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

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 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:
Afghanistan
Hide [q01b] Contact information:
Full name of institution:
Ministry of Public Health
Name of designated national authority:
Wahid Majrooh
Title of designated national authority:
Dr
Telephone number:
+93 796777177
Email:
moph.ird@gmail.com
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Implementation of the Code

Hide [q1] 1. Has your country taken steps to implement the Code?
No
Hide [q3] 3. Is there specific support you require to strengthen implementation of the Code?
3.a Support to strengthen data and information
Conducting research and studies on health personnel migration reasons and motivators
3.b Support for policy dialogue and development
Technical Support in development of a web-based databased to keep records of health personnel migration and international health personnel recruitment
3.c Support for the development of bilateral agreements
Technical Support in development of a web-based databased to keep records of health personnel migration and international health personnel recruitment
3.d Other areas of support:
Partnership and collaboration in Technical and Financial areas
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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?
No
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 5092 N/A N/A N/A N/A N/A HRMIS N/A
Nurses 5305 N/A N/A N/A N/A N/A HRMIS N/A
Midwives 3543 N/A N/A N/A N/A N/A HRMIS N/A
Dentists N/A N/A N/A N/A N/A N/A N/A N/A
Pharmacists 681 N/A N/A N/A N/A N/A HRMIS N/A
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
N/A
6.b Support for health system strengthening
N/A
6.c Support for health personnel development
N/A
6.d Other areas of support:
N/A
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
N/A
7.b Support for health system strengthening
N/A
7.c Support for health personnel development
N/A
7.d Other areas of support:
N/A
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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?
No
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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
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9.1 Measures taken to educate the health workforce
1. National and International training programs 2. Conduct Training Needs Analysis (TNA) 3. Capacity building and measurement through competitive programs. 4. Health work force tend to improve their knowledge by attending graduate, under-graduate and short-term programs inside the country also (Private Educational Institutions/Universities) 5. Workshops, seminars and training programs which are conducted by donors for medical personnel.
9.2 Measures taken to retain the health workforce
1. Reduction of working hours. 2. Shifts in job 3. Develop quality of life initiatives 4. Ensuring job safety and privileges 5. Promotion and prevention of internal conflicts
9.3 Measures taken to ensure the sustainability* of the health workforce
1. Provision of office equipment 2. Provision of capacity building programs 3. Equal distribution of benefits among the workers 4. Rewards and recognitions 5. Regulate gender sensitivities 6. Positive discrimination to the female health workers
9.4 Measures taken to address the geographical mal-distribution of health workers
1. Revision of National Salary Policy 2. Consideration of hardship according to the remoteness 3. Equal distribution of benefits among the workers 4. Recruitment of relatives of female workers in remote working areas
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?
No
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?
No
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?
No
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.
Foreign and domestically educated health professionals are treated the same rules and regulations which are applied for the recruitment of other staff management documents e.g Laws, acts, rules, procedures and guidelines.
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.
Lack of specific policies and guidelines in this area
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
N/A
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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
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