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
[INFOxNRI2]
National Reporting instrument 2024
[disclaim]
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
[INFOxNRI3]
National Reporting instrument 2024
[CI]
Contact Details
Name of Member State:
Bhutan
Name of designated national authority:
Ugyen Dema
Title of designated national authority:
Deputy Chief Human Resource Officer
Institution of the designated national authority:
Human Resource Division, Ministry of Health
Email:
udema@health.gov.bt,WHOGlobalCode@who.int,dhilloni@who.int
Telephone number :
77151414
Contemporary issues
[INFOxNRI4]
National Reporting instrument 2024
[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 increasing in intensity
Yes, because of the global demand for healthcare professionals, especially doctors and nurses, many international countries are recruiting them. This has led to a high attrition rate in the health sector, with professionals migrating to high-income countries, impacting the UN-classified Least Developed Countries (LDCs) and Lower-Middle-Income Countries (LMICs).
[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 increasing in intensity
Yes the reliance on the international health professionals has been increasing in last 2 years due to high attrition rate.
Health Personnel Education
[INFOxNRI5]
National Reporting instrument 2024
[INFOx2]
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
implementation of the Code (https://www.who.int/publications/i/item/wha68.32). HCWF forecasting and recruitment was based on the HR Master 2017- 2023, however, due to changes in requirements Ministry of Health is currently drafting service standards that will specify the types and numbers of healthcare professionals needed for different types of health facilities. These standards will also help identify the current workforce, determine future needs, and highlight any gaps that need to be addressed.
Aligning domestic health and care workforce education with health system needs
To align domestic HCWF education with health system needs, the Government has initiated the following: Increased the intake of students in the Nursing Institutes in the country. Increased the number of medical and health sciences scholarships for both in-service MD/MS and undergraduate programs in the region as well as at the National University. Increased the intake of MBBS in Bangladesh from 21 to 30.
Improving quality of education and health personnel in alignment with service delivery needs
In order to enhance the capacity of the health personnel, clinical attachment and Continuing Medical Education (CME) are being provided by the Government.
Creating employment opportunities aligned with population health needs
The service standards of the Ministry of Health determines the level and nature of services to be provided by the respective health facilities. The type and number of health professionals required in each of the facilities are determined based on the demography and disease pattern.
Managing international recruitment of health personnel
To address the HR gap in the country, international recruitment of health professionals is being considered. The Ministry of Health determines the categories and numbers of health professionals needed, while the Bhutan Qualifications and Professionals Certification Authority (BQPCA) will verify their qualifications and certify them to practice. Additionally, the Ministry of Finance will be negotiating and managing the salary and financial aspects.
Improving management of health personnel
Alternative career pathways and performance management systems for health professionals in being developed and its in the draft stage.
Specific provisions on health personnel regulation and recruitment during emergencies
The emergency deployment plan created during the COVID-19 pandemic is now being integrated into the Health Emergency and Disaster Contingency Plan to enhance HR surge capacity, which is inline with the Disaster Management Act of Bhutan
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
[Q2x2x1x1]
2.2.1.1 Education Measure
Education institutions based in rural/underserved areas
NA
Student intake from rural/underserved areas and communities
There are no specific recruitment or support strategies for targeted groups. The government offers free education for all students, but once they reach the 12th grade, scholarships for professional education are limited. As a result, students from all backgrounds must compete for these merit-based scholarships, regardless of their geographic origin.
Scholarships and subsidies for education
In addition to the above, the government provides free scholarships that allow healthcare professionals to pursue further studies and specializations
Relevant topics/curricula in education and/or professional development programmes
In response to the disease burden, emerging illnesses, and advancing technologies, relevant education and professional development programs are designed and planned. Some of these programs are developed domestically, while others are pursued abroad due to limitations in local capacity. These initiatives focus on enhancing clinical skills, staying updated with emerging medical technologies, improving patient care practices, and advancing healthcare management and continuous improvement methodologies.
