国家报告文书（2021年）

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背景

Hide [iBG] 2010年在第63届世界卫生大会（WHA63.16号决议）上通过的《世界卫生组织国际卫生人员招聘全球行为守则》（“《守则》”）旨在通过经改进的数据、信息和国际合作，加强对国际卫生人员招聘的理解和符合伦理的管理。

《守则》第7条鼓励世卫组织会员国交流关于卫生人员国际招聘和移徙的信息。还委托世卫组织总干事每三年向世界卫生大会作出报告。

2019年3月，世卫组织会员国完成了第三轮国家报告。2019年5月，世卫组织总干事向第七十二届世界卫生大会报告了实施进展情况（A72/23）。第三轮国家报告还为2020年向第七十三届世界卫生大会介绍的由会员国牵头的《守则》相关性和有效性审查（A73/9）提供了信息。

审查突出强调，通过有针对性的支持和保障实施《守则》是确保会员国在突发卫生事件和实现全民健康覆盖方面取得的进展有助于支持而不是损害其它国家的类似成就所必需的。鉴于该报告和WHA73(30)号决定中的考虑因素，世卫组织秘书处还编制了2020年卫生人力支持和保障清单。

国家报告文书是以国家为基础的自我评估工具，目的是进行信息交流和《守则》监测。国家报告文书使世卫组织得以收集和交换有关卫生人员国际招聘和移徙的最新证据和信息。第四轮国家报告的结果将于2022年5月提交第七十五届世界卫生大会。鉴于COVID-19大流行仍在继续，国家报告文书（2021年）已进行了调整，以另外获取与大流行背景下卫生人员招聘和移徙相关的信息。

提交报告的截止日期为2021年8月31日。

如果国家主管部门因限于技术能力而无法填写在线调查问卷，可通过以下链接下载国家报告文书：http://www.who.int/hrh/migration/code/code_nri/en/。请完成国家报告文书并以电子方式或以硬拷贝形式送达以下地址：

Health Workforce Department
Universal Health Coverage and Health Systems
World Health Organization
20 Avenue Appia, 1211 Geneva 27
Switzerland
hrhinfo@who.int

免责声明：通过国家报告文书收集的数据和信息将视第七十五届世界卫生大会的议事情况通过世卫组织网站予以公布。所收集的定量数据将通过国家卫生人力账户在线平台（http://www.who.int/hrh/statistics/nhwa/en/）进行更新和提供。
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请描述：
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免責聲明

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 For more information on WHO Data Policy kindly refer to http://www.who.int/publishing/datapolicy/en/
我已閱讀並理解世衛組織關於在突發公共衛生事件之外在會員國使用和共享世衛組織收集的數據的政策
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联系方式

Hide [q01b] 联系方式
國家
Latvia
机构全称：
Roga
国家指定主管部门名称：
Ministry of Health Republic of Latvia
国家指定主管部门头衔：
Ministry of Health Republic of Latvia
电话：
+ 371 67876000
电子邮件：
dace.roga@vm.gov.lv,hrhinfo@who.int
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《守则》的实施

