国家报告文书（2024年）

To predict the need for health and care workers in the future, the analysis usually used is; the ratio of health workers to the population in Timor Leste, the National Strategic Plan for the Health Sector 2011-2030, and the National Strategic Plan for HRH. In addition, support has been obtained from WHO-TL experts to help forecast the needed per year, for the next 30 years.

Efforts that need to be made and have been outlined in the National Strategic Plan for Human Resources for Health (NSPHRH) are: Strengthen and update content and modalities for pre-service education, including: Curriculum review, Supervision of curricula in accordance with competencies defined for health personnel, and also Increase practice locations for students and new graduates (interns).

Develop the capacity of training and education institutions for the production of a qualified health workforce. Strengthen training/education institutions, Accreditation, Common Examination, Establishment of a Timorese Examinations Board, Regulation of private sector education

• Strategic interventions are needed such as; a standard staffing needs analysis aligned to the 2019 Essential Services Package, with complementary updates to costs and service requirements by level, which would also include pharmaceuticals and medical equipment needs, allowing for a comprehensive review of the medium-term needs of the entire health system. There may also be consideration of existing financial capacity and a realistic estimate of fiscal space for the next five years• Create a mechanism to deploy new graduates from remote areas to primary health care facilities in their places of origin. • Implement the $100 per month housing allowance for health workers in remote areas as stated by law • Implement the rural supplemental payments as required by law.

Timor-Leste is involved in bilateral consultations on international recruitment of health personnel. In 2003-2018, the Ministry of Health through the Ministry of Foreign Affairs of the TL carried out MOUs of cooperation with several countries such as the Republic of Cuba, Cabo Verde, Indonesia, Australia, China and others for health workers, especially general practitioners and specialist doctors, Legal Advisors to meet the demand in the Health sector at that time. Recruitment is usually based on expertise through CV analysis and interviews. In addition, bilateral discussions for visa exemptions for diplomatic and official passports took place with Cabo Verde, the Republic of Cuba, the Republic of China, and Indonesia.

Establish and roll out a human resources management manual to guide managers at the municipal and sub district levels in implementing policies and procedures as it applies to health workers under their purview. MOH to facilitate development and acquisition of management and leadership capacity for health professionals at all levels of the health system. Strengthen/build the capacity of Municipal Managers in the areas of management and decentralization.

Until now, MOH TL has not had any arrangements or recruitment of health workers during emergency response

As a new country that is still in the development process, there are many problems such as inadequate educational buildings and facilities, lack of teaching staff, low salaries and not attracting people to work in remote areas

It is true that through academic selection sometimes their academic grades do not meet the requirements

Scholarships and educational subsidies are available from the Government, managed by the Ministry of Education ( Human Capital Development Funding)

Six nationally accredited institutions provide health training courses for pre-service candidates in the country. Most health staff are educated with the ultimate goal – and implicit assumption – of being absorbed into the public sector. All Faculties have curriculum topics available

Ministry of Health Directorate of Public Health needs to have a technical meeting to see this program in depth

Scholarships and education subsidies with service return agreements are regulated by ministerial regulations. Scholarships are given based on the length of education. For example, general practitioners have a 6-year education period. So, when they finish their education, they must work or serve for 6 years before they can move to another place, for example to a private health sector or others.

None, usually working as a civil servant who is willing to be placed anywhere.

All health facilities starting from Health Post, CHC, Referral and National Hospital are filled with all health workers who provide primary, secondary and tertiary health services to the people of Timor Leste

The HRH Directorate assisted by WHO Partner, USAID, developed a Job Description Manual for all health professions working in PHC, Secondary Health Care and Tertiary Health Care. So that health professionals work based on the existing job description

This aspect is still under discussion, namely that a doctor who works in remote and very remote areas for 2-3 years will be given priority to take a specialist. However, there are no written ministerial regulations

Additional financial reimbursement, subject to proof of expenditure

Educational opportunities, many with various MOH partners, in addition to scholarships from the Government’s Human Capital Development Fund (HCDF/FDCH)

Not prioritized for opportunities for career advancement or professional growth

Professional recognition, this is done when someone retires or dies.

Decent and safe working conditions exist, but only in a few places, not yet available in all places

Decent and safe living conditions, this is very subjective

Distance learning/e-learning opportunities, this opportunity is always available, depending on the person concerned to manage it. Only for internet access the connection is very low

Timor-Leste has been actively working on improving its health personnel legislation and policies. Here are some key steps and considerations: Human Resources for Health Retention Strategy: Timor-Leste, with support from WHO-TL, USAID, has developed a strategy to retain health personnel. This includes initiatives for rural recruitment, continuing professional development, financial incentives, and management support . Law No. 11/2023 on Safety, Health, and Hygiene at Work: This law establishes general principles and rules to promote safety, health, and hygiene in workplaces across Timor-Leste. It applies to all workers, including health personnel, and includes special protections for vulnerable groups. National Medicines Policy and Pharmaceutical Legislation: Revisions to these policies aim to improve access to quality medicines and strengthen regulatory systems, which indirectly supports health personnel by ensuring they have the necessary resources to provide care. These steps reflect Timor-Leste’s commitment to enhancing its health workforce and aligning with international recommendations

The country has been working on strengthening its health workforce through various initiatives and collaborations. For instance: International Collaboration: Timor-Leste collaborates with international organizations like the International Organization for Migration (IOM) to support the government in strengthening institutional capacities and sharing information across sectors. Publicizing the Code: Efforts have been made to publicize the WHO Global Code of Practice on the International Recruitment of Health Personnel among relevant Ministries, Departments, and Agencies to ensure ethical recruitment practices.