(Re)orientation of education programmes towards primary health care
Primary health care has been a cornerstone of Bhutan's healthcare system, significantly enhancing the country’s health and wellbeing outcomes. Despite challenges posed by complex diseases and advancing technologies, the Ministry of Health views primary health care as a key pillar for strengthening and sustaining the healthcare system in Bhutan. The Department of Public Health is tasked with advancing preventive and promotive health, supported by the network of primary health care centers across the country. Furthermore, the 13th Five-Year Plan includes an indicator to increase budget allocations for primary health care
Others
[Q2x2x2x1]
2.2.2.1 Regulation Measure
Scholarships and education subsidies with return of service agreements
Yes, while the government offers scholarships for further studies and specialization, beneficiaries are required to sign a return-of-service agreement with the Royal Civil Service Commission. For example, those who receive a first scholarship must serve twice the length of their training period, while those with a second scholarship must serve three times the duration of their training. Alternatively, if they choose not to fulfill the service requirement, they must repay an amount double or triple the expenses incurred during their training, respectively
Mandatory service agreements with health personnel that are not related to scholarships or education subsidies
no
Enhanced scope of practice of existing health personnel
Existing health personnel are given opportunities to expand their roles and responsibilities, as well as enhance their skills and expertise through training and fellowship programs. These opportunities are aimed at meeting the patient needs and to adapt to the evolving demands of the healthcare system.
Task sharing between different professions
asks are assigned to health professionals based on their specific job responsibilities and are monitored by the Bhutan Qualifications and Professionals Certification Authority (BQPCA). To address workforce gaps, new roles such as emergency medical responders and phlebotomists have been introduced. These professionals undergo six months to a year of training, allowing nurses and laboratory technicians to focus on their core responsibilities. Additionally, health assistants are permitted to diagnose and manage patients within a limited scope. These measures are part of the strategies adopted to address the HR gap in the country
Provisions for pathways to enter new or specialised practice after rural service
All healthcare professionals have equal opportunities to enter new or specialized practice based on the availability of programs. There are no specific provisions for pathways into new or specialized practice exclusively for those who have completed rural service. However, individuals with rural service experience may receive a slight advantage during selection interviews, as there is a criterion that awards additional points to those who have served in rural areas
Others
[Q2x2x3x1]
2.2.3.1 Incentives Measure
Additional financial reimbursement
Health professionals receive a clinical allowance that ranges from 20% to a certain percentage of their base salary, depending on their years of service and qualifications. Additionally, those working in challenging locations receive extra allowances, such as high altitude compensation. In some facilities, health professionals can also earn additional income through specialized clinical consultations and by working extended hours.
Education opportunities
professionals have opportunities to participate in continuous medical education, training programs, workshops, and fellowships, which are aligned with health needs, emerging priorities, and new health technologies. However, not everyone may have access to these opportunities.
Opportunities for career advancement or professional growth
Most health professionals will retain similar job responsibilities, but as the volume of services increases, they may be promoted to higher grades with additional supervisory, monitoring, and managerial responsibilities. They are also eligible to participate in training, further studies, and specialization programs to achieve higher
Professional recognition
The Royal Civil Service Commission (RCSC) acknowledges professionals with service medals for milestones such as 10, 20, and 30 years of service. Additionally, obtaining a master's degree and specialized qualifications is recognized, and higher allowances are granted to those who achieve specialist status in the healthcare field.
Social recognition
Although there are no formal social recognition programs by the government, health professionals informally acknowledge each other's achievements through gatherings and celebrations. For instance, the entire health sector was honored with the Drug Thugsey (the highest award) by His Majesty the King on National Day for their contributions to the COVID-19 response. Additionally, the media and public offer informal commendations for their efforts.
Opportunity for pathways to permanent residency and/or citizenship for international health personnel
Currently, there are no rules, regulations, policies, or programs in place to facilitate long-term residency or citizenship for international health personnel. However, depending on the necessity and importance of their services, their stay permits may be extended.
Others
[Q2x2x4x1]
2.2.4.1 Support Measure
Decent and safe working conditions
While the Ministry of Health is working to provide decent and safe working conditions, efforts include programs like the Bhutan Health Care Standards for Quality Assurance (BHSQA). However, due to HR shortages and limited resources, there is always room for improvement to achieve the standards. Further, there is an internal framework in place to address gender and disability related issues at the workplace. We also have the comply with the Occupational Health and Safety Provision under the Labor and Employment Act of Bhutan 2007.
