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:
Israel
Name of designated national authority:
Adam Cutler
Title of designated national authority:
Deputy Director, International Affairs
Institution of the designated national authority:
Ministry of Health
Email:
riginao@who.int,adam.cutler@MOH.GOV.IL,WHOGlobalCode@who.int
Telephone number :
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

Israel is exceptional as it trains majority of its physicians abroad. We have vast concerns about our students return rates. There is a significant report by OECD on physicians training in Israel. We currently work on increasing domestic medical schools, subsidizing medical training abroad and intensify doctors migration to Israel.

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?
No, this is not a problem in my country

Despite working to encourage immigration of eligible physicians from the jewish diaspora - this does not represent a significant number of physicians in our system (about 10 per cent of annual licenses) . We do work hard to prevent brain drain - i.e. physicians leaving for opportunities abroad - but this too is not very significant in terms of numbers.

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
We have developed a forecasting model to provide future develpment of Israeli workforce. Currently the model is being upgraded to produce forecast on specialists level.
Aligning domestic health and care workforce education with health system needs
Our biggest challenge is relience on foreign training (60 per cent). Our major priority is increasing local training dramatically. We have succeeded to increase from 780 new students in 2019 to 1140 in 2023 and are planned to increase even further to 1700 in 2027. 3 new medical schools are expected to join our current 6 medical schools.
Improving quality of education and health personnel in alignment with service delivery needs
Our major priority as mentioned above is to decrease significantly the dependence on foreign training.
Creating employment opportunities aligned with population health needs
Managing international recruitment of health personnel
We encourage physicians from the jewish diaspora to immigrate to Israel, but it is not our major policy.
Improving management of health personnel
We promote policies of working environment and remuneration improvements
Specific provisions on health personnel regulation and recruitment during emergencies
As you know, Israel has been brutally attacked on October 7, 2023 killin more than 1200 people. Since then , Israel is at state of war on 2 fronts. We operate to increase rapidly a number of professionals in mental health and physical rehabillitation
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
In 2022 we had introduced a program "Ilanot" which trains physicians specifically for the undeserved areas in the North (Gallillee) and South (Negev). https://ilanot-program.co.il/
Student intake from rural/underserved areas and communities
As part of "Ilanot" program the selection process aims at students from those areas.
Scholarships and subsidies for education
"Ilanot" program provides full scholarship and monthly stipend as a part of benefits.
Relevant topics/curricula in education and/or professional development programmes
As part of their training "Ilanot" attendees learn about local medicine
(Re)orientation of education programmes towards primary health care
We have recently completed to develop a switch of some parts of medical education from hospitals to primary care facilities.
Others
Hide [Q2x2x3x1] 2.2.3.1 Incentives Measure
Additional financial reimbursement
In the past various programs suggested financial incentives for undeserved areas and specialties. Those programs were not found as very effective. Today we provide financial incentives but within a framework of excellency training - "Medical Stars".
Education opportunities
As a part of "Medical stars" program we provide training in medical management, medical education and medical research
Opportunities for career advancement or professional growth
As a part of "Medical stars" program we provide training in medical management, medical education and medical research
Professional recognition
Social recognition
Opportunity for pathways to permanent residency and/or citizenship for international health personnel
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.
1. Icreasing unprecedently the number of local students 2. "Ilanot" program for physicians in periphery 3. "Ofakim" program which subsidized medical education in Europe on the basis of conditional government loans
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?
Yes
Hide [Q3x1x1] 3.1.1 Please provide further information in the box below:
Law/policy 1
Incentives for return of israelis studying abroad and working in periphery
Law/policy 2
Standards set for acceptable medical schools abroad. Since 2019 Israel does not recognize most of the non-OECD countries on the matter of medical license eligibility.
Law/policy 3
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?
Yes
Hide [Q4x1] Please describe
There is a tight cooperation with the Ministry of Immigration and Absorbtion. A joint commitee and a dedicated personel have been established to manage monitoring of international recruitment. The government cooperates with various NGOs operating in areas of recruitment.