Not involving all stakeholders. Done per institution only as needed

So far it is done per Institution only

There is no comprehensive information available

Done per Institutions

The country has implemented various policies and legislation aimed at ensuring ethical recruitment practices. These measures are designed to align with international standards and principles, such as those outlined in the International Labor Organization (ILO) Code of Practice on Ethical Recruitment. For instance, Timor-Leste’s Labor Code includes provisions that regulate the activities of private employment agencies, ensuring they operate transparently and ethically. The Labor Code mandates that these agencies must be licensed and comply with specific standards to protect workers from exploitation and abuse. Additionally, SEFOPE (Secretary state for Labour) Timor-Leste has been working on improving its legal framework to better protect workers’ rights and promote fair recruitment practices. This includes efforts to enhance the enforcement of existing laws and to raise awareness among employers and workers about ethical recruitment standards.

Certification of public or private ethical practices for private recruitment agencies is conducted by SFOPE (Secretary State of Labor)

In Timor-Leste, there are ongoing efforts to improve the recruitment and retention of health personnel, including migrant health workers. The specific mechanisms that allow migrant health personnel to assess the benefits and risks associated with employment positions and make timely and informed decisions are not explicitly detailed in the available resources. The broader goal is to strengthen the healthcare system and ensure that all health workers, including migrants, are well-supported

In Timor-Leste, the recruitment and management of health personnel, including migrant workers, aim to follow objective criteria such as qualifications, experience, and professional responsibilities. However, there are challenges in consistently applying these standards due to factors like the availability of qualified personnel and the need to fill positions in remote areas. Efforts are being made to improve the recruitment process and ensure equitable treatment for all health workers, whether domestically trained or migrants. This includes initiatives to enhance training, provide financial incentives, and support professional development.

In Timor-Leste, migrant health personnel face some challenges in accessing the same opportunities as domestically trained health workers. While there are efforts to integrate and support all health professionals, disparities still exist in terms of professional education, qualifications, and career progression.

Timor-Leste has institutional arrangements in place to ensure the safe migration, mobility, and integration of migrant health personnel. The government, with support from the International Organization for Migration (IOM), has developed policies and frameworks to manage migration effectively. These include: Migration Governance: Timor-Leste has established comprehensive migration governance structures to address various aspects of migration, including health. Health Integration: Specific projects, such as community-based tuberculosis screening, have been implemented to ensure the health needs of migrants are met. Labour Mobility Schemes: Timor-Leste participates in international labour mobility schemes, such as the Employment Permit System with South Korea and the Pacific Labour Scheme with Australia, which include provisions for the welfare and integration of migrant workers. These efforts are part of a broader strategy to facilitate safe, orderly, and regular migration, ensuring that migrant health personnel are well-integrated and supported.

Some key efforts include: Labour Mobility Schemes: Timor-Leste participates in labour mobility schemes such as the Employment Permit System (EPS) with South Korea and the Pacific Labour Scheme (PLS) with Australia. These programs facilitate the temporary migration of workers, including health professionals, allowing them to gain experience abroad and return with enhanced skills

In Timor-Leste, fair recruitment and employment practices for foreign-trained and immigrant health personnel are guided by several legal and administrative measures. Here are some key aspects: 1. Adherence to International Standards: Timor-Leste aligns with the WHO Global Code of Practice on the International Recruitment of Health Personnel. This code emphasizes ethical recruitment practices, ensuring that the rights of health workers are protected and that recruitment does not negatively impact the health systems of source countries 2. National Legislation: Timor-Leste has national laws that govern the employment of foreign workers, including health personnel. These laws ensure that foreign workers are treated fairly and have the same rights and protections as local workers. This includes compliance with labor laws, non-discrimination policies, and fair wage practices 3. Administrative Procedures: The government has established administrative procedures to facilitate the fair recruitment of foreign health workers. This includes transparent recruitment processes, proper documentation, and support services to help foreign workers integrate into the local health system 4. Timor-Leste collaborates with international organizations such as the International Labour Organization (ILO) and the International Organization for Migration (IOM) to implement best practices in the recruitment and employment of foreign health personnel. These collaborations help ensure that recruitment practices are ethical and that foreign workers are supported throughout their employment

Specifically, for health workers from Timor Leste who work abroad, there is no special recruitment yet. All workers, including health workers from Timor Leste working abroad, currently have all recruitment processes handled by SEFOPE (Secretary State for Labor) Timor Leste

Capacity Building: Focus on building local capacity to analyze and use health data effectively. This includes training health workers and managers to use data for decision-making; Human Resources Information Systems (HRIS): Implementing and improving HRIS helps in managing and utilizing health workforce data. This system supports better planning, recruitment, and retention of health personnel

Professional Development: Enhancing training and professional development opportunities for health workers ensures they have the necessary skills and knowledge. This includes continuous education and specialized training programs; Equitable Workforce Distribution: Efforts are made to ensure that health personnel are distributed equitably across the country, addressing disparities in healthcare access; Financial and Social Incentives: Providing financial incentives and improving working conditions can help retain health workers, especially in rural and underserved areas.