Decent and safe living conditions
Health professionals, like other civil servants, receive a housing allowance, although it often falls short of covering the full cost of rent depending on the area of residence. Additionally, critical healthcare professionals are provided with housing on the health facility campus at a subsidised rate.
Distance learning/e-learning opportunities
The Ministry of Health promotes e-learning programs and offers numerous opportunities for online education and courses. However, these programs are less preferred by many individuals unless it is made mandatory by agencies.
Others
[Q3x1]
Are there specific policies and/or laws that guide international recruitment, migration and integration of foreign-trained health personnel in your country?
Yes
[Q3x1x1]
Please provide further information in the box below:
Law/policy 1
Bhutan Civil Service Rules and Regulation 2023
Law/policy 2
Bhutan Medical and Health Council Act 2002
Law/policy 3
[Q3x2]
Are there any policies and/or provision for international telehealth services in your country through health personnel based abroad?
Yes
[Q3x2x1]
Please describe
National Health Policy 2011
[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.
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.
Yes
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.
NA
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
[INFOxNRI6]
National Reporting instrument 2024
[INFOx3]
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?
Yes
[Q6x1xA]
Please use the table below to describe each of the active bilateral, regional or multilateral agreements or arrangements:
| a. Title of Agreement | b. Type of Agreement | |
|---|---|---|
| Agreement 1 | MoU MoH and Government of People's Republic of Bangladesh | 1 |
| Agreement 2 | Memorandum of Understanding Between Ministry of Health, Royal Government of Bhutan And Health Volunteers Overseas, United States of America And Bhutan Foundation, Thimphu, Bhutan on Medical Education Programs and Clinical Services | 1 |
| Agreement 3 | ||
| Agreement 4 | ||
| Agreement 5 | ||
| Agreement 6 | ||
| Agreement 7 | ||
| Agreement 8 | ||
| Agreement 9 | ||
| Agreement 10 | ||
| Agreement 11 | ||
| Agreement 12 | ||
| Agreement 13 | ||
| Agreement 14 | ||
| Agreement 15 |
Government Agreements - 6.1 A
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National Reporting instrument 2024
[Q6x1xAx1]
c. Countries involved
MoU MoH and Government of People's Republic of Bangladesh
BGD,BTN
Memorandum of Understanding Between Ministry of Health, Royal Government of Bhutan And Health Volunteers Overseas, United States of America And Bhutan Foundation, Thimphu, Bhutan on Medical Education Programs and Clinical Services
BTN,USA
[Q6x1xAx2]
d. Coverage
MoU MoH and Government of People's Republic of Bangladesh
National
Memorandum of Understanding Between Ministry of Health, Royal Government of Bhutan And Health Volunteers Overseas, United States of America And Bhutan Foundation, Thimphu, Bhutan on Medical Education Programs and Clinical Services
National
[Q6x1xAx3]
e. Main focus of agreement (check all that apply)
| Education and training | Health cooperation | Promotion of circular migration | Philanthropy or technical support | Qualification recognition | Recruitment of health personnel | Trade in services | Others | |
|---|---|---|---|---|---|---|---|---|
| MoU MoH and Government of People's Republic of Bangladesh | 1 | |||||||
| Memorandum of Understanding Between Ministry of Health, Royal Government of Bhutan And Health Volunteers Overseas, United States of America And Bhutan Foundation, Thimphu, Bhutan on Medical Education Programs and Clinical Services | 1 | 1 | ||||||
[Q6x1xAx4]
f. Categories of Health Personnel (check all that apply)
| Doctors | Nurses | Midwives | Dentists | Pharmacists | Other occupations | |
|---|---|---|---|---|---|---|