Hide [q1] 1. 贵国是否采取了步骤实施《守则》？（
是
Hide [q1x1x] 1.1 已采取行动，跨部门交流和分享卫生人员国际招聘和移徙信息，并在国家和/或国家以下地区相关部委、部门和机构宣传《守则》。
是
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行动 1
In Latvia, the Ministry of Education and Science is the coordinating institution for the recognition of qualifications, including the health profession, in order to ensure equal and fair rights in the recognition of foreign qualifications. The Ministry of Health cooperates with the Ministry of Education and Science in this matter.
行动 2
The Ministry of Health also cooperates with medical institutions (mainly large hospitals), which, based on their experience in attracting foreign medical professionals, make proposals to improve the process and reduce barriers (administrative, time resources, costs) to the recognition of professions and specialties. This also applies to short-term professional recognition, where the institution of medical practice attracts a foreign specialist to provide one specific service.
行动 3
In turn, professional organizations in the health sector (Latvian Medical Association, Latvian Association of Professional Organizations of Medical Practitioners, Latvian Nurses' Association) and the Health Inspectorate are competent institutions that recognize foreign qualifications for health professions in accordance with the Directive 2005/36/EC of the European Parliament and of the Council of 7 September 2005 on the recognition of professional qualifications. An important aspect of cooperation with the competent authorities is to ensure that clear, comprehensible information on the recognition of regulated professions in the health sector is published in the database of regulated professions.
Hide [q1x2x] 1.2 已经采取或考虑采取措施，参照《守则》的建议，修改法律或政策。
是
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措施 1
During the current pandemic, vaccination against Covid-19 is also provided to foreign specialists, including foreign medical students, especially those who participated in mitigating the effects of Covid-19 by participating in the treatment process within their competence.
措施 2
According to the health policy and regulatory enactments developed by Latvia, only persons registered in the register have the right to engage in medical treatment in Latvia. As soon as a medical practitioner recognizes his or her qualification in Latvia, it is registered in the national register of medical practitioners. If a medical practitioner is registered in the register (regardless of nationality, country of origin, education obtained abroad or in Latvia) all legislation regulating employment relations (for example, salary, working hours, responsibilities, and duties, etc.), as well as conditions of professional activity are the same for all medical practitioners in the register (regardless of nationality, country of origin, education acquired abroad or in Latvia).
措施 3
Hide [q1x3x] 1.3 对主管当局批准在其管辖范围内工作的所有招聘者进行登记。
是
Hide [q1x3] 请描述：
Please see section 1.2. information provided. We confirm that in accordance with the regulatory enactments regulating the field of health, all medical practitioners are registered in the register of medical practitioners, including those who have received education abroad (both in the EU and third countries) and a qualification recognized in Latvia. If a medical treatment is performed by an unregistered medical practitioner, it is an unauthorized medical treatment that is criminally punishable and supervised by the Health Inspectorate (it is determined by Section 12 of the Medical Treatment Law: Ārstniecības likums (likumi.lv)).
Hide [q1x4x] 1.4 如《守则》所要求，鼓励和提倡招聘机构的良好行为。
否
Hide [q1x5x] 1.5 已采取措施，在决策过程中与利益攸关方协商，并/或推动它们参与卫生人员国际招聘相关活动。
是
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措施 1
Please see section 1.1. information provided. When developing regulatory enactments, the Ministry of Health consults with the involved parties to ensure the availability of information on the recognition of professional qualifications, as well as to improve the requirements and procedures for the recognition of professional qualifications. However, Latvia is basically a donor country, so there is no active recruitment of foreign specialists. Latvia currently places more emphasis on the return of the diaspora, for example, it is a little easier to recognize the right to practice and financial compensation is offered if a person returns to work in the health sector in Latvia. This applies to all foreign doctors, but there are more chances to attract doctors of Latvian nationality who return to live in Latvia.
措施 2
措施 3
Hide [q1x6x] 1.6 其它步骤：
否
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伙伴关系、技术合作和财政支持

Hide [q2x1] 2.1. 贵国是否向一个或多个世卫组织会员国，尤其是发展中国家，或其他利益攸关方提供了技术或财政援助以支持实施《守则》？
2.1.1 促进实施《守则》的特别支助
2.1.2 支持加强卫生系统
2.1.3 支持卫生人员发展
2.1.4 没有提供支持
2.1.5 其它领域的支持：
Hide [q2x1oth] 2.1.5 其它领域的支持：
支持领域 1
To help other countries overcome the Covid-19 pandemic, Latvia donates Covid-19 vaccines to third countries.
支持领域 2
Latvia is a member of the WHO and the International Red Cross and makes mandatory contributions accordingly.
支持领域 3
Hide [q2x2] 2.2. 贵国是否得到一个或多个世卫组织会员国、世卫组织秘书处或其他利益攸关方的技术或财政援助，支持实施《守则》？
2.2.1 促进实施《守则》的特别支助
2.2.2 支持加强卫生系统
2.2.3 支持卫生人员发展
2.2.4 没有得到支持
2.2.5 其它领域的支持：
Hide [q2x2oth] 2.2.5 其它领域的支持：
支持领域1
Support for the Health Workforce Planning and Forecasting Expert Network (SEPEN) provided support to Latvia, which resulted in the REPORT ON TAILORED ADVICE AND GUIDANCE FOR THE IMPROVEMENT OF THE LATVIAN HEALTH WORKFORCE PLANNING SYSTEM, June-August, 2020. SEPEN's joint bid was funded by the European Union Third health program with the service contract of the Executive Agency for Consumers, Health, Agriculture and Food No. 2016 73 01. It was chaired by the University of Zemmelweiss in Hungary, and the members of the consortium included the Standing Committee of European Physicians (CPME), the Catholic University of Leuven, the Italian Ministry of Health, and the Italian National Agency for Regional Health Services (AGENAS).
支持领域2
支持领域3
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伙伴关系、技术合作和财政支持

