National Reporting Instrument 2021

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Background

Hide [iBG] 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 additionally mandated to report to the World Health Assembly every 3 years.

WHO Member States completed the 3rd round of national reporting in March 2019. The WHO Director General reported progress on implementation to the 72nd World Health Assembly in May 2019 (A 72/23). The 3rd Round of National Reporting additionally informed the Member-State led Review of the Code’s relevance and effectiveness, as presented to the 73rd WHA in 2020 (A 73/9).

The Review highlights that Code implementation, through targeted support and safeguards, is necessary to ensure that Health Emergency and Universal Health Coverage-related progress in Member States serves to reinforce rather than compromise similar achievement in others. In light of the considerations in the Report and decision WHA 73(30), the WHO Secretariat has additionally prepared the Health Workforce Support and Safeguards List, 2020.

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 4th Round of National Reporting are to be presented at the 75th World Health Assembly in May 2022. Given the ongoing COVID-19 pandemic, the NRI (2021) has been adapted to additionally capture information related to health personnel recruitment and migration in the context of the pandemic.

The deadline for submitting reports is 31 January 2022.

Should technical difficulties prevent national authorities from filling in the online questionnaire, it is also possible to download the NRI via the link: https://www.who.int/teams/health-workforce/migration/code-nri. Please complete the NRI and submit it, electronically or in hard copy, to the following address:

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

Disclaimer: The data and information collected through the National Reporting Instrument will be made publicly available via the WHO web-site following the proceedings of the 75th WHA in 2022. The quantitative data collected will be updated on and available through the National Health Workforce Accounts online platform. (http://www.who.int/hrh/statistics/nhwa/en/).
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Please describe
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Disclaimer

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 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
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Designated National Authority Contact Details

Hide [q01b] Contact information:
Country
China
Full name of institution:
Guangpeng
Name of designated national authority:
Zhang Guangpeng
Title of designated national authority:
Vice director
Telephone number: (E.g. +41227911530 .)
0086-65766273
Email: (Please enter one email address only.)
13693514836@139.com,hrhinfo@who.int
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Implementation of the Code

Hide [q1] 1. Has your country taken steps to implement the Code?
Yes
Hide [q1x1x] 1.1 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.
No
Hide [q1x2x] 1.2 Measures have been taken or are being considered to introduce changes to laws or policies consistent with the recommendations of the Code.
No
Hide [q1x3x] 1.3 Records are maintained on all recruiters authorized by competent authorities to operate within their jurisdiction.
Yes
Hide [q1x3] Please describe:
The management measures has been issued to register the foreign doctors practice medicine in China and domestic medical staff (doctors and nurses) go abroad to engage in medical and nursing activities.
Hide [q1x4x] 1.4 Good practices, as called for by the Code, are encouraged and promoted among recruitment agencies.
No
Hide [q1x5x] 1.5 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.
No
Hide [q1x6x] 1.6 Other steps:
No
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Partnerships, Technical Collaboration and Financial Support 1/2

Hide [q2x1] 2.1. Has your country provided technical or financial assistance to one or more WHO Member States, particularly developing countries, or other stakeholders to support the implementation of the Code?
2.1.1 Specific support for implementation of the Code
2.1.2 Support for health system strengthening
2.1.3 Support for health personnel development
2.1.4 No support provided
2.1.5 Other areas of support:
Hide [q2x1oth] 2.1.5 Other areas of support:
Support Area 1
To dispatch China’s international medical aid team. Over the past 50 years, China has dispatched nearly 30000 person-times medical team members to 71 countries in Asia, Africa, Latin America, Europe and Oceania. At present, there are 57 medical aid teams with more than 1000 members served in 56 countries around the world. China has provided more than 50 times emergency medical assistance and public health emergency assistance to fight Ebola, yellow fever, dengue fever, avian influenza, cholera and Lassa fever, etc.
Support Area 2
To promote the building of global public health cooperation mechanisms and networks. China has taken a series of foreign aid measures such as the China-Africa Public Health Cooperation Plan, 100 Maternal and Child Health Projects and Health Action, etc. Has established the Belt and Road public health cooperation alliance and the hydatid disease prevention and control alliance, and a mechanism for infectious disease surveillance, prevention and control, and epidemic notification in Mekong countries.
Support Area 3
To support the global response to COVID-19. China has actively shared epidemic information and experience, provided other countries with protective facilities and testing reagents, and assisted in the establishment of virus testing laboratories. China has also provided large-scale vaccine assistance to developing countries, and sent 37 teams of medical experts to 34 countries to guide the diagnosis, treatment and treatment of COVID-19.
Hide [q2x2] 2.2. Has your country received technical or financial assistance from one or more WHO Member States, the WHO secretariat, or other stakeholders to support the implementation of the Code?
2.2.1 Specific support for implementation of the Code
2.2.2 Support for health system strengthening
2.2.3 Support for health personnel development
2.2.4 No support received
2.2.5 Other areas of support:
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Partnerships, Technical Collaboration and Financial Support 2/2

