National Reporting Instrument 2024
Background
[INFOxNRI1]
National Reporting instrument 2024
[BGxINT]
Background
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 mandated to report to the World Health Assembly every 3 years.
WHO Member States completed the 4th round of national reporting in May 2022. The WHO Director General reported progress on implementation to the 75th World Health Assembly in May 2022 (A75/14). The report on the fourth round highlighted the need to assess implications of health personnel emigration in the context of additional vulnerabilities brought about by the COVID-19 pandemic. For this purpose, the Expert Advisory Group on the relevance and effectiveness of the Code (A 73/9) was reconvened. Following the recommendations of the Expert Advisory Group, the Secretariat has published the WHO health workforce support and safeguards list 2023.
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 findings from the 5th round of national reporting will be presented to the Executive Board (EB156) in January 2025 in preparation for the 78th World Health Assembly.
The deadline for submitting reports is 31 August 2024.
Article 9 of the Code mandates the WHO Director General to periodically report to the World Health Assembly on the review of the Code’s effectiveness in achieving its stated objectives and suggestions for its improvement. In 2024 a Member-State led expert advisory group will be convened for the third review of the Code’s relevance and effectiveness. The final report of the review will be presented to the 78th World Health Assembly.
For any queries or clarifications on filling in the online questionnaire please contact us at WHOGlobalCode@who.int.
What is the WHO Global Code of Practice?
Disclaimer: The data and information collected through the National Reporting Instrument will be made publicly available via the NRI database (https://www.who.int/teams/health-workforce/migration/practice/reports-database) following the proceedings of the 78th World Health Assembly. The quantitative data will be used to inform the National Health Workforce Accounts data portal (http://www.apps.who.int/nhwaportal/).
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 mandated to report to the World Health Assembly every 3 years.
WHO Member States completed the 4th round of national reporting in May 2022. The WHO Director General reported progress on implementation to the 75th World Health Assembly in May 2022 (A75/14). The report on the fourth round highlighted the need to assess implications of health personnel emigration in the context of additional vulnerabilities brought about by the COVID-19 pandemic. For this purpose, the Expert Advisory Group on the relevance and effectiveness of the Code (A 73/9) was reconvened. Following the recommendations of the Expert Advisory Group, the Secretariat has published the WHO health workforce support and safeguards list 2023.
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 findings from the 5th round of national reporting will be presented to the Executive Board (EB156) in January 2025 in preparation for the 78th World Health Assembly.
The deadline for submitting reports is 31 August 2024.
Article 9 of the Code mandates the WHO Director General to periodically report to the World Health Assembly on the review of the Code’s effectiveness in achieving its stated objectives and suggestions for its improvement. In 2024 a Member-State led expert advisory group will be convened for the third review of the Code’s relevance and effectiveness. The final report of the review will be presented to the 78th World Health Assembly.
For any queries or clarifications on filling in the online questionnaire please contact us at WHOGlobalCode@who.int.
What is the WHO Global Code of Practice?
Disclaimer: The data and information collected through the National Reporting Instrument will be made publicly available via the NRI database (https://www.who.int/teams/health-workforce/migration/practice/reports-database) following the proceedings of the 78th World Health Assembly. The quantitative data will be used to inform the National Health Workforce Accounts data portal (http://www.apps.who.int/nhwaportal/).
Disclaimer
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National Reporting instrument 2024
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Disclaimer
[1] Note: Case-based facility data collection as that in the WHO Global Bum Registry does not require WHO Member State approval.
[2] The world health report 2013: research for universal coverage. Geneva: World Health Organization; 2013 (http://apps.who.int/iris/bitstream/10665/85761/2/9789240690837_eng.pdf)
[3] WHO statement on public disclosure of clinical trial results: Geneva: World Health Organization; 2015 (http://www.who.int/ictrp/results/en/, accessed 21 February 2018).
For more information on WHO Data Policy kindly refer to http://www.who.int/publishing/datapolicy/en/
[1] Note: Case-based facility data collection as that in the WHO Global Bum Registry does not require WHO Member State approval.