Hide [q3] 3. 贵国政府或地方政府是否已就促进卫生人员的国际招聘和移徙达成双边、多边或区域协议和/或安排？
否
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卫生人力发展和卫生系统可持续性

Hide [q4] 4. 贵国是否努力利用本国培训的卫生人员满足其卫生人员需要，并为此采取措施，包括在有最大需要的领域教育、留用和维持符合本国国情的卫生人力？
是
Hide [q4x1x] 4.1 卫生人力教育措施
是
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4.1.1 管理生产
4.1.2 改善教育质量
4.1.3 加强监管
4.4 其它
Hide [q4x2x] 4.2 确保卫生人力可持续性*的措施
是
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4.2.1 人力计划/预测
4.2.2 增加国内生产和教育机会
4.2.3 增加就业机会
4.2.4 管理卫生人员国际招聘
其它
Hide [q4x3x] 4.3 处理卫生工作者地域分布不均和留用问题的措施*
是
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4.3.1 教育（缺少卫生服务地区的教育机构；缺少卫生服务地区的学生；教育/职业发展规划中的相关专题；其它）
There are medical education institutions in the regions, including one higher education institution that started the general care nurse education program in 2021, as well as educational institutions have structural units in the regions. Professional development programs are financed from the European Union funds and the conditions for the implementation of these programs are to ensure regional accessibility.
4.3.2 监管（强制性服务协议；附有服务协议的奖学金和教育津贴；扩大从业范围；任务转移；技能组合；其它）
When acquiring a doctor's specialty at the residency, there is a regional principle that a person can study in state-funded studies, but after completing studies and obtaining a doctor's specialist certificate, it is a condition to work in a state or municipal institution for three years.
4.3.3 激励措施（财政和非财政）
Regional residents (persons studying for a medical specialty) are entitled to a higher resident's salary by 30%; Also in Latvia, a project of European Union funds is being implemented, which provides compensation for starting work in regions outside the capital, as well as for starting work in the most critical professions in the sector (including the capital) - nurses and nursing assistants in hospitals, family doctors and medical assistants.
4.3.4 支助（体面、安全的生活和工作条件；职业发展机会；社会承认措施；其它）
Hide [q4x4x] 4.4 其它相关措施
是
Hide [q4x4] 请描述：
Investments by European Union funds to improve the infrastructure of hospitals and GP practices, including in the outermost regions, which, among other things, provide decent working conditions for doctors.
Hide [q5] 5. 5. 贵国是否制定了专门政策和/或法律，用于指导在外国接受培训的卫生人员国际招聘、移徙和融入工作？
否
Hide [q6x] 6. 认识到其它政府实体的作用，卫生部是否有相关方式（如政策、机制、机构）在卫生人员国际招聘和移徙问题上进行跨部门监测和协调？
是
Hide [q6x1] 6.1 如果回答“是”，请在下框中提供进一步信息。
There are competent bodies that ensure the recognition of qualifications. There is a Health Inspectorate that maintains a database of medical personnel, including foreigners. There is a Health Inspectorate, which monitors that the professional activities of a medical practitioner (including from abroad) comply with the law.
Hide [q7x] 7. 贵国是否就卫生人员的国际招聘和移徙建立了数据库，或汇编了法律法规，以及适当时与实施情况相关的信息？
是
Hide [q7x1x]

7.1.a 如果回答“是”，请进一步详述或提供链接：

Latvian e-Government portal to serve e-services to citizens - Latvijas valsts portāls, where information is also available in English
Hide [q7x2x]

