National Reporting Instrument 2018
Background
[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/).
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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Please describe
Disclaimer
[disclaim]
For more information on WHO Data Policy kindly refer to http://www.who.int/publishing/datapolicy/en/
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
Designated National Authority Contact Details
[q01a]
Name of Member State:
Sudan
[q01b]
Contact information:
Full name of institution:
The National HRH Observatory [NHRHO]
Name of designated national authority:
Dr. Amel Abdu Abdalla Gesmalla
Title of designated national authority:
Director of NHRHO & The Deputy DG of the HRD Directorate General
Telephone number:
+249 9129 10 252
Email:
amolabdou@yahoo.com
Implementation of the Code
[q1]
1. Has your country taken steps to implement the Code?
Yes
[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.
Sudan health autharaties established a technical standing committee focusing on the health workforce domain, that committee through strengthening the CCF and use it as a platform for advocating for the importance of the health workforce issues they established a mean for communication with the different HRH stakeholders at the country. Moreover, this technical committee work as a secretariat for the National HRH Committee, a sub-committee of the Naational Health Council that headed by the President of the country, where they again use this committee to communicate and share the information on migration and recuritment among the stakeholders at the high political level for more highly level commitment and consideration. Also, the regular bi-annual HRD meeting for the state level departments was used as a hub for sharing the migration and recuritment information as well as to expand the knowledge about the WHO code of practice.
2.b Measures have been taken or are being considered to introduce changes to laws or policies consistent with the recommendations of the Code.
Through the HRH Committee the issue of reviewing some of the national regulation especially the Civil Services regulations as well as the Training policies is raised to consider the current challenges facing the health workforce domain, the initiative and the lesson learnt in addressing those challenges, aiming for improving those regulation and policies to serve the over all development processes.
2.c Records are maintained on all recruiters authorized by competent authorities to operate within their jurisdiction.
That was and is mainly focusing on the Recruitment Agencies working on attracting the qualified health workers. The Ministry of Labor is keeping records about those agencies and have measures to ensure they are following the regulation; but there are big concern around their comply with those regulations which is becoming a challenge to the authorities.
2.d Good practices, as called for by the Code, are encouraged and promoted among recruitment agencies.
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.
Several mechanisms were adopted to ensure the involvement of all the relevant stakeholders including even the diaspor in the discussion of the migration and its impact of the health system and the provision of the heaalthcare services, and all the related activities to the recuitment of the health workforce.
2.f Other steps:
[q3]
3. Is there specific support you require to strengthen implementation of the Code?
3.a Support to strengthen data and information
Having a complete data set on migration is of the acknowledge challenges at the country, there are steps taken to establish an auxillary data system on migration that expected to be part of the national health workforce system. Therefore; having technical support to establish that data system will inform the decision and the strategic actions to be taken.
3.b Support for policy dialogue and development
Policy development in term of capacity to implement and to monitor and evalute the policies again is an area of investment to improve the technical capacity of the involved institutes and personnel; considering that many stakeholders are involved in health workforce issues at the country with different mandates and focus.
3.c Support for the development of bilateral agreements
Enhancing the negotiation capacity is very much needed to support building appropriate bilateral agreements that are implementable and really serving the health workforce as well as the benifits of the involved parties.
3.d Other areas of support:
Data on International Health Personnel Recruitment & Migration
[iq4]
Improving the availability and international comparability of data is essential to understanding and addressing the global dynamic of health worker migration.
[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
[q4x1]
Please describe:
At the country we dont have a mean or an entity where detailed information about the foreign-born and foreign trained health workers. But at the HRD Directorate General we have:
- The Internship Department where all the records about the foreign-born Sudanese house officers who are trained at the country;
- The Fellowship Department where all documents about the foreign-trained doctors where kept
The Sudan Medical Council also have data on pre-services medical foreign-trained medical doctors [analyzed according to the need]
[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.
[q5x1]
5. Data on the stock of health personnel, disaggregated by country of training and birth
5.1 Consolidated stock of health personnel
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 | 10683 | 10683 | NA | NA | NA | NA | 2015 PHC Mapping Survey | - |
| Nurses | 12234 | 12234 | NA | NA | NA | NA | 2015 PHC Mapping Survey | - |
| Midwives | 16138 | 16138 | NA | NA | NA | NA | 2015 PHC Mapping Survey | - |
| Dentists | 484 | 484 | NA | NA | NA | NA | 2015 PHC Mapping Survey | - |
| Pharmacists | 1027 | 1027 | NA | NA | NA | NA | 2015 PHC Mapping Survey | - |
[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:
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:
[q5x2x2]
Option B: Uploading any format of documentation providing such information (e.g. pdf, excel, word).
Please upload file
No comment
No comment
[Q5fn]
*e.g. professional register, census data, national survey, other
#e.g. active stock, cumulative stock, public employees only etc.
#e.g. active stock, cumulative stock, public employees only etc.
Partnerships, Technical Collaboration and Financial Support 1/2
[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:
[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
Sudan recieved technical and financial support from GAVI as one of the health system partners inthe country to strengethn the health workforce domain with focus on migration and retention policy development.
