding legal, administrative and other measures that have been taken or are planned in your country to ensure fair recruitment and employment practices of foreign-trained and/or immigrant health personnel.
-
Hide [q15] 15. Please submit any comments or information on policies and practices to support the integration of foreign-trained or immigrant health personnel, as well as difficulties encountered.
-
Hide [q16] 16. Regarding domestically trained/ emigrant health personnel working outside your country, please submit any comments or information on measures that have been taken or are planned in your country to ensure their fair recruitment and employment practices, as well as difficulties encountered
-
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Constraints, Solutions, and Complementary Comments

Hide [q17] 17. Please list in priority order, the three main constraints to the implementation of the Code in your country and propose possible solutions:
Main constraints Possible solution
Resources Funding, Manpower
Competency Training
- -
Hide [q18] 18. Please submit any other complementary comments or material you may wish to provide regarding the international recruitment and migration of health personnel, as related to implementation of the Code.
-
Hide [q18x1] Please upload any supporting files