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:
Slovakia
[q01b]
Contact information:
Full name of institution:
The Ministry of Health of the Slovak Republic
Name of designated national authority:
Miloslava Kováčová
Title of designated national authority:
Ing. MPH
Telephone number:
++421 2 593 73 160
Email:
Miloslava.kovacova@health.gov.sk
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.
2.b Measures have been taken or are being considered to introduce changes to laws or policies consistent with the recommendations of the Code.
Competence and performance of health profession, education of health professionals, individual and collective labor relations, including compensation, collective bargaining, the principle of equal treatment and non-discrimination, labor inspection, employment of third country nationals, recruitment reward, prohibition of illegal work and illegal employment, control of illegal work is primarily regulated by the laws. Legislation is consistent with the recommendations of the Code. Hospitals as well as other health care facilities are recruiting healthcare workers independently. These employers do not use recruitment agencies.
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.
2.f Other steps:
Steps to provide the necessary number of healthcare workers, improve pay, stabilize them, increase interest in the performance of the healthcare profession, improve working conditions and finance further education (Residential Program). Introducing incentive scholarships for missing/shortage qualifications. The Ministry of Health of the Slovak Republic (MoH) introduces stabilization scholarships for nurses when entering the profession. Communication with educational institutions and professional associations. From September 2019 MoH will keep a central register of healthcare workers in further education. Investments in healthcare infrastructure. Improvement of remuneration of doctors, dental doctors, nurses, and other health workers in hospitals The main goal of the Slovak residential programme - designed and initiated in 2014 - is to support of the postgraduate education of healthcare professionals, especially with respect to the general medicine. At the same time, all efforts should lead to provide adequate number GPs and paediatricians in all regions across Slovakia, to decrease the average age of primary care doctors and to improve the quality of primary health care. The residential program will be expanded with further specializations. The programme was prepared in accordance with the conditions of “the Operational programme Education” and executed in co-operation with three medical universities. From 2016 is the residential program fully guided and supported by MoH and at the present time we aim the inclusion of its principle to the Slovak legislation. Based on negotiations with self-governing regions, health care providers and professional companies MoH will assess the need for further specializations to be included in the residential program. MoH is convinced that it is an effective tool for motivating young doctors, guaranteeing their work experience as well as supplementing the missing number of doctors.
[q3]
3. Is there specific support you require to strengthen implementation of the Code?
3.a Support to strengthen data and information
National Health information Centre (NHIC) is a state-funded organization founded by the Ministry of Health of the Slovak Republic. Status and role of the NHIC is governed by Act no. 153/2013 Coll. on the National Health Information System and on Amendments and Additions to Certain Laws. NHIC performs tasks in the following areas: informatisation of health service, administration of the National Health Information System, standardisation of health informatics, health statistics, administration of national health administrative registries and national health registries. NHIC collaborates with institutions such as the Statistical Office of the Slovak Republic, the Health Care Surveillance Authority, the Public Health Authority of the Slovak Republic, the State Institute for Drug Control, institutes of the Slovak Academy of Sciences, health care providers, chambers and health professional organisations, health insurance companies and medical faculties. At international level, NHIC collaborates with WHO, EOCD, EUROSTAT and EMCDDA. Available data: NHIC administers national health registries and national health administrative registries (National Registry of Health Workers, National Registry of Health Care Providers). NHIC collects and processes data from various statistics about the employment (and working conditions) in the health resort. The purpose of data collection and their processing within national health administrative registries is: database management; fulfilment of identification, registration, integration, information and statistical function of registries at both national and international level; creation and evaluation of statistical outputs; insurance and use of electronic health professional cards. http://www.nczisk.sk/en/Pages/default.aspx
3.b Support for policy dialogue and development
Dialogues with Employers, Ministries, Self-Governing Regions, educational institutions, Professional Associations and Trade Unions.
3.c Support for the development of bilateral agreements
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:
1. National Health Information Centre is the entity with its National Registry of Health Professionals (NRHP) having ready mechanisms to manage such data, export, and process related statistical data in its Information System for processing outputs.
2. If a health professional performing his health profession in Slovak Republic gained any or all qualifications in a foreign country, this information is captured in NRHP/shall be captured in future, yet without mentioning this particular country.
3. Recently we do not process that data, we expect them in future. It will be possible to provide data, when
- Registration of qualification data from the professional chambers is completed,
- Integration of information systems providing data sources for HRHP is completed.