[2] The world health report 2013: research for universal coverage. Geneva: World Health Organization; 2013 (http://apps.who.int/iris/bitstream/10665/85761/2/9789240690837_eng.pdf)
[3] WHO statement on public disclosure of clinical trial results: Geneva: World Health Organization; 2015 (http://www.who.int/ictrp/results/en/, accessed 21 February 2018).
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
Contact Details
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Contact Details
Name of Member State:
Zimbabwe
Name of designated national authority:
Christopher Pasi
Title of designated national authority:
Secretary
Institution of the designated national authority:
Health Service Commission
Email:
christopherpasi68@gmail.com,christopher.pasi@hsc.org.zw,WHOGlobalCode@who.int,bediakonk@who.int
Telephone number :
+263242775581
Contemporary issues
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[NRIxI]
The questions marked * are mandatory. The system will not allow submission until all mandatory questions are answered.
[INFOx1]
Contemporary issues on health personnel migration and mobility
[Q1x1]
In the past 3 years, has the issue of international recruitment of health personnel been a concern for your country?
Yes, and it is decreasing in intensity
Between January and June 2024, the sector lost 625 health Workers the majority being Nurses and Doctors, These workers potentially migrated to other countries. However, when compared with the previous years the flight of health workers has slightly decreased due to financial, non-financial and regulatory mechanisms that were introduced.
[Q1x2]
In the past 3 years, has the issue of international reliance on health personnel (international recruitment of health personnel to meet domestic needs) been a concern for your country?
Yes, and it is decreasing in intensity
Between 2021 and 2023, there was a 55% overall reduction in the number of terminations recorded - The outmigration of critical health workers decreased from the highest figures recorded in 2021 due to several interventions by the Government and Partners. however, the sector continued to record high terminations for specialised cadres such as Doctors, Nurses, Laboratory, Pharmacy and Radiography staff.
Health Personnel Education
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Health personnel education, employment and health system sustainability
[Q2]
Is your country taking measures to educate, employ and retain a health and care workforce that is appropriate for the specific conditions of your country, including areas of greatest need?
Yes
[Q2x1]
Please check all items that apply from the list below:
2.1 Measures taken to ensure the sustainability of the health and care workforce
2.2 Measures taken to address the geographical mal-distribution and retention of health and care workers*
2.3 Other relevant measures taken to educate, employ and retain a health and care workforce that is appropriate for the specific conditions of your country
[Q2x1x1]
2.1.1 Measures taken to ensure the sustainability of the health and care workforce
Forecasting future health and care workforce requirements to inform planning
Aligning domestic health and care workforce education with health system needs
measures put in place to optimise education capacity utilisation from 75% to 100% and gradually increase to train to meet the population needs.to
Improving quality of education and health personnel in alignment with service delivery needs
Resuscitated the joint manpower planning forum, to ensure collaboration, governance and stewardship in education of health professionals
Creating employment opportunities aligned with population health needs
lobbying for creation of an additional 30 000 posts, through the HWF investment Compact
Managing international recruitment of health personnel
working with the Ministry of Foreign affairs, Public Service Labour and Social Welfare to engage major destination countries and come up with mutually beneficial bilateral agreements.
Improving management of health personnel
Health Service Commission operationalised, resuscitated the HRH Technical Working Group
Specific provisions on health personnel regulation and recruitment during emergencies
Previous net freeze on recruitment of health professionals lifted
Others
[Q2x2x1]
Check all that apply for Measures taken to address the geographical mal-distribution and retention of health and care workers
2.2.1 Education
2.2.2 Regulation
2.2.3 Incentives
2.2.4 Support
[Q2x2x3x1]
2.2.3.1 Incentives Measure
Additional financial reimbursement
All specialised health professionals were supported with a retention allowance through the GF Grant which ended in December 2023
Education opportunities
Quotas introduced to recruit in particular Nursing students from rural and underserved areas
Opportunities for career advancement or professional growth
Earlier open practice certification for doctors in rural areas and early opportunity for post graduate training for doctors.