| MoU MoH and Government of People's Republic of Bangladesh | 1 | |||||
| Memorandum of Understanding Between Ministry of Health, Royal Government of Bhutan And Health Volunteers Overseas, United States of America And Bhutan Foundation, Thimphu, Bhutan on Medical Education Programs and Clinical Services | 1 | 1 | 1 | 1 | 1 | 1 |
[Q6x1xAx4xoth]
Please specify category of health personnel:
MoU MoH and Government of People's Republic of Bangladesh
Memorandum of Understanding Between Ministry of Health, Royal Government of Bhutan And Health Volunteers Overseas, United States of America And Bhutan Foundation, Thimphu, Bhutan on Medical Education Programs and Clinical Services
All category and Specialist
[Q6x1xAx5]
g. Validity period
| Start Year | End Year | |
|---|---|---|
| MoU MoH and Government of People's Republic of Bangladesh | 2019 | 2024 |
| Memorandum of Understanding Between Ministry of Health, Royal Government of Bhutan And Health Volunteers Overseas, United States of America And Bhutan Foundation, Thimphu, Bhutan on Medical Education Programs and Clinical Services | 2023 | 2028 |
[Q6x1xAx6]
h. Signatory of the agreement from your country
MoU MoH and Government of People's Republic of Bangladesh
Ministry of Health
Memorandum of Understanding Between Ministry of Health, Royal Government of Bhutan And Health Volunteers Overseas, United States of America And Bhutan Foundation, Thimphu, Bhutan on Medical Education Programs and Clinical Services
Ministry of Health
[Q6x1xAx7]
i. Signatory of the agreement from the partner country (ies)
MoU MoH and Government of People's Republic of Bangladesh
Ministry of Health
Memorandum of Understanding Between Ministry of Health, Royal Government of Bhutan And Health Volunteers Overseas, United States of America And Bhutan Foundation, Thimphu, Bhutan on Medical Education Programs and Clinical Services
Others:
[Q6x1xAx7xoth]
If other signatory of the agreement from your country(Please specify:)
MoU MoH and Government of People's Republic of Bangladesh
Memorandum of Understanding Between Ministry of Health, Royal Government of Bhutan And Health Volunteers Overseas, United States of America And Bhutan Foundation, Thimphu, Bhutan on Medical Education Programs and Clinical Services
HVO
[Q6x1xAx7x1]
If Ministry of Health is not a signatory, did the Ministry of Health participate in the development of the agreement?
MoU MoH and Government of People's Republic of Bangladesh
Memorandum of Understanding Between Ministry of Health, Royal Government of Bhutan And Health Volunteers Overseas, United States of America And Bhutan Foundation, Thimphu, Bhutan on Medical Education Programs and Clinical Services
Yes
[Q6x1xAx8]
j. Content of agreement
[Q6x1xAx8x1]
j.i. Does the agreement include elements to benefit the health system of your country and the partner country(ies)?
MoU MoH and Government of People's Republic of Bangladesh
Yes, has elements to
benefit the health system of my country and partner country(ies)
benefit the health system of my country and partner country(ies)
Memorandum of Understanding Between Ministry of Health, Royal Government of Bhutan And Health Volunteers Overseas, United States of America And Bhutan Foundation, Thimphu, Bhutan on Medical Education Programs and Clinical Services
Yes, has elements to
benefit the health system of my country only
benefit the health system of my country only
[Q6x1xAx8x1x]
Please explain:
MoU MoH and Government of People's Republic of Bangladesh
Employment opportunities for Bangladesh and address HR shortage for Bhutan
Memorandum of Understanding Between Ministry of Health, Royal Government of Bhutan And Health Volunteers Overseas, United States of America And Bhutan Foundation, Thimphu, Bhutan on Medical Education Programs and Clinical Services
Address HR requirement for Bhutan and for HVO skill enhancement
[Q6x1xAx8x2]
j.ii. Does the agreement include elements on health worker rights and welfare?