7.1.b 上传提供此类信息的任何格式的文件（例如pdf、excel、word）

請上傳文件
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责任、权利和招聘做法

Hide [q8x] 8. 有哪些法律保障措施和/或其它机制来确保移徙卫生人员与在国内接受培训的卫生人员享有同样权利和负有同样责任？请从下表中勾选所有适用选项：
8.1 利用相关机制对移徙卫生人员进行国际招聘，此类机制有助于他们评估就业岗位上的利益和风险，并及时作出关于就业的知情决定
8.2 移徙卫生人员在与于国内接受培训的卫生人力平等的基础上，依据资历、工作年限和专业责任程度等客观标准获得雇用、提升和报酬
8.3 移徙卫生人员与在国内接受培训的卫生人力在加强专业教育、资历和职业发展方面拥有同等机会
8.4 其它机制，可能时请详述：
Hide [q9x] 9. 请本着自己的意愿，提交任何其它评论或信息，说明贵国已经采取或计划采取哪些法律、行政和其它措施，以确保对在外国接受培训和/或移民卫生人员的公平招聘和就业做法。
No additional information
Hide [q10x] 10. 关于在贵国境外工作的在国内接受培训/移居国外的卫生人员（移民），请提交任何评论或信息，说明贵国已经采取或计划采取哪些措施来确保对其公平招聘和就业做法，以及遇到哪些困难。
措施1
1 Addressing the issue of attracting human resources in the field of health care, the Ministry of Health has prepared amendments to several regulations of the Cabinet of Ministers, which were approved by the government on 18 August 2020. Significant changes - relaxed requirements for doctors in the diaspora who want to move to Latvia to be able to continue their professional work here. To provide an opportunity for physicians living in the diaspora to continue their professional activities when moving to Latvia, the procedure for registration in the Register of Medical Practitioners and Medical Support Persons has been facilitated. Namely, if a medical practitioner (with a diploma obtained in Latvia) has worked in a profession outside Latvia in a Member State of the European Economic Area or Switzerland for at least three years in the last five years and wants to continue working in Latvia, the person will have to submit certain certificates of professional activity abroad. A person will also be able to do it remotely, for example, while still outside Latvia, and if everything is correct, return to Latvia immediately to work. Until now, the so-called "registry exam" had to be taken, which made the process more difficult. As a result, it will be a positive impulse for Latvia to return highly qualified specialists in the field of health care.
措施2
措施3
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卫生人员国际招聘和移徙数据

Hide [iq11] 提高数据的可得性和国际可比较性对于理解和处理全球卫生工作者移徙的动态至关重要。
Hide [q11] 11. 贵国是否有任何机制或实体负责保存在外国出生或接受培训的卫生人员的统计资料？
是
Hide [q11x1] 请描述：
The Health Inspectorate does not have statistical data on health care workers born and trained abroad in Latvia. But in accordance with Regulation no. 827 “Procedures for Recognition of Professional Qualifications for Permanent Professional Activity in the Republic of Latvia” (Paragraph 22), the institution that issues recognition certificates shall send copies of decisions on recognition of professional qualifications to the Academic Information Center (https://likumi.lv/ta/en/en/id/287586-procedures-for-the-recognition-of-a-professional-qualification-for-independent-professional-activity-in-the-republic-of-latvia).
Hide [iQ12] 12. 活跃卫生人员储备数据，按培训国和出生国分类
先前与世卫组织分享的数据可在这里查阅。请与贵国的国家卫生人力账户归口单位联系，并更新相关信息。

按照国家卫生人力账户指标1-07和1-08，请提供现有最近一年关于贵国卫生人员总储备的信息（最好是活跃劳动力1），按培训国（在外国接受培训）和出生国（在外国出生）分类。贵国如存在国家卫生人力账户归口单位，请与之联系，以确保报告的如下数据与国家卫生人力账户的报告保持一致。
Hide [q12x0] 12.1 活跃卫生人员综合储备
此项信息可通过下列三个选项之一提供。请选择您首选的数据输入方式：
选项B：下载填有已有数据的Excel表模板，并 上传更新后的数据
Hide [q12x1x2] 选项B：下载填有已有数据的Excel表模板，并 上传更新后的数据
請上傳文件
WHO_foreign_trained_pers_Latvia
No comment
Hide [q12x1x3] 上传提供此类信息的任何格式的文件（例如pdf、excel、word）
Hide [q13x2] 12.2 对在外国接受培训的卫生人员进行培训的前10个国家
请提供对贵国在外国接受培训的卫生人员进行培训的前10个国家的数据 此项信息可通过下列三个选项之一提供：
选项B：下载 填有已有数据的Excel表模板，并 上传更新后的数据
Hide [q13x2x2] 选项B：下载 填有已有数据的Excel表模板，并 上传更新后的数据
請上傳文件（最大文件大小：5MB）
WHO_foreign_trained_pers_Latvia
No comment
Hide [q13x2x3] 上传提供此类信息的任何格式的文件（例如pdf、excel、word）
請上傳文件
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COVID-19和卫生人员流动