[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 | NA | NA | NA | NA | NA | NA | NHIC | not available |
| Nurses | NA | NA | NA | NA | NA | NA | NHIC | not available |
| Midwives | NA | NA | NA | NA | NA | NA | NHIC | not available |
| Dentists | NA | NA | NA | NA | NA | NA | NHIC | not available |
| Pharmacists | NA | NA | NA | NA | NA | NA | NHIC | not available |
[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
[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
Technical assistance in the pre-accession negotiations for EU accession for Bosnia and Herzegovina on implementation Directive 2005/36/EC of the European Parliament and of the Council on the recognition of professional qualifications (for the medical profession: doctor, dental doctor, nurse, midwife and pharmacist).
6.d Other areas of support:
Technical assistance within TAIEX for nurses and midwives.
[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:
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:
[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
-
[q8x2ax1]
Type of Agreement
Bilateral
[q8x2bx1]
Countries Involved
Czech Republic
[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
-
[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
Steps to increase interest in the performance of the healthcare profession, improvement in education, enhancing the competencies of nurses and midwives.
9.2 Measures taken to retain the health workforce
Legislative adjustment to the gradual prolongation of the retirement age, including healthcare workers.
9.3 Measures taken to ensure the sustainability* of the health workforce
Investments in healthcare infrastructure, improve working conditions and remuneration.
9.4 Measures taken to address the geographical mal-distribution of health workers
Investments in healthcare infrastructure and finance further education (Residential Program).
[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 performance of the medical profession and the field of employment relations are regulated by special laws.
Legislation regulating employment facilitates the employment of workers in professions with a shortage of specialists (lacking occupations), including healthcare and health professions.
[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:
Coordination of data with the Ministry of Education, Science, Research and Sport of the Slovak Republic in the field of qualification and recognition of foreign qualifications.
[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
[q12x1]
12.1 Please provide further information in the box below:
The main indicator used to follow health workforce mobility in Slovakia is nationality (foreign nationality).
Information about laws and regulations are published on the website of the Ministry of Labour, Social Affairs and Family of the Slovak Republic (The Ministry of Labour, Social Affairs and Family of the Slovak Republic is responsible for employment support, social care and functioning of the pension scheme. It is an important state administration body for the social-legal protection of children and family policy coordination), the Ministry of Interior of the Slovak Republic, (which is coordinator of migration policy in the Slovak Republic), the Ministry of Health of the Slovak Republic and the Ministry of Education, Science, Research and Sport of the Slovak Republic.
https://www.employment.gov.sk/en/labour-employment/
https://www.employment.gov.sk/en/integration-foreigners-slovakia/
https://www.employment.gov.sk/en/information-foreigners/
https://www.employment.gov.sk/en/information-foreigners/employment/
http://www.minv.sk/?mi-and-european-union
https://www.minedu.sk/about-the-ministry/
Health legislation, information on education and recognition of qualifications are available on the Ministry of Health website.
http://www.health.gov.sk/?legislativa-a-financovanie
http://www.health.gov.sk/?uznavanie-kvalifikacii
http://www.health.gov.sk/?priprava-na-vykon-povolania-1
[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
Competence and performance of health profession, education of health professionals, individual and collective labour relations, including compensation, collective bargaining, the principle of equal treatment and non-discrimination, labour inspection, employment of third country nationals, recruitment reward, prohibition of illegal work and illegal employment, control of illegal work is regulated by the laws.
13.c Migrant health personnel enjoy the same opportunities as the domestically trained health workforce to strengthen their professional education, qualifications and career progression
Competence and performance of health profession, education of health professionals, individual and collective labour relations, including compensation, collective bargaining, the principle of equal treatment and non-discrimination, labour inspection, employment of third country nationals, recruitment reward, prohibition of illegal work and illegal employment, control of illegal work is regulated by the laws.
13.d Other mechanisms, please provide details below if possible:
Competence and performance of health profession, education of health professionals, individual and collective labour relations, including compensation, collective bargaining, the principle of equal treatment and non-discrimination, labour inspection, employment of third country nationals, recruitment reward, prohibition of illegal work and illegal employment, control of illegal work is regulated by the laws.
[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.
-
[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.
-
[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
Emigration is often attractive for young doctors, given the ease of mobility within the EU.
The share of doctors trained in the Slovak Republic and practising abroad was 19 % of the total number of Slovak doctors, which is high in international comparison.
This brain drain is more pronounced among medical graduates than among those from other fields of study. It is estimated that about 20 % of students who completed their medical studies between 2012 and 2014 left the country to practice abroad, essentially in the Czech Republic, Germany or Austria.
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 | |
|---|---|---|
| - | - | |
| - | - | |
| - | - |
[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 main indicator used to follow health workforce mobility in Slovakia is nationality (foreign nationality).
The number of foreign health professionals in the Slovak Republic is marginal (in 2016: 2,18 % doctors, 1,67 % dental doctors, 0,31 % pharmacists, 0,11 % nurses, 0,11 % midwives).
[q18x1]
Please upload any supporting files