MoU MoH and Government of People's Republic of Bangladesh
Yes
Memorandum of Understanding Between Ministry of Health, Royal Government of Bhutan And Health Volunteers Overseas, United States of America And Bhutan Foundation, Thimphu, Bhutan on Medical Education Programs and Clinical Services
Yes
[Q6x1xAx8x2x]
Please explain:
MoU MoH and Government of People's Republic of Bangladesh
Included as per the existing policies and requirement of the partner
Memorandum of Understanding Between Ministry of Health, Royal Government of Bhutan And Health Volunteers Overseas, United States of America And Bhutan Foundation, Thimphu, Bhutan on Medical Education Programs and Clinical Services
Included as per the existing policies and requirement of the partner
Government Agreements - 6.1 B
[INFOxNRI8]
National Reporting instrument 2024
[Q6x1xB]
Please use the table below to describe the implementation of each of the active bilateral, regional or multilateral agreements or arrangements
[Q6x1xBx1]
Has the agreement been implemented?
MoU MoH and Government of People's Republic of Bangladesh
Yes
Memorandum of Understanding Between Ministry of Health, Royal Government of Bhutan And Health Volunteers Overseas, United States of America And Bhutan Foundation, Thimphu, Bhutan on Medical Education Programs and Clinical Services
Yes
[Q6x1xBx1x1]
| Start year of implementation: | |
|---|---|
| MoU MoH and Government of People's Republic of Bangladesh | 2019 |
| Memorandum of Understanding Between Ministry of Health, Royal Government of Bhutan And Health Volunteers Overseas, United States of America And Bhutan Foundation, Thimphu, Bhutan on Medical Education Programs and Clinical Services | 2023 |
[Q6x1xBx2a]
How many health personnel have left or entered your country through this agreement since its implementation?
Agreement: MoU MoH and Government of People's Republic of Bangladesh
Agreement: MoU MoH and Government of People's Republic of Bangladesh
| Number of personnel | |
|---|---|
| Doctors | |
| Nurses | |
| Midwives | |
| Dentists | |
| Pharmacists | |
[Q6x1xBx2b]
How many health personnel have left or entered your country through this agreement since its implementation?
Agreement: Memorandum of Understanding Between Ministry of Health, Royal Government of Bhutan And Health Volunteers Overseas, United States of America And Bhutan Foundation, Thimphu, Bhutan on Medical Education Programs and Clinical Services
Agreement: Memorandum of Understanding Between Ministry of Health, Royal Government of Bhutan And Health Volunteers Overseas, United States of America And Bhutan Foundation, Thimphu, Bhutan on Medical Education Programs and Clinical Services
| Number of personnel | |
|---|---|
| Doctors | |
| Nurses | |
| Midwives | |
| Dentists | |
| Pharmacists | |
| All category and Specialist |
[Q6x1xBx3]
Please explain if and how has the health system of your country benefitted from the agreement.
MoU MoH and Government of People's Republic of Bangladesh
helped in addressing the HR shortage and capacity healthworkers
Memorandum of Understanding Between Ministry of Health, Royal Government of Bhutan And Health Volunteers Overseas, United States of America And Bhutan Foundation, Thimphu, Bhutan on Medical Education Programs and Clinical Services
helped in addressing the HR shortage and capacity healthworkers (on going)
[Q6x1xBx4]
Please describe if and how the health system of other country(ies) has benefitted from the agreement.
MoU MoH and Government of People's Republic of Bangladesh
Employment
Memorandum of Understanding Between Ministry of Health, Royal Government of Bhutan And Health Volunteers Overseas, United States of America And Bhutan Foundation, Thimphu, Bhutan on Medical Education Programs and Clinical Services
[Q6x1xBx5]
Please explain if and how the provisions on health workers rights and welfare were implemented.
MoU MoH and Government of People's Republic of Bangladesh
will be implemented as per the understanding signed
Memorandum of Understanding Between Ministry of Health, Royal Government of Bhutan And Health Volunteers Overseas, United States of America And Bhutan Foundation, Thimphu, Bhutan on Medical Education Programs and Clinical Services
will be implemented as per the understanding signed
[Q6x1xBx6]
Please provide any other relevant information on the agreement (e.g., context, positive elements, gaps and lessons learnt).
