National Reporting Instrument 2024

Hide all

Background

Hide [INFOxNRI1] National Reporting instrument 2024
Hide [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/).
Hide all

Disclaimer

Hide [INFOxNRI2] National Reporting instrument 2024
Hide [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/
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
Hide all

Contact Details

Hide [INFOxNRI3] National Reporting instrument 2024
Hide [CI] Contact Details
Name of Member State:
Somalia
Name of designated national authority:
Mohamed Hussein Alasow
Title of designated national authority:
Human Resource for Health Department Director
Institution of the designated national authority:
Federal Ministry of Health and Human Services.
Email:
hr@moh.gov.so,WHOGlobalCode@who.int,jalala@who.int,jalala@who.int
Telephone number :
00252615562618
Hide all

Contemporary issues

Hide [INFOxNRI4] National Reporting instrument 2024
Hide [NRIxI] The questions marked * are mandatory. The system will not allow submission until all mandatory questions are answered.
Hide [INFOx1]
Contemporary issues on health personnel migration and mobility
Hide [Q1x1] 1.1 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

A large number of international healthcare workers are being recruited into the country, particularly in the private sector. Most of these international health staff possess qualifications similar to those of the local workforce. This has created challenges in terms of domestic deployment. Somalia faces a severe shortage of health workers and limited deployment capacity. The influx of international health personnel has exacerbated the issue of high unemployment among local health professionals.

Hide [Q1x2] 1.2 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

There is a significant reliance on recruiting international health workers, driven by the assumption that they possess greater skills and knowledge than local health workers. In the private sector, the community often prefers international health workers over local ones, leading to financial implications. International healthcare workers are paid more than their local counterparts. As a result of this recruitment trend, the local workforce is increasingly shifting to other fields, such as business, or leaving the country due to unemployment. This situation exacerbates the current challenges, particularly the already low density of health workers in the country.

Hide all

Health Personnel Education

Hide [INFOxNRI5] National Reporting instrument 2024
Hide [INFOx2]
Health personnel education, employment and health system sustainability
Hide [Q2] 2. 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
Hide [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
Hide [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
Improving quality of education and health personnel in alignment with service delivery needs
The Ministry of Health Somalia has trained certian carders in specific areas, we have trained about 2000 midwifes and 1500 community health workers to reduce the maternal mortality in SSomallia.
Creating employment opportunities aligned with population health needs
The ministry has endorsed the Somali Health investment case which has baved the way for investments from Multilateral Institutions and other donors
Managing international recruitment of health personnel
Improving management of health personnel
Specific provisions on health personnel regulation and recruitment during emergencies
Regulation has been enhanced by developing SOPS for health workers and also enhancing the capacity of the National Health professional Council f
Others
Hide [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
Hide [Q2x2x1x1] 2.2.1.1 Education Measure
Education institutions based in rural/underserved areas
Rural Schools or State level Education programs has been enhanced, the midwifery program supports schools in rural areas and students drawn from these rural areas
Student intake from rural/underserved areas and communities
Yes, Midwifes are enrolled from the rural areas
Scholarships and subsidies for education
Relevant topics/curricula in education and/or professional development programmes
(Re)orientation of education programmes towards primary health care
Others
Hide [Q2x2x4x1] 2.2.4.1 Support Measure
Decent and safe working conditions
Programs have been established in rural areas which gives favors to the midwifes or nurses from these areas.
Decent and safe living conditions
Distance learning/e-learning opportunities
Others
Hide [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.
Education institutions have been updated by the Ministry of Health with support to create suitable working conditions for the health workforce in Somalia, there's a link between the Ministry of Higher Education and the Ministry of Health Somalia to create occupational standards for all health carders
Hide [Q3x1] 3.1 Are there specific policies and/or laws that guide international recruitment, migration and integration of foreign-trained health personnel in your country?
No
Hide [Q3x2] 3.2 Are there any policies and/or provision for international telehealth services in your country through health personnel based abroad?
No
Hide [Q3x3] 3.3 Has your country established a database or compilation of laws and regulations related to international health personnel recruitment and migration and, as appropriate, information related to their implementation?
No
Hide [Q4] 4. 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
Hide [Q5] 5. Please describe the steps taken by your country to implement the following Code recommendations.
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.
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.
5.4 Records are maintained on all private recruitment agencies for health
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
Most the measures above haven't been taken yet by the Ministry of Health
Hide all