Professional recognition
Social recognition
Opportunity for pathways to permanent residency and/or citizenship for international health personnel
Others
[Q2x3x1]
2.3.1 Please describe - Other relevant measures taken to educate, employ and retain a health and care workforce that is appropriate for the specific conditions of your country.
through the HWF Investment compact Government and partners will refurbish 10 training schools and also equip them with Digital Learning Platforms, this is meant to help improve the enrolment capacity of training schools.
[Q3x1]
Are there specific policies and/or laws that guide international recruitment, migration and integration of foreign-trained health personnel in your country?
No
[Q3x2]
Are there any policies and/or provision for international telehealth services in your country through health personnel based abroad?
No
[Q3x3]
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
[Q4]
Recognizing the role of other government entities, does the Ministry of Health have mechanisms (e.g. policies, processes, unit) to monitor and coordinate across sectors on issues related to the international recruitment and migration of health personnel?
No
[Q5]
Please describe the steps taken by your country to implement the following Code recommendations.
Check all items that apply from the list below:
Check all items that apply from the list below:
5.1 Measures have been taken or are being considered to introduce changes to laws or policies on health personnel consistent with the recommendations of the Code.
the country is working on developing a migration framework for all sectors
5.2 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.
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.
5.3 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.
processes and/or involve them in activities related to the international recruitment of health personnel.
5.4 Records are maintained on all private recruitment agencies for health
personnel authorized by competent authorities to operate within their jurisdiction.
personnel authorized by competent authorities to operate within their jurisdiction.
5.5 Good practices, as called for by the Code, are encouraged and promoted among private recruitment agencies.
5.5a Promotion of the Code among private recruitment agencies.
5.5b Domestic legislation or policy requiring ethical practice of private recruitment agencies, as consistent with the principles and articles of the Code.
5.5c Public or private certification of ethical practice for private recruitment agencies.
5.5d Others
5.6 None of the above
Government Agreements
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Government-to-Government agreements on migration or mobility of health personnel
[Q6]
Has your country or sub-national governments entered into any bilateral, multilateral, or regional agreements and/or arrangements with respect to the international recruitment and/or mobility of health personnel?
No
Responsibilities, rights and recruitment practices
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Responsibilities, rights and recruitment practices
[Q7]
If your country employs/hosts international health personnel to work in the health and care sectors, which legal safeguards and/or other mechanisms are in place for migrant health personnel and to ensure that enjoy the same legal rights and responsibilities as the domestically trained health workforce?
Please check all items that apply from the list below:
Please check all items that apply from the list below:
Migrant health personnel are recruited using mechanisms that allow them to assess the benefits and risk associated with employment positions and to make timely and informed decisions on the employment.
The recruitment process in the country is in line with the tenants of fair and eqaul employment for both local and migrant workers
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.
Fair and equal employment opportunities for all workers both local and migrant are applied
Migrant health personnel enjoy the same opportunities as the domestically trained health workforce to strengthen their professional education, qualifications and career progression.
Institutional arrangements are in place to ensure safe migration/ mobility and integration of migrant health personnel.
Measures have been taken to promote circular migration of international health personnel
Other measures (including legal and administrative) for fair recruitment and employment practices of foreign-trained and/or immigrant health personnel (please provide details)
No measures in place
Not applicable – does not host/employ foreign health personnel
[Q8]
If health personnel from your country are working abroad in the health and care sectors, please provide information on measures that have been taken or are planned in your country to ensure their fair recruitment and employment; safe migration; return; and diaspora utilization in your country, as well as difficulties encountered.
Please check all items that apply from the list below:
Please check all items that apply from the list below:
Arrangements for fair recruitment
Arrangements for decent employment contracts and working conditions in destination countries
Arrangements for safe mobility
Arrangements for return and reintegration to the health labour market in your country
Arrangements for diaspora engagement to support your country health system
Other
a migration framework is being developed for the country and to be shared with potential recruiting countries to guide engagement.