MoU MoH and Government of People's Republic of Bangladesh
Memorandum of Understanding Between Ministry of Health, Royal Government of Bhutan And Health Volunteers Overseas, United States of America And Bhutan Foundation, Thimphu, Bhutan on Medical Education Programs and Clinical Services
[Q6x1xBx7]
Full text of the agreement and associated documents (implementation plan, progress report, implementation report, evaluation report, etc.)
| Upload document(s) | |
|---|---|
| MoU MoH and Government of People's Republic of Bangladesh | |
| Memorandum of Understanding Between Ministry of Health, Royal Government of Bhutan And Health Volunteers Overseas, United States of America And Bhutan Foundation, Thimphu, Bhutan on Medical Education Programs and Clinical Services | |
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Responsibilities, rights and recruitment practices
[INFOxNRI9]
National Reporting instrument 2024
[INFOx4]
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.
Based on the Bhutan Civil Service Rules, Financial Rrules and Regulations, and Memorandum ofoU
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.
Based on the Bhutan Civil Service Rules, Financial Rrules and Regulations, and Memorandum ofoU
Migrant health personnel enjoy the same opportunities as the domestically trained health workforce to strengthen their professional education, qualifications and career progression.
NA
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)
Based on the Bhutan Civil Service Rules,
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
No measures in place
Not applicable – health personnel from my country are not working abroad
International migration
[INFOxNRI10]
National Reporting instrument 2024
[INFOx5]
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 | 0 | 1 | 0 | 0 | ||
| Nurses | 0 | 1 | 0 | 0 | ||
| Midwives | 0 | 1 | 0 | 0 | ||
| Dentists | 0 | 0 | 0 | 0 | ||
| Pharmacists | 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 | ||
| 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 | 1 | 0 | 1 | ||
| Nurses | 1 | 1 | 0 | 1 | ||
| Midwives | 0 | 0 | 0 | 0 | ||
| Dentists | 0 | 0 | 0 | 0 | ||
| Pharmacists | 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 | ||
| Other occupations | 0 | 0 | 0 | 0 |
[Q9x2oth]
Recruitment & migration
[INFOxNRI11]
National Reporting instrument 2024
[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?
No
Inflow and outflow of health personnel
[INFOxNRI12]
National Reporting instrument 2024
[INFOx7]
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
[Q11xI]
If yes for inflow:
Share data in the NHWA platform (indicator 1-09) through NHWA focal point
[Q11x1]
How many foreign-trained or foreign-born health personnel were newly active (temporarily and/or permanently) in your country in the past three years (inflow)?
| Doctors | Nurses | Midwives | Dentists | Pharmacists | Remarks | |
|---|---|---|---|---|---|---|
| 2021 | 52 | 177 | 18 | Nurses and Midwives (clubbed together), Pharmacist and Pharm Tech (Clubbed together) | ||
| 2022 | 38 | 72 | 15 | Nurses and Midwives (clubbed together), Pharmacist and Pharm Tech (Clubbed together) | ||
| 2023 | 41 | 131 | 12 | Nurses and Midwives (clubbed together), Pharmacist and Pharm Tech (Clubbed together) | ||
| Data Source (e.g. Regulatory authority, immigration records, work permits, etc.) | administration record | administration record | administration record |
[Q11xO]
If yes for outflow:
Share data in the NHWA platform (indicator 1-10) through NHWA focal point
[Q11x2]
How many domestically trained health personnel left your country in the past years for temporary or permanent migration (outflow)?
| Doctors | Nurses | Midwives | Dentists | Pharmacists | Remarks | |
|---|---|---|---|---|---|---|
| 2021 | 16 | 81 | 18 | |||
| 2022 | 18 | 66 | 3 | |||
| 2023 | 19 | 259 | 12 | |||
| Data Source (e.g. letters of good standing, emigration records, government to government agreements etc.) | administrative record | administrative record | administrative record |
[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) | |
|---|---|---|
| WHO | Health workforce capacity building | |
| WHO | Developing Performance Management System Proposal for the Health Human Resource | |
[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) | |
|---|---|---|
| WHO | Both technical and financial support | |
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 for policy dialogue and development
Support for the development of bilateral/multi-lateral 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.
We did not utilize the information as we haven't received any feedback or recommendations from this report. However, the WHO has supported Bhutan in areas such as health systems strengthening, planning, and human resource development.
[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)
[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
[INFOxNRI16]
National Reporting instrument 2024
[WARN]
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’.