Government Agreements

Hide [INFOxNRI6] National Reporting instrument 2024
Hide [INFOx3]
Government-to-Government agreements on migration or mobility of health personnel
Hide [Q6] 6. 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
Hide all

Responsibilities, rights and recruitment practices

Hide [INFOxNRI9] National Reporting instrument 2024
Hide [INFOx4]
Responsibilities, rights and recruitment practices
Hide [Q7] 7. 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:
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.
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.
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
Currently, our country does not have specific legal safeguards or established mechanisms that govern the recruitment of international health personnel in the health and care sectors. Consequently, there are no formal policies in place to ensure that migrant health personnel enjoy the same legal rights and responsibilities as the domestically trained health workforce.
Not applicable – does not host/employ foreign health personnel
Hide [Q8] 8. 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:
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
Our country currently does not have specific policies or mechanisms in place to manage or oversee the deployment of health workers to work abroad. While there are individuals who independently seek and secure employment in the health sector in other countries, this process is self-driven, and these workers are personally responsible for navigating their employment, legal rights, and responsibilities in the host countries.
Not applicable – health personnel from my country are not working abroad
Hide all

International migration

Hide [INFOxNRI10] National Reporting instrument 2024
Hide [INFOx5]
International migration and mobility pathways for health personnel
Hide [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 0 1 1
Nurses 1 0 1 0
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
Hide [Q9x1oth]
Hide [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 1
Nurses 1 0 1 1
Midwives 1 0 1 1
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
Hide [Q9x2oth]
Hide all

Recruitment & migration

Hide [INFOxNRI11] National Reporting instrument 2024
Hide [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.

Hide [Q10] 10. Does your country have any mechanism(s) or entity(ies) to maintain statistical records of foreign-born and foreign-trained health personnel?
No
Hide all

Inflow and outflow of health personnel

Hide [INFOxNRI12] National Reporting instrument 2024
Hide [INFOx7] Inflow and outflow of health personnel
Hide [Q11] 11. 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
Hide [Q11x3] 11.3 If you have any document with information on health worker inflows and outflows for your country, please upload
Hide all

Stock of health personnel

Hide [INFOxNRI13] National Reporting instrument 2024
Hide [INFOx8] Stock of health personnel
Hide [Q12x1] 12.1 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).
Hide [Q12x1a] Please provide data on the stock of active health personnel in your country by one of the following ways:
Data not available
Hide [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
Hide [Q12x2] 12.2 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:
Fill in the table below
Hide [Q12x2x1]
Doctors Nurses Midwives Dentists Pharmacists
Total foreign trained personnel
Country 1: Top country of training SDN SDN SYR PAK
Country 1: No. of foreign trained health personnel
Country 2: Top country of training
Country 2: No. of foreign trained health personnel
Country 3: Top country of training
Country 3: No. of foreign trained health personnel
Country 4: Top country of training
Country 4: No. of foreign trained health personnel
Country 5: Top country of training
Country 5: No. of foreign trained health personnel
Country 6: Top country of training
Country 6: No. of foreign trained health personnel
Country 7: Top country of training
Country 7: No. of foreign trained health personnel
Country 8: Top country of training
Country 8: No. of foreign trained health personnel
Country 9: Top country of training
Country 9: No. of foreign trained health personnel
Country 10: Top country of training
Country 10: No. of foreign trained health personnel
Source (e.g. professional register, census data, national survey, other)
Year of data (Please provide the data of the latest year available)
Remarks
Hide [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
Hide all

Technical and financial support

Hide [INFOxNRI14] National Reporting instrument 2024
Hide [INFOx9]
Technical and financial support
Hide [Q13] 13. 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
Hide [Q14] 14. 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.)?
No
Hide all

