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:
Uganda
Name of designated national authority:
Alfred Driwale
Title of designated national authority:
Commissioner Institutional and Human Resource Development
Institution of the designated national authority:
Ministry of Health
Email:
driwalealfred2019@gmail.com,WHOGlobalCode@who.int,kbediakon@who.int,okoroafors@who.int
Telephone number :
0772515222
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
Specifically exporting some health care workers to countries that are in need
[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?
No, this is not a problem in my country
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
This is done . Uganda has a 10 year strategic plan for Health work force development
Aligning domestic health and care workforce education with health system needs
Recently supported by WHO to conduct the HLMA. This raised major policy questions that are being discussed now
Improving quality of education and health personnel in alignment with service delivery needs
MOH Uganda, together with Ministry of Education are working to develop a health worker training and internship policy
Creating employment opportunities aligned with population health needs
Uganda, with assistance from patners recently conducted the workforce needs assessment and revise the structure of health care facilities, created new posts in the public service structure.
Managing international recruitment of health personnel
This is still a huge debate. Currently there is not a streamlined way of managing international recruitment.
Improving management of health personnel
Have developed the Human Resources information system to track performance of health workers. Uganda had developed key performance indicators for cadres at National and subnational levels to ensure performance management and raise awareness on personnel outputs
Specific provisions on health personnel regulation and recruitment during emergencies
Public service in Uganda provides for redeployment and designation of staff any time and this provision can be called in event of outbreaks to constitute a response team. these staff are bound by the Public service standing orders and other statutory laws.. Additionally , we work with partners to recruit responders.
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
Student intake from rural/underserved areas and communities
District Quota system
Scholarships and subsidies for education
Relevant topics/curricula in education and/or professional development programmes
Community based course units are included in most curricula for health care worker training. During these course units, students are deployed to communities including rural communities to appreciate diversity of health care needs and foster adaptation once they qualitfy
(Re)orientation of education programmes towards primary health care
Primary health care is a key facet of health service delivery and has been incorporated in training curricula
Others
[Q2x2x2x1]
2.2.2.1 Regulation Measure
Scholarships and education subsidies with return of service agreements
Staff are bonded when sponsored by government to specialize
Mandatory service agreements with health personnel that are not related to scholarships or education subsidies
Enhanced scope of practice of existing health personnel
Task sharing between different professions
Provisions for pathways to enter new or specialised practice after rural service
After confirmation of service, Local governments permit health workers to upgrade and even receive specialized trianing
Others
[Q2x2x4x1]
2.2.4.1 Support Measure
Decent and safe working conditions
Ensure availability of equipment and medicnes
Decent and safe living conditions
Ensuring staff houses are built. Health worker salary enhanced
Distance learning/e-learning opportunities
Several training institutions now have distance and e-learning platforms that have been leveraged to train health workers. Many health health workers have taken advantage of these to upgrade their skills and qualifications
Others
[Q2x3x1]
2.3.1 Please describe - Other relevant measures taken to educate, employ and retain a health and care workforce that is appropriate for the specific conditions of your country.
Motivation of health care workers across board has been critical to improve their engagement, retention and performance. Recently salary for all health care worker in pubic service were enhanced.
Additionally government has reviewed the staffing structure for public service and included new cadres as well as increased the number of staff for each of the levels of care thus enhancing the demand for health care workers.
[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
Constitution of the republic of Uganda
Law/policy 2
Emplomeyment Act of 2006
Law/policy 3
The employment Regulation (Migrant worker regulation)
[Q3x2]
Are there any policies and/or provision for international telehealth services in your country through health personnel based abroad?
No
[Q3x3]
Has your country established a database or compilation of laws and regulations related to international health personnel recruitment and migration and, as appropriate, information related to their implementation?
Yes
[Q3x3x1]
Please provide a web-link
https://mglsd.go.ug/laws/
[Q3x3x2]
Please upload any format of documentation that provides such information (e.g. pdf, excel, word)
Upload document:
Upload document:
Employment Regulations
Provides guidance on recruitment of migrant workers
[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?
Yes
[Q4x1]
Please describe
MOH recently functionalized the department of institutional and Human resource development that is implementing a 10 Year Human resources for health strategy. The department works closely with the Allied, Nurses and midwifery, Medical and dental practitioners councils to guide and regulate medical /health care practice. The same institutions license immigrant health workers as well a recommend migrant health workers for jobs outside Uganda. They however need to be strengthened
[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.
Health work force training and retention have been core priorities for Government to strengthen Uganda's health system. Policies that guide externalisation are also in place but have not been implemented to export health workers.
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.