Hide [q3] 3. Has your country or its sub-national governments entered into bilateral, multilateral, or regional agreements and/or arrangements with respect to the international recruitment and migration of health personnel?
Yes
Hide [q3xTitle] Title of Agreement
Title Web-link to agreement Upload the full text of the agreement
Agreement 1 China’s international medical aid team (the options available for the validity period are not applicable so dummy entries have been made to proceed to the next question. See Q18 for explanation)
Agreement 2
Agreement 3
Agreement 4
Agreement 5
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Hide [q3xTOA] If you cannot share the full text of the agreement please fill :
Type of Agreement Coverage
China’s international medical aid team (the options available for the validity period are not applicable so dummy entries have been made to proceed to the next question. See Q18 for explanation) (SQ001) Bilateral (A1) National (A1)
(SQ002)
(SQ003)
(SQ004)
(SQ005)
Hide [q3xMCA] Main content of agreement (check all that apply)
Education and training Institutional capacity building Promotion of circular migration Retention strategies Recognition of health personnel Recruitment of health personnel Twinning of health care facilities Other mechanism (include details if possible):
China’s international medical aid team (the options available for the validity period are not applicable so dummy entries have been made to proceed to the next question. See Q18 for explanation) 1 1 1 1
Hide [q3xMCAOth] Main content of agreement (Please specify:)
China’s international medical aid team (the options available for the validity period are not applicable so dummy entries have been made to proceed to the next question. See Q18 for explanation)
NA
Hide [q3xCHP] Categories of Health Personnel (check all that apply)
Doctors Nurses Midwives Dentists Pharmacists Other (include details as necessary) :
China’s international medical aid team (the options available for the validity period are not applicable so dummy entries have been made to proceed to the next question. See Q18 for explanation) 1 1
Hide [q3xVP] Validity period
From: To:
China’s international medical aid team (the options available for the validity period are not applicable so dummy entries have been made to proceed to the next question. See Q18 for explanation) (SQ001) 2010 (2010) 2050 (A1)
(SQ002)
(SQ003)
(SQ004)
(SQ005)
Hide [q3xCN] Countries that are involved
China’s international medical aid team (the options available for the validity period are not applicable so dummy entries have been made to proceed to the next question. See Q18 for explanation)
NA
Hide [q3xSYC] Signatory of the agreement from your country
Ministry of Foreign Affairs Ministry of Health Ministry of Education Ministry of Trade Ministry of Labour Ministry of Immigration /Home Affairs Other:
China’s international medical aid team (the options available for the validity period are not applicable so dummy entries have been made to proceed to the next question. See Q18 for explanation) 1
Hide [q3xSPC] Signatory of the agreement from the partner country (ies)
Ministry of Foreign Affairs Ministry of Health Ministry of Education Ministry of Trade Ministry of Labour Ministry of Immigration /Home Affairs Other:
China’s international medical aid team (the options available for the validity period are not applicable so dummy entries have been made to proceed to the next question. See Q18 for explanation) 1
Hide [q3xSPCOth] Signatory of the agreement from the partner country (ies) (Please specify:)
China’s international medical aid team (the options available for the validity period are not applicable so dummy entries have been made to proceed to the next question. See Q18 for explanation)
NA
Hide [q3xCOP] Does the agreement explicitly reference the Code?
China’s international medical aid team (the options available for the validity period are not applicable so dummy entries have been made to proceed to the next question. See Q18 for explanation)
Yes
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Health Workforce Development and Health System Sustainability