Hide [q13] 13. 是否在国家或国家以下层面采取了与国际卫生人员临时或永久流动有关的COVID-19大流行应对措施？
13.1 与在外国接受培训或在外国出生的卫生人员入境或出境相关的国家或地方法规、政策或程序没有变化
In the Covid -19 situation, although there is a general shortage of doctors, hospitals restructured existing facilities and attracted additional staff - medical students, people with medical training but not working in the sector - their return was encouraged.
13.2 为方便在外国接受培训或在外国出生的卫生人员入境和融入制定的国家和/或地方法规、政策或程序
13.3 为限制外国卫生人员入境制定的国家和/或地方法规、政策或程序
13.4 其它
Hide [q14] 14. 在COVID-19大流行期间，贵国是否有监测卫生人员流入/流出贵国的机制？
流入
流出
没有
Hide [q14x1] 14.1 2019年和2020年，贵国新增（流入）了多少在外国接受培训或在外国出生的活跃（临时和/或永久）卫生人员？
医生 护士 助产士 牙医 药剂师 备注
数据来源（如监管当局、移民记录、工作许可证等）

请确保这两年的各类人员数据来源保持一致 		Desicions of the recognitions of profesional qualifications in Latvia Desicions of the recognitions of profesional qualifications in Latvia Desicions of the recognitions of profesional qualifications in Latvia Desicions of the recognitions of profesional qualifications in Latvia Desicions of the recognitions of profesional qualifications in Latvia
2020年 8 2 0 1 2
2019年 5 3 0 1 2 Including 1 European Professional Card issued to pharmacists, information from the Internal Market Information System (IMI)
Hide [q14x2] 14.2 2019年和2020年，有多少在国内接受培训的卫生人员（因临时或永久移徙）离开（流出）贵国？
医生 护士 助产士 牙医 药剂师 备注
数据来源（如良好信誉信、移民记录、政府间协议等）

请确保这两年的各类人员数据来源保持一致 		Professional qualifications of certificates issued by the Latvian Medical Association recognition abroad. Notifications of recognition of professional qualifications abroad + information from the Internal Market Information System (European Professional Card) Professional qualifications of certificates issued by the Latvian Medical Association recognition abroad. Notices on the recognition of professional qualifications abroad + information from the Internal Market Information System (European Professional Card - EPC) Notifications of recognition of professional qualifications abroad + information from the Internal Market Information System (European Professional Card)
2020年 212 36 0 37 3 212 doctors (of them 66 inhabitants of Latvia, 146 - foreigners who have graduated from Latvia);1-biomedical laboratory assistant; 1-medical assistant; 5-physiotherapist; 1-optometrists; 1-nutrition specialist; 2-dental hygienist 2- farmaceiti; 1-farmaceita asistents;
2019年 241 44 0 42 3 2019 - 241 doctors (of them - 86 inhabitants of Latvia, 155 - foreigners who have graduated from Latvia) and 42 dentists (6 of them) Latvian residents, 36 - foreigners who have graduated from Latvia).;4-medical assistant; 4-physiotherapist; 1- nursing assistant; 3-ergotherapist; 1-masseuse; 2- radiographer; 1-dental assistant; 3-dental technician. 2 – farmaceiti; 1-farmaceits (EPK)
Hide [q15] 15. 请列出在COVID-19大流行期间与符合伦理的卫生人员国际招聘相关的任何挑战

请描述（如主动招聘重症监护室人员）
第一项挑战
Language barrier - in order to work in Latvia, a medical practitioner must know the Latvian language.
第二项挑战
第三项挑战
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限制、解决办法和补充评论

Hide [q16] 16. 请按照优先顺序，列举贵国对国际移徙进行符合伦理的管理的三个主要限制因素，并提出可能的解决办法：
主要限制因素 可能的解决办法/建议
There are insufficient resources in the public sector for the development, implementation and improvement of long-term and comprehensive health workforce policies for attraction and retention, but there are some successful measures. to develop the capacity of public administration on these issues
Implementation and monitoring of human resources strategy in medical institutions (especially for recruitment and retention of labor force). involvement of employers, administration of medical institutions in the development of the national health human resources strategy.
Availability and quality of data, compatibility for monitoring of human resources, including recruitment Modernization of the register of medical practitioners - which has already started.
Hide [q17] 17. 贵国是否需要特别支持来加强《守则》的实施？
17.1 支持加强数据和信息
17.2 支持政策对话和发展
17.3 支持制定双边/多边协议
17.4 其它领域的支持：
Hide [q18] 18. 请本着自己的意愿，就卫生人员的国际招聘和移徙，提交与《守则》的实施相关的任何其它补充评论或材料。

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