Constraints, Solutions, and Complementary Comments

Hide [INFOxNRI15] National Reporting instrument 2024
Hide [INFOx10]
Constraints, Solutions, and Complementary Comments
Hide [Q15] 15. 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
Somalia lacks a comprehensive legal framework to effectively regulate and manage international migration. Develop and implement a robust legal framework that includes clear regulations on recruitment practices, protections for migrant workers, and enforcement mechanisms.
Institutions responsible for migration management in Somalia have insufficient capacity and resources to enforce regulations and protect migrants. Invest in capacity-building for relevant government agencies through training, increased funding, and partnerships with international organizations to strengthen institutional capabilities.
There is limited public awareness in Somalia about the rights of migrants and the need for their social integration Launch public awareness campaigns and develop social integration programs to educate citizens, promote cultural understanding, and foster social cohesion for migrant communities.
Hide [Q16] 16. 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
Hide [Q17] 17. 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.
Hide [Q17x1] Please comment on if/how the Code has been useful to your country.
1. Limited Implementation: Somalia has struggled to fully implement the WHO Code due to inadequate legal frameworks and weak institutional capacity. The absence of comprehensive policies to regulate the recruitment and migration of health workers has hindered our ability to align with the Code's guidelines effectively. 2. Brain Drain Concerns: One of the critical issues Somalia has encountered is the continued emigration of skilled health professionals seeking better opportunities abroad. This "brain drain" has exacerbated the already critical shortage of healthcare personnel in the country, negatively impacting the delivery of essential health services. 3. Need for Strengthened Partnerships: The past 14 years have highlighted the need for stronger international collaboration and support. Somalia requires technical assistance and capacity-building initiatives to develop and enforce policies that align with the WHO Code. Strengthening partnerships with WHO and other international bodies is crucial to enhancing our healthcare system and managing the migration of health workers more ethically. Future Considerations: Moving forward, Somalia is committed to updating its policies in line with the WHO Code's principles. We recognize the need to develop comprehensive strategies to retain health workers, improve working conditions, and establish ethical recruitment practices. Continued support from international partners will be essential to achieving these goals and ensuring that the WHO Code remains a relevant and effective tool for improving global health workforce management.
Hide [Q17x2] Do any articles of the Code need to be updated?
No

Hide [Q17x3] Does the process of reporting on Code implementation and the review of the Code relevance and effectiveness need to be updated?
No

Hide [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)
1. If Somalia is Included in the WHO Health Workforce Support and Safeguards List: Somalia's inclusion in the WHO health workforce support and safeguards list has been beneficial by providing access to targeted support and resources. This inclusion has facilitated technical assistance, capacity-building initiatives, and the development of policies aligned with global standards. However, the impact has been limited by the ongoing challenges in implementing these recommendations due to political instability and resource constraints. 2. If Somalia is Reliant on International Health Personnel: Somalia's reliance on international health personnel has been significantly affected by the WHO health workforce support and safeguards list. While the list highlights the need for ethical recruitment and the protection of international health workers, the country's dependency on such personnel underscores the urgent need for robust systems to manage their integration and ensure their rights. The list has increased awareness of these issues, but more comprehensive actions and support are needed to address the challenges associated with this reliance. 3. If Somalia is Not Included in the WHO Health Workforce Support and Safeguards List: Somalia's absence from the WHO health workforce support and safeguards list has limited our access to essential support and resources. This exclusion has affected our ability to benefit from global best practices and technical assistance aimed at improving health workforce management. The lack of inclusion highlights the need for targeted efforts to strengthen our healthcare system and ensure that we are aligned with international standards for managing health personnel. Overall Impact: The WHO health workforce support and safeguards list plays a crucial role in shaping global health workforce policies. For Somalia, being included, reliant on international personnel, or excluded from the list has significant implications for our healthcare system. Moving forward, Somalia will continue to seek ways to improve its alignment with international standards and benefit from global support to address health workforce challenges effectively.
Hide [Q18] 18. 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)
N/A
Hide [Q18x1]
Hide all

Warning

Hide [INFOxNRI16] National Reporting instrument 2024
Hide [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’.