No measures in place
Not applicable – health personnel from my country are not working abroad
International migration
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International migration and mobility pathways for health personnel
[Q9x1]
9.1 If your country hosts international health personnel to work in the health and care sector, how do they come to your country? (check all that apply)
| Direct (individual) application for education, employment, trade, immigration or entry in country |
Government to government agreements that allow health personnel mobility |
Private recruitment agencies or employer facilitated recruitment |
Private education/ immigration consultancies facilitated mobility |
Other pathways (please specify) | Which pathway is used the most? Please include quantitative data if available. | |
|---|---|---|---|---|---|---|
| Doctors | 1 | 1 | 0 | 0 | ||
| Nurses | 1 | 0 | 0 | 0 | ||
| Midwives | 1 | 0 | 0 | 0 | ||
| Dentists | 1 | 0 | 0 | 0 | ||
| Pharmacists | 1 | 0 | 0 | 0 | ||
| Other occupations | 0 | 0 | 0 | 0 | ||
| Other occupations | 0 | 0 | 0 | 0 | ||
| Other occupations | 0 | 0 | 0 | 0 | ||
| Other occupations | 0 | 0 | 0 | 0 | ||
| Other occupations | 0 | 0 | 0 | 0 |
[Q9x1oth]
[Q9x2]
9.2 If health personnel from your country work/study abroad, how do they leave your country?
(check all that apply)
| Direct (individual) application for education, employment, trade, immigration, or entry in the destination country |
Government to government agreements that allow health personnel mobility |
Private recruitment agencies or employer facilitated recruitment |
Private education/ immigration consultancies facilitated mobility |
Other pathways (please specify) | Which pathway is used the most? Please include quantitative data if available. | |
|---|---|---|---|---|---|---|
| Doctors | 1 | 0 | 1 | 0 | Direct | |
| Nurses | 1 | 0 | 1 | 0 | Direct | |
| Midwives | 1 | 0 | 1 | 0 | Direct | |
| Dentists | 1 | 0 | 1 | 0 | Direct | |
| Pharmacists | 1 | 0 | 1 | 0 | Direct | |
| Other occupations | 0 | 0 | 0 | 0 | ||
| Other occupations | 0 | 0 | 0 | 0 | ||
| Other occupations | 0 | 0 | 0 | 0 | ||
| Other occupations | 0 | 0 | 0 | 0 | ||
| Other occupations | 0 | 0 | 0 | 0 |
[Q9x2oth]
Recruitment & migration
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[INFOx6]
Data on international health personnel recruitment & migration
Improving the availability and international comparability of data is essential to understanding and addressing the global dynamic of health worker migration. Please consult with your NHWA focal point, if available, to ensure that data reported below is consistent with NHWA reporting*.
(The list of NHWA focal points is available here. Please find the focal point(s) for your country from the list and consult with them.)
For countries reporting through the WHO-Euro/EuroStat/OECD Joint data collection process, please liaise with the JDC focal point.
[Q10]
Does your country have any mechanism(s) or entity(ies) to maintain statistical records of foreign-born and foreign-trained health personnel?
Yes
[Q10x1]
Where are the records maintained? (check all that apply)
Employment records or work permits
Ministry of health personnel database
Registry of health personnel authorized to practice
Other
[Q10x2]
Does the record include gender-disaggregated data on the foreign-born and/or foreign-trained health personnel?
Yes
Inflow and outflow of health personnel
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Inflow and outflow of health personnel
[Q11]
Do you have a mechanism to monitor the inflow and outflow of health personnel to/from your country? (check all that apply)
Inflow
Outflow
No
[Q11x3]
If you have any document with information on health worker inflows and outflows for your country, please upload
Stock of health personnel
[INFOxNRI13]
National Reporting instrument 2024
[INFOx8]
Stock of health personnel
[Q12x1]
Consolidated stock on health personnel, disaggregated by place of training and birth
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 place of training (foreign-trained) and the place of birth (foreign-born).
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 place of training (foreign-trained) and the place of birth (foreign-born).