International recruitment is currently focusing on other professionals. Currently, externalization of health care workers in Uganda is still restricted by the WHO recommendations
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.
This is still ongoing. It started with the second health labor market analysis that raised very important policy recommendations including considerations to export a surplus health care workers to serve in other countries in need
5.4 Records are maintained on all private recruitment agencies for health
personnel authorized by competent authorities to operate within their jurisdiction.
personnel authorized by competent authorities to operate within their jurisdiction.
5.5 Good practices, as called for by the Code, are encouraged and promoted among private recruitment agencies.
5.5a Promotion of the Code among private recruitment agencies.
5.5b Domestic legislation or policy requiring ethical practice of private recruitment agencies, as consistent with the principles and articles of the Code.
5.5c Public or private certification of ethical practice for private recruitment agencies.
5.5d Others
5.6 None of the above
Government Agreements
[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?
No
Responsibilities, rights and recruitment practices
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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.
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 personel are recruited basically by the private sector. They are evaluated and licensed by the respective councils before they can practice in Uganda. Thie employment is with in the guidance of the Employment Act ..
Migrant health personnel enjoy the same opportunities as the domestically trained health workforce to strengthen their professional education, qualifications and career progression.
Institutional arrangements are in place to ensure safe migration/ mobility and integration of migrant health personnel.
Measures have been taken to promote circular migration of international health personnel
Other measures (including legal and administrative) for fair recruitment and employment practices of foreign-trained and/or immigrant health personnel (please provide details)
No measures in place
Not applicable – does not host/employ foreign health personnel
[Q8]
If health personnel from your country are working abroad in the health and care sectors, please provide information on measures that have been taken or are planned in your country to ensure their fair recruitment and employment; safe migration; return; and diaspora utilization in your country, as well as difficulties encountered.
Please check all items that apply from the list below:
Please check all items that apply from the list below:
Arrangements for fair recruitment
Arrangements for decent employment contracts and working conditions in destination countries
Arrangements for safe mobility
Arrangements for return and reintegration to the health labour market in your country
Arrangements for diaspora engagement to support your country health system
Other
No measures in place
Government has not entered any bilateral agreement to externalize health workers. THose that find work outside Uganda negotiate their own terms
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 | 0 | 0 | 0 | ||
| Nurses | 0 | 0 | 0 | 0 | ||
| Midwives | 0 | 0 | 0 | 0 | ||
| Dentists | 0 | 0 | 0 | 0 | ||
| Pharmacists | 0 | 0 | 0 | 0 | ||
| Other occupations | 0 | 0 | 0 | 0 | Privately sourced by private health care providers | |
| Other occupations | 0 | 0 | 0 | 0 | Sourced by Centers of excellence( specilised) Hospitals to provide specialised services during medical and surgical camps | |
| Other occupations | 0 | 0 | 0 | 0 | ||
| Other occupations | 0 | 0 | 0 | 0 | ||
| Other occupations | 0 | 0 | 0 | 0 |
[Q9x1oth]
Opticians
Super specialist ; Cardio thoracic surgeons, Neuro surgeons, Vascular surgeons,
[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 | 1 | 1 | 0 | 1 | ||
| Dentists | 1 | 1 | 0 | 1 | ||
| Pharmacists | 1 | 1 | 0 | 1 | ||
| Other occupations | 1 | 1 | 0 | 1 | ||
| Other occupations | 1 | 0 | 0 | 1 | ||
| Other occupations | 0 | 0 | 0 | 0 | ||
| Other occupations | 0 | 0 | 0 | 0 | ||
| Other occupations | 0 | 0 | 0 | 0 |
[Q9x2oth]
Imaging specialists
Laboratory technologists
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?
Yes
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 | ||||||
| 2022 | ||||||
| 2023 | ||||||
| Data Source (e.g. Regulatory authority, immigration records, work permits, etc.) |
[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.)?
No
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
We have a weak information system that needs to be strengthened to capture and integrate supply and demand data across all the HRH stakeholders
Support for policy dialogue and development
Hold Policy dialogue meetings, Review HRH policies, Build capacity write policy briefs, Mid term review of the HRH policy
Support for the development of bilateral/multi-lateral agreements
Others
Review of the position of WHO on Uganda's current health labor market analysis to migrate the country from the safeguard category to enable full implemetation of the code
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.
Several recommendations form the code have been implemented. Policies and regulations for Migrant workers developed, Staff retention prioritized, Employment created in both public and private sector.
Only bilateral agreements have not been established because Uganda is categorized among countries that need to be safeguarded due to previously observed critical staffing gaps. These have since changed and there is a need to reconsider the categorization.
[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)
The safeguards needs to be cadre specific and reviewed periodically at least every two years.
[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’.