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/).
[hidLabels]
//hidden: Please not delete.
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:
Zimbabwe
[q01b]
Contact information:
Full name of institution:
Health Service Board
Name of designated national authority:
Ruth Runyararo Kaseke
Title of designated national authority:
Executive Director
Telephone number:
+263-4-775581
Email:
ruthkaseke26@gmail.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.
Communication and presentations have been made to key stakeholders that include the Ministry of Health and Child Care and Regulating Professional Councils.
2.b Measures have been taken or are being considered to introduce changes to laws or policies consistent with the recommendations of the Code.
Dialogue is on-going with Professional Councils to harmonise policies and regulations on migration
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.
The various Councils and Associations continue to improve their relationships with other recruiters on good recruitment practices. This is hinged upon the Labour Act.
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.
This is currently not very well coordinated although each professional council has its own regulations that are followed on all recruitments.
2.f Other steps:
Communication with all stakeholders on the need to provide information to strengthen the National Health-worker observatory.
[q3]
3. Is there specific support you require to strengthen implementation of the Code?
3.a Support to strengthen data and information
To create a central repository where all regulating authorities will provide information to a central data base.
3.b Support for policy dialogue and development
Strngthen the capacity of the Ministry of Health Child Care, who is the regulating authority for all professional councils.
3.c Support for the development of bilateral agreements
3.d Other areas of support:
Support with data gathering and management tools for the NRI.
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?
No
[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 | 1808 | 1490 | 318 | n/a | 1739 | 69 | MDPCZ Database | Data not disaggregated by country of training, for foreign trained professionals. |
| Nurses | 24611 | 24443 | 168 | n/a | no data | no data | Nurses Council of Zimbabwe Database | Data not disaggregated by country of training, for foreign trained professionals. |
| Midwives | 8806 | 8804 | 2 | n/a | no data | no data | Nurses Council of Zimbabwe database | Data not disaggregated by country of training, for foreign trained professionals. |
| Dentists | 225 | 141 | 84 | n/a | 210 | 15 | MDPCZ Database | Data not disaggregated by country of training, for foreign trained professionals. |
| Pharmacists | 1347 | 657 | 690 | n/a | no data | no data | Pharmacists Council of Zimbabwe | Data not disaggregated by country of training, for foreign trained professionals. |
[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:
No comment
[q5x2x2]
Option B: Uploading any format of documentation providing such information (e.g. pdf, excel, word).
Please upload file
[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
WHO continues to provide technical support to the Ministry of Health and Child Care
7.c Support for health personnel development
Training was recently done for the Ministry of Health and Child Care on National Health Workforce Accounts
7.d Other areas of support:
Technical guidance by the Geneva WHO office and the WHO Zimbabwe Country office
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
No comment
No comment
No comment
[q8x1wl]
Web-links:
[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
Cooperation AGreement between the Ministry of Public Health of the Republic of Cuba and the Ministry of Health and Child CAre of the Republic of Zimbabwe
[q8x2ax1]
Type of Agreement
Bilateral
[q8x2bx1]
Countries Involved
Zimbabwe and Cuba
[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
Physiotherapists, Xray Operators
Other (include details as necessary)
[q8x2gx1]
Validity period
2014 to 2016, renewable
[q8x2fx2]
Title of Agreement
[q8x2ax2]
Type of Agreement
[q8x2bx2]
Countries Involved
[q8x2cx2]
Coverage
[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
[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
There are Health training programmes at various universities in Zimbabwe. The Ministry of Health runs a number of training schools in nursing, dental therapy and technician, environmental health, radiography etc
9.2 Measures taken to retain the health workforce
The Health Service Board continues to review the health sector specific conditions of service and has also agreed retention schemes with the Global Fund and the Health Development Fund
9.3 Measures taken to ensure the sustainability* of the health workforce
The establishment of the health workforce is carefully monitored by the Ministry of Health, the Health Service Board and the Ministry of Finance to ensure that sustainability issues are taken care of.
9.4 Measures taken to address the geographical mal-distribution of health workers
In designing the staff establishments of the various sub-national levels uniformity and equity have been taken into consideration.
[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
[q10x1]
10.1 Please provide further information in the box below:
The recruitment of foreign professionals is guided by a number of institutions, such as the Zimbabwe Council for Higher Education (ZIMCHE) who monitor qualifications and the various professionals regulatory councils
[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:
As indicated above, the Ministry of Health and the Health Service Board collaborate with ZIMCHE on the assessment of qualifications of foreign trained professionals.
[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
These are provided for in the Health Service Regulations
13.c Migrant health personnel enjoy the same opportunities as the domestically trained health workforce to strengthen their professional education, qualifications and career progression
These are provided for in the Health Service Regulations
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.
Foreign trained personnel don-ot suffer any prejudice when they enter into employment in the Zimbabwe Health Service, the only variance is that they are initially appointed on fixed term contracts that relate to the Immigration laws of the country.
[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.
Foreign trained personnel don-ot suffer any prejudice when they enter into employment in the Zimbabwe Health Service, the only variance is that they are initially appointed on fixed term contracts that relate to the Immigration laws of the country.
[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
Domestically trained health personnel working outside Zimbabwe are bound by the person specific terms and conditions agreed. Zimbabwe has been working on possible provisions for seconding staff to other countries.
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 | |
|---|---|---|
| Data not appropriately disaggregated by Regulatory Councils. | Continued lobbying and engagement with the Councils and the establishment of a fully functional Health Workforce Observatory which would be the central repository of data for ALL health personnel | |
| No electronic link between the databases of Regulatory authorities and the Health Service Board | Strengthen the Health Human Resource Information System such that data on ALL health personnel is directly available for the Board. | |
| Limited dialogue between key stakeholders on Human Resources for Health | Establish structured engagements to facilitate information exchange. |
[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.
The Health Service Board and the Ministry of Health and Child Care continue to make efforts improve processes for the recruitment of foreign professionals. The recently launched National Qualifications framework will help in the assessment of local and international qualifications to make it even more efficient to recruit personnel.
[q18x1]
Please upload any supporting files