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:
China
[q01b]
Contact information:
Full name of institution:
National Health Development Research Center, National Health and Family Plan Committe
Name of designated national authority:
Zhang Guangpeng
Title of designated national authority:
Division Director of Health Human Resource
Telephone number:
86-10-8838 5767
Email:
zhanggp@nhfpc.gov.cn
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.
2.c Records are maintained on all recruiters authorized by competent authorities to operate within their jurisdiction.
Administrative measures have been formulated for the short-term practice of foreign physicians in China and the qualification certification of domestic medical personnel abroad. Registration is conducted for foreign doctors practicing in China and domestic medical personnel engaging in medical care activities abroad.
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:
[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:
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 | 3,390,000 | 3,390,000 | NA | NA | NA | NA | NA | NA |
| Nurses | 3,804,000 | 3,804,000 | NA | NA | NA | NA | NA | NA |
| Midwives | NA | NA | NA | NA | NA | NA | NA | NA |
| Dentists | 637,000 | 637,000 | NA | NA | NA | NA | NA | NA |
| Pharmacists | 453,000 | 453,000 | NA | NA | NA | NA | NA | NA |
[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
[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:
Over the past 50 years, China has sent a total of 26,000 medical personnel to 71 countries in Asia, Africa, Latin America, Europe and Oceania. Around the world, China have sent 1,095 medical personnel to 56 countries that provide free medical services to the local people. In Africa, 983 Chinese medical personnel provide free medical services to the local people in 45 countries.In the meanwhile, China sends medicine and medical equipment to the recipient countries, and cultivates the local personnel every year, carries out health cooperation projects and health emergency rescue work.
[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:
Over the past 50 years, through government to government cooperation, China has sent a total of 26,000 medical personnel to 71 countries in Asia, Africa, Latin America, Europe and Oceania. Around the world, China have sent 1,095 medical personnel to 56 countries that provide free medical services to the local people. In Africa, 983 Chinese medical personnel provide free medical services to the local people in 45 countries.In the meanwhile, China sends medicine and medical equipment to the recipient countries, and cultivates the local personnel every year, carries out health cooperation projects and health emergency rescue work.
[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
quit many
[q8x2ax1]
Type of Agreement
Bilateral
[q8x2bx1]
Countries Involved
Asia, Africa, Latin America, Europe and Oceania
[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
since 1963
[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
Established and gradually improved the education system of health personnel,including medical education, postgraduate medical education, and continuing medical education. (1)At the stage of medical education, strengthened medical education cooperation, met the medical needs of the residents, and improved the quality of medical personnel training.(2)At the stage of postgraduate medical education, established and implemented the national standardized training base for resident doctors, carried out trials of standardized training base for specialists, and gradually unify the standards.(3)At the stage of continuing medical education, developed the education training program for health personnel, strengthened the whole staff to continue medical education, and improve the learning system of lifelong education.
9.2 Measures taken to retain the health workforce
To strengthen the attraction and retention of health personnel in terms of education training, financial investment, incentive and security, and career development, etc.(1)Establishing medical personnel training system in line with the characteristics of the medical and health industry, developing medical education and health personnel training program.(2)Establishing and improving the health professional and technical post setup and title system, clearing the health personnel development career ladder of medical, nursing, pharmaceutical, technical and other types.(3)Reforming and improving the salary system of medical institutions, reflecting the long training cycle, technical difficulties, high occupational risk, heavy social responsibility and other characteristics of the industry, reflecting the value of medical staff knowledge services.(4)To establish an honorary system for health professionals, carry out multi-level recognition and selection, publicize outstanding people and deeds, enhance the pride and honor of health professionals, safeguard the social rights and interests of medical professionals, and create a social environment in which medical professionals are respected and protected.
9.3 Measures taken to ensure the sustainability* of the health workforce
The 13th Five-Year Plan and the medium and long-term plan for the development of health manpower were formulated. The goal and task of the development of health manpower were defined. By 2020, the total number of health manpower in China will reach 12.55 million, with more than 2.50 practitioners per 1,000 people and 3.14 registered nurses. The main tasks, strategies and measures to achieve the goals were defined to provide adequate health human resources for the health of residents.Formulated a training plan for medical education and health personnel training, established and improved a standardized medical personnel training system with Chinese characteristics in line with the demands, and ensure that the medical personnel team meets the needs of health services.
9.4 Measures taken to address the geographical mal-distribution of health workers
Through a series of measures, such as education and training, counterpart support, incentive guarantee, career development, flexible Introduction and so on, health workers should be guided to move to remote areas, grass-roots units and central and western regions to optimize the geographical distribution of health manpower.(1) According to strengthen the local training of health manpower, through carrying out order-oriented free training of medical students, Western health personnel training, “3+ 2” medical personnel training, to train medical personnel for grass-roots, remote poverty and central and western regions.(2)To promote cooperation and collaboration among urban and rural health manpower by means of medical association, telemedicine and specialized medical alliance.(3)Carried out the policy of "county management and rural use" to promote the integrated management and service of urban and rural health personnel.(4)Implemented the project of matching urban health manpower to support rural health, and set up counterpart support between urban hospitals and primary medical and health institutions.(5) Established and improved the professional title promotion system of grassroots health workers and clarify the career ladder of grassroots health workforce development.(6)Special subsidies for medical workers working in difficult and remote areas were set up.(7)Implemented plans and projects such as “recruiting practicing doctors in township hospitals” and “setting up special positions for general practitioners”and recruited doctors and general practitioners for primary medical and health institutions in remote areas.
[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:
In 2008, “the mechanism of health human resource development cooperation in China’s foreign aid”was established by the Ministry of Commerce, the Ministry of Foreign Affairs, the National health Commission and other 12 ministries. In 2011, it was upgraded to an inter-ministerial coordination mechanism and kept close cooperation between the ministries on foreign aid training in different areas.
[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
[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:
Administrative measures have been formulated for the short-term practice of foreign physicians in China and the qualification certification of domestic medical personnel abroad. Registration is conducted for foreign doctors practicing in China and domestic medical personnel engaging in medical care activities abroad.
[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
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.
[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
[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
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 | |
|---|---|---|
| Lack of systematic databases and statistics on international migration of health personnel | Establish and improve the database and information exchange mechanism for international migration of health personnel | |
| Lack of international exchange of information on health personnel mobility | Use the code to promote the establishment of an international exchange platform for health personnel mobility | |
| NA | NA |
[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.
[q18x1]
Please upload any supporting files