[Q12x1a]
Please provide data on the stock of active health personnel in your country by one of the following ways:
Share data in the NHWA platform through NHWA focal point
[Q12x1x1x]
If you have any document with information on stock of active health personnel for your country, their distribution by place of training and place of birth, please upload
[Q12x2]
Please provide data on the top 10 countries of training for foreign-trained health personnel in your country.
This information can be provided by one of the following two options:
This information can be provided by one of the following two options:
Share data in the NHWA platform through NHWA focal point
[Q12x2x1x]
If you have any document with information on the distribution of foreign-trained health personnel for your country by their country of training, please upload
Technical and financial support
[INFOxNRI14]
National Reporting instrument 2024
[INFOx9]
Technical and financial support
[Q13]
Has your country provided technical or financial assistance to any source countries or countries in the WHO health workforce support and safeguards list 2023, or other low- and middle-income countries on health workforce development, health system strengthening, or for implementing other recommendations of the Code (e.g., strengthening data, information and research on health workforce for translation to policies and planning, etc.)
No
[Q14]
Has your country received technical or financial assistance from any WHO Member State or other stakeholders (e.g., development partners, other agencies) for health workforce development, health system strengthening, or for implementing other recommendations of the Code (e.g., strengthening data, information and research on health workforce for translation to policies and planning, etc.)?
Yes
[Q14x]
Please provide additional information below (check all that apply):
Support for health workforce development (planning, education, employment, retention)
Support for other elements for health system strengthening (service delivery; health information systems; health financing; medical products and technology; and health leadership and governance)
Other areas of support:
[Q14x1]
Please specify support for health workforce development (planning, education, employment, retention)
| Supporting country/entity | Type of support (please specify) | |
|---|---|---|
| Global Fund | Retention Scheme for health workers (Grade C5 and above) | |
[Q14x2]
Please specify support for other elements of health system strengthening (service delivery; health information systems; health financing; medical products and technology; and health leadership and governance)
| Supporting country/entity: | Type of support (please specify) | |
|---|---|---|
| Global Fund | HRIS Hardware (Ipads, Laptops) | |
Constraints, Solutions, and Complementary Comments
[INFOxNRI15]
National Reporting instrument 2024
[INFOx10]
Constraints, Solutions, and Complementary Comments
[Q15]
Please list in priority order, the three main constraints to the ethical management of international migration in your country and propose possible solutions:
| Main constraints | Possible solutions/recommendations | |
|---|---|---|
[Q16]
What support do you require to strengthen implementation of the Code?
Support to strengthen data and information on health personnel
support to collect data on workers that migrated and also to collect data from individuals who have intention to migrate
Support for policy dialogue and development
support to develop the National Migration Framework for Zimbabwe
Support for the development of bilateral/multi-lateral agreements
support to engage with major destination countries and develope bilateral agreements
Others
No support required
[Q17]
Considering that the Code is a dynamic document that should be updated as required, please provide reflections from your country on the past 14 years since the resolution on the Code.
[Q17x1]
Please comment on if/how the Code has been useful to your country.
there is need to reinforce compliance, especially given that governments sometimes do not recruit directly, but rather leave private entities and recruiting agencies to recruit from countries on the safeguard list. there is need to protect affected countries from private recruiting agencies.
[Q17x2]
Do any articles of the Code need to be updated?
No
[Q17x3]
Does the process of reporting on Code implementation and the review of the Code relevance and effectiveness need to be updated?
No
[Q17x4]
Please comment on the WHO health workforce support and safeguards list (e.g. if your country is included in the list, how has that affected you; if your country is reliant on international health personnel, how has the list affected you; if your country is not in the list, how has it affected you)
Zimbabwe was included on the safeguard list, this has opened avenues for engagement with major destination countries to come up with mutually beneficial practices. There has also been a marked reduction in voluntary attrition figures as a result.
[Q18]
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.
Please describe OR Upload (Maximum file size 10 MB)
Please describe OR Upload (Maximum file size 10 MB)
[Q18x1]
Warning
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You have reached the end of the National Reporting Instrument - 2024. You may go back to any question to update your answers or confirm your entry by clicking ‘Submit’.