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
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.
After complition of licensing process the employment is similar to locally trained personell
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
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
There some initiatives to have a pool of professionals among the diaspora willing to support the country in case of emergency and sudden demand
Other
No measures in place
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 0 0
Nurses 1 0 0 0
Midwives 0 0 0 0
Dentists 1 0 0 0
Pharmacists 1 0 0 0
Other occupations 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
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 0 0 1 0
Nurses 0 0 1 0
Midwives 0 0 1 0
Dentists 0 0 1 0
Pharmacists 0 0 1 0
Other occupations 0 0 1 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?
Yes
Hide [Q10x1] 10.1 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
Hide [Q10x2] 10.2 Does the record include gender-disaggregated data on the foreign-born and/or foreign-trained health personnel?
Yes
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 [Q11xI] If yes for inflow:
Fill in the table below
Hide [Q11x1] 11.1 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 245 473 1 301 305
2022 265 618 2 448 303
2023 420 791 3
Data Source (e.g. Regulatory authority, immigration records, work permits, etc.) MoH MoH MoH MoH
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:
Fill in the table below
Hide [Q12x1x1]
Total Place of training-Domestic Trained Place of training-Foreign trained-total Place of training-Foreign trained-national born Place of training-Foreign trained-foreign born Place of birth-National Born Place of birth-Foreign Born Data Source* Year of data Does the data represent active stock? Does the data represent active stock?
Medical Doctors (generalist + specialists) 47382 18223 29159 12907 16252 MOH 2024 1
Nurses 66647 58767 7907 4438 3469 41938 24736 MOH 2024 1
Midwives 2706 1902 804 MOH 2024
Dentists 13165 3392 9773 MOH 2022
Pharmacists 10308 4907 5401 MOH 2022
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 20563 6812 2061 1946
Country 1: Top country of training RUS OTH ROU JOR
Country 1: No. of foreign trained health personnel 8589 3377 1899 703
Country 2: Top country of training ROU RUS RUS RUS
Country 2: No. of foreign trained health personnel 3520 1978 737 470
Country 3: Top country of training UKR USA UKR OTH
Country 3: No. of foreign trained health personnel 2596 268 730 367
Country 4: Top country of training ITA UKR OTH ROU
Country 4: No. of foreign trained health personnel 2372 219 624 342
Country 5: Top country of training HUN FRA MDA ITA
Country 5: No. of foreign trained health personnel 1674 98 456 216
Country 6: Top country of training USA DEU FRA UKR
Country 6: No. of foreign trained health personnel 931 48 419 174
Country 7: Top country of training FRA NLD JOR FRA
Country 7: No. of foreign trained health personnel 830 40 324 114
Country 8: Top country of training ARG ROU USA USA
Country 8: No. of foreign trained health personnel 705 37 245 112
Country 9: Top country of training DEU GBR HUN ARG
Country 9: No. of foreign trained health personnel 637 75 243 106
Country 10: Top country of training POL AUS ARG GBR
Country 10: No. of foreign trained health personnel 437 33 86
Source (e.g. professional register, census data, national survey, other) professional register MOH MOH
Year of data (Please provide the data of the latest year available) 2024 2023 2022
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
Israel faces a challenge in expanding medical school capacity, many Israelis opt for training abroad It requires mechanisms for quality management in education
Hide [Q16] 16. What support do you require to strengthen implementation of the Code?
Support to strengthen data and information on health personnel
We've recently developed systems to better document Israelis opting for medical education abroad and are continuing to improve both our tracking and engagement with that population
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.
Provides holistic information to the varying components of the health personnel system
Hide [Q17x2] Do any articles of the Code need to be updated?

Hide [Q17x3] Does the process of reporting on Code implementation and the review of the Code relevance and effectiveness need to be updated?

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)

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)
It is important to note that Israeli data may look skewed due to the repatriated diaspora from the former Soviet Union, creating a critical mass of doctors trained abroad within the system. Moreover, the vast majority of foreign-trained physicians are national-born (see above reference to Israel's challenge in terms of opening new spaces in our medical schools). The new medical schools that take them tend to see Israeli students as a welcome financial benefit to their institutions. Further, please note that the data for new activation of dentists and pharmacists for 2023 is not yet published and as such is not included in the data submitted.
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’.