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:
Belgium
Hide [q01b] Contact information:
Full name of institution:
Service Public Féderal Santé publique, Sécurité de la Chaîne alimentaire et Environnement
Name of designated national authority:
Tom Auwers
Title of designated national authority:
Secretary-general
Telephone number:
0032 2 524 90 00
Email:
ibri@health.belgium.be
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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.
Le contenu du Code a été communiqué aux instances publique et aux différents conseils consultatifs qui contribuent à déterminer la politique publique belge en matière de migration de professionnels de santé
2.b Measures have been taken or are being considered to introduce changes to laws or policies consistent with the recommendations of the Code.
La politique de migration des professionnels de santé est intégrée à la politique de planification et de contingentement des professionnels de santé en Belgique. Cette politique fait l’objet d’une réévaluation permanente et, dans ce cadre, toute modification veille à tenir compte des recommandations du Code
2.c Records are maintained on all recruiters authorized by competent authorities to operate within their jurisdiction.
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.
Toute politique publique en matière de planification et de contingentement des professionnels fait l’objet préalablement d’un avis d’organes consultatifs où peuvent s’exprimer les différentes parties prenantes
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:
Service Planification du Service public fédéral Santé publique, Sécurité de la Chaîne alimentaire et Environnement
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 63615 55814 7801 NA 51075 12540 Base de données fédérale des professionnels de soin de santé NA
Nurses 204256 197041 7215 NA 182002 22254 Base de données fédérale des professionnels de soin de santé NA
Midwives 12417 12225 192 NA 10872 1545 Base de données fédérale des professionnels de soin de santé NA
Dentists 11440 10147 1293 NA 9179 2261 Base de données fédérale des professionnels de soin de santé NA
Pharmacists 21413 20940 473 NA 19877 1536 Base de données fédérale des professionnels de soin de santé NA
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

No comment
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:
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:
NA
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
NA
Hide [q8x2ax1] Type of Agreement
Bilateral
Hide [q8x2bx1] Countries Involved
NA
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
NA
Hide [q8x2fx2] Title of Agreement
NA
Hide [q8x2ax2] Type of Agreement
Multilateral
Hide [q8x2bx2] Countries Involved
NA
Hide [q8x2cx2] Coverage
Subnational
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
NA
Hide [q8x2fx3] Title of Agreement
NA
Hide [q8x2ax3] Type of Agreement
Regional
Hide [q8x2bx3] Countries Involved
NA
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
NA
Hide [q8x2fx4] Title of Agreement
NA
Hide [q8x2ax4] Type of Agreement
Hide [q8x2bx4] Countries Involved
NA
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
NA
Hide [q8x2fx5] Title of Agreement
NA
Hide [q8x2ax5] Type of Agreement
Hide [q8x2bx5] Countries Involved
NA
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
NA
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
Le système de formation des professionnels de santé vise à être parmi les plus performant au monde, en termes de formation pratique et théorique
9.2 Measures taken to retain the health workforce
Le système soins belge vise à assurer le meilleur environnement de travail (qualité de l’environnement de travail, rémunération, équilibre vie-travail, …) aux professionnels de santé
9.3 Measures taken to ensure the sustainability* of the health workforce
L’effectif des professionnels de santé est monitoré de manière continue, afin de pouvoir réorienter les flux vers les métiers en pénurie ou les secteurs en demande
9.4 Measures taken to address the geographical mal-distribution of health workers
L’effectif des professionnels de santé est monitoré de manière continue, afin de pouvoir réorienter les flux vers les métiers en pénurie ou les secteurs en demande. Des mesures sont également prises, au niveau principalement de la médecine générale, pour pallier aux disparités régionales
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:
La Belgique dispose de normes encadrant le flux de professionnels de santé migrants, en terme de protection de la santé publique (reconnaissance des qualifications), d’encadrement de la formation et de monitoring des flux. La Belgique étant membre de l’UE, il existe cependant une différence entre les professionnels originaires de l’EU et hors EU.
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:
protection de la santé publique (reconnaissance des qualifications), d’encadrement de la formation et de monitoring des flux.
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:
Les données relatives aux professionnels de santé migrants sont intégrés à la planification et au contingentement des professionnels de santé et font l’objet d’un monitoring permanent : http://organesdeconcertation.sante.belgique.be/fr/organe-davis-et-de-concertation/commission-de-planification-offre-medicale
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.
Dans la situation où un ressortissant étranger sollicite un poste dans le domaine de la santé en Wallonie, il nous semble intéressant d’évoquer le dispositif d’équivalence des diplômes de la Fédération Wallonie-Bruxelles. La FWB étant compétente non seulement pour l’équivalence des diplômes, mais également pour l’agrément des professionnels de santé, l’AViQ n’est qu’un observateur des flux. Les opérateurs des « consommateurs » suggèrent l’idée que les flux de personnel de soins venant de l’étranger pourraient potentiellement compenser le déficit de l’offre et la planification défavorable à l’égard des Francophones. En Belgique, il est obligatoire, d’un point de vue administratif, de suivre une formation dans les établissements d’enseignement si l’équivalence n’est pas octroyée.
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.
NA
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
NA
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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
17.a1 Le recrutement de professionnels de santé migrants est laissé aux opérateurs privés 17.a2 diffuser plus largement (via un portail dédié, par exemple) l’information utile aux professionnels candidats migrants
17.b1 Les flux de professionnels migrants peuvent déséquilibrer les systèmes de planification mis en place au niveau national. 17.b2 introduire totalement les flux de migrants dans les système de contingentement
17.c1 les professionnels migrants venant se former en Belgique de manière temporaire ont tendances à contourner les normes pour rester sur le marché belge, ce qui pourrait mettre en péril les accords pris NA
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