7.c Support for health personnel development
7.d Other areas of support:
Facilitation of the bilateral negotiation with the reciepent countries mainly kingdom of Saudi Arabia and Irland from the Sudanese Dispora as a key stakeholders and from the WHO-EMRO and the country office as well
Partnerships, Technical Collaboration and Financial Support 2/2
[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
[q8x1]
8.1 Please provide the text and/or web-links to the agreements or arrangements
Please upload file
[q8x1wl]
Web-links:
NA
[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
Table A Description of bilateral, multilateral, regional agreements or arrangements
1.
2.
3.
4.
5.
[q8x2fx1]
Title of Agreement
Bilateral Agreement with Kingdom of Saudi Arabia and Republic of Sudan
[q8x2ax1]
Type of Agreement
Bilateral
[q8x2bx1]
Countries Involved
Kingdom of Saudi Arabia & Sudan
[q8x2cx1]
Coverage
National
[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)
[q8x2ex1]
Categories of Health Personnel (Include all that apply)
Doctors
Nurses
Midwives
Dentists
Pharmacists
Other (include details as necessary)
[q8x2gx1]
Validity period
2017-2020
[q8x2fx2]
Title of Agreement
Bilateral Agreement with the Republic of Ireland and Republic of Sudan
[q8x2ax2]
Type of Agreement
Bilateral
[q8x2bx2]
Countries Involved
Ireland And Sudan
[q8x2cx2]
Coverage
National
[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)
[q8x2ex2]
Categories of Health Personnel (Include all that apply)
Doctors
Nurses
Midwives
Dentists
Pharmacists
Other (include details as necessary)
[q8x2gx2]
Validity period
2017-2020
[q8x2fx3]
Title of Agreement
[q8x2ax3]
Type of Agreement
[q8x2bx3]
Countries Involved
[q8x2cx3]
Coverage
[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)
[q8x2ex3]
Categories of Health Personnel (Include all that apply)
Doctors
Nurses
Midwives
Dentists
Pharmacists
Other (include details as necessary)
[q8x2gx3]
Validity period
[q8x2fx4]
Title of Agreement
[q8x2ax4]
Type of Agreement
[q8x2bx4]
Countries Involved
[q8x2cx4]
Coverage
[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)
[q8x2ex4]
Categories of Health Personnel (Include all that apply)
Doctors
Nurses
Midwives
Dentists
Pharmacists
Other (include details as necessary)
[q8x2gx4]
Validity period
[q8x2fx5]
Title of Agreement
[q8x2ax5]
Type of Agreement
[q8x2bx5]
Countries Involved
[q8x2cx5]
Coverage
[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)
[q8x2ex5]
Categories of Health Personnel (Include all that apply)
Doctors
Nurses
Midwives
Dentists
Pharmacists
Other (include details as necessary)
[q8x2gx5]
Validity period
[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
Health Workforce Development and Health System Sustainability
[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
[q9x1]
9.1 Measures taken to educate the health workforce
Establishment of the Academy of Health Sciences to respond to the gap on non-doctor categories and to serve correcting the skill mix and the shortage of those categories
Provision of postgraduate training chances sponsored by the Ministry of Health at the Sudan Medical Specialization Board [SMSB]
9.2 Measures taken to retain the health workforce
Establishing financial incentive scheme to return the specialized doctors at the rural, remote and underserved areas … the scheme is supported by the high level authorities at the country.
Improving the working conditions at those targeted areas through provision of needed equipment, supplies and infrastructure
9.3 Measures taken to ensure the sustainability* of the health workforce
Strengthening the HRD at the decentralized level
9.4 Measures taken to address the geographical mal-distribution of health workers
Shared incentive package schemes between the federal and state levels were established to address the mal-distribution through attracting health workers to those areas the package include financial and non-financial incentives
[q10]
10. Are there specific policies and/or laws, across governmental ministries, for internationally recruited and/or foreign-trained health personnel in your country?
No
[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
[q11x1]
11.1 Please provide further information in the box below:
The National HRH Observatory through the Stakeholders Forum is tackling this task and co-ordinate the dialogue with the stakeholders on HRH migration and retention and all the related issues
[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?
No
[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
).
Responsibilities, Rights and Recruitment Practices
[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
It is mainly practiced by the Private Sector and Private Hospitals
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:
[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.
No additional information
[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.
- The immigrant health personnel are registered by the Sudan Medical Council after doing an assessment of their certification and qualification and it is a mandatory for them to practice
- Foreign-trained health personnel are licensed and registered by the Sudan Medical Council and an assessment period under supervision
[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
- Strengthening the link with the Diaspora which already started and being involved even at the negotiation with the recipient countries, they do participate in building the capacity of the national health workforce. the plan is to establish clear joint programs with the Sudanese Diaspora.
- The plan is to work with the Ministry of Labor to establish strategies to control the Recruitment Agencies which play a role in facilitating the irregular migration of the health workforce at the country
Constraints, Solutions, and Complementary Comments
[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 | |
|---|---|---|
| Turnover of the leadership | Strengthening the leadership and enhance its sustanability since the olitical commitment is there | |
| capacity limitation for the code implementation at the different involved stakeholders institutes | Make use of the experience and the capacity that are fast developing at the intrenational and regional levels supported by the committed international organization | |
| The looming power of the recruitment agencies | Work with the relevant bodies at the country t set standards and control those agencies |
[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.
NAD
[q18x1]
Please upload any supporting files