Hide [q4] 4. Does your country strive to meet its health personnel needs with its domestically trained health personnel, including measures to educate, retain and sustain a health workforce that is appropriate for the specific conditions of your country, including areas of greatest need?
Yes
Hide [q4x1x] 4.1 Measures taken to educate the health workforce
Yes
Hide [q4x1]
4.1.1 Manage production
4.1.2 Improve quality of education
4.1.3 Strengthen regulation
Please describe: China has established and gradually improved the three-stage health education system, including college medical education, postgraduate medical education and continuing medical education. (1) To recruit the medical students according to the demand for health services. The new enrollment plan favors talents in short supply, high-level talents and compound talents. (2) To improve the education and training quality by raising the admission threshold for medical students, strengthening discipline construction, improving the quality of standardized training of residents, and encouraging on-the-job medical personnel to receive continuing education, etc. (3) To establish the medical education quality evaluation and certification system. The certification result for clinical medicine specialty is applied for college enrollment. The passing rate of the physician and nurse licensing examination will be taken as an important part to evaluate the quality of medical education, and colleges and universities whose passing rate below 50 percent for three consecutive years will be reduced in enrollment amount. Government also carries out the certification of post-graduate medical education bases and continuing medical education. The passing rate of residential training and annual professional proficiency test result are taken as the core indicators to assess the residential training bases, and bases whose passing rate of residential training ranked in the bottom 5% of the country for two consecutive years will reduce the enrollment.
4.4 Others
Hide [q4x2x] 4.2 Measures taken to ensure the sustainability* of the health workforce
Yes
Hide [q4x2]
4.2.1 Workforce planning/forecasting
4.2.2 Increasing domestic production and education opportunities
4.2.3 Increasing employment opportunities
4.2.4 Manage recruitment of international health personnel
1) To establish the mechanism for HRH training and development planning. By formulating mid-and-long term HRH development plans, to predict the overall amount of HRH and define the goals, specific tasks and supporting measures for HRH development. By formulating special plans for medical education and training, to train health professionals demand-oriented and ensure that medical professionals to meet the needs of health services. (2) To increase the enrollment in anesthesia, infection, critical care, pediatrics, general practice, and public health, etc. At the same time, the government has issued preferential policies to attract health professionals to work in rural and remote areas, built the special recruitment network, and encouraged HRH service institutions to provide employment guidance, job hunting consultation, skill training and other services to promote the employment of medical graduates. (3) To regulate the foreign doctors working in China, the accreditation of doctors and nurses going abroad, and the management of China’s international medical aid team.
Other
Hide [q4x3x] 4.3 Measures taken to address the geographical mal-distribution and retention of health workers*
Yes
Hide [q4x3]
4.3.1 Education (Education institutions in underserved areas; students from under-served areas; relevant topics in education/professional development programmes; others)
Please describe: (1) To strengthen the HRH localized cultivation. China has implemented a series of projects such as order training for medical students with rural background for free, HRH training for western areas, and "3+2" assistant general practitioners training (3 -year in junior college and 2-year for GP postgraduate training), to cultivate health professionals for grassroots, remote and poor areas and central and western regions. (2) To strengthen the support from the city or major medical institutions to primary health institutions by health alliance, telemedicine, professional section alliance, etc. (3) To improve the capacity of primary health professionals by means of distance education, focused training, clinical advanced study and partner assistant, etc. (4) To set up special training programs for health workers in grass-roots or remote areas and formulate training plans, such as the National Plan for Rural Doctors Education (2011-2020). R4.3.2 Regulation (Mandatory service agreements; scholarships and education subsidies with return of service agreements; enhanced scope of practice; task shifting; skill-mix; others) Please describe: (1) To fix the service period in grassroot level or remote areas by agreements or administrative orders. For example, medical students who participate in the targeted free training program of rural orders must sign a targeted employment agreement before enrollment and promise to serve in targeted rural primary medical and health institutions for 6 years after graduation. Doctors must serve at or below the county level or in a corresponding medical institution for one year before being promoted to senior title. (2) To implement compensatory measures to support medical students or health workers in primary health institutions such as tuition fee compensation and loan compensation for graduates employed at the grassroots level, job subsidies, and priority to promotion in professional titles or positions. (3) To add the special examination for those on-the-job practice without assistant practicing doctors' qualifications in township health centers, and village doctors. The eligible can be assistant medical practitioners and rural general assistant medical practitioners who only serve in the township health centers and village clinics. (4) To employ health professionals at county or town level institutions but actually serve at lower-level institutions, or go around visiting patients, to keep the health workers work in grassroot institutions. (5) To increase the standardized practice training bases for general practitioners. So that the trained general practitioners can contact and spend much time on the grassroots as soon as possible, and enhance their sense of identity for the primary health institutions. R4.3.3 Incentives (Financial and non-financial) Please describe: (1) To improve the professional title promotion system for primary health professionals, to adopt proper evaluation standards and paper and foreign language no longer as the preconditions for primary health professionals to apply for professional titles. (2) To establish allowances for health professionals working in hardship and remote areas and subsidies for working in township level. (3) To allow the primary health institutions to use a certain proportion of the balance of medical revenue and expenditure for personnel distribution, set up the general practitioners’ subsidy and the contracted service fees of family doctors are mainly used for team rewards to motivate the health professionals at grassroot level.
4.3.2 Regulation (Mandatory service agreements; scholarships and education subsidies with return of service agreements; enhanced scope of practice; task shifting; skill-mix; others)
1) To fix the service period in grassroot level or remote areas by agreements or administrative orders. For example, medical students who participate in the targeted free training program of rural orders must sign a targeted employment agreement before enrollment and promise to serve in targeted rural primary medical and health institutions for 6 years after graduation. Doctors must serve at or below the county level or in a corresponding medical institution for one year before being promoted to senior title. (2) To implement compensatory measures to support medical students or health workers in primary health institutions such as tuition fee compensation and loan compensation for graduates employed at the grassroots level, job subsidies, and priority to promotion in professional titles or positions. (3) To add the special examination for those on-the-job practice without assistant practicing doctors' qualifications in township health centers, and village doctors. The eligible can be assistant medical practitioners and rural general assistant medical practitioners who only serve in the township health centers and village clinics. (4) To employ health professionals at county or town level institutions but actually serve at lower-level institutions, or go around visiting patients, to keep the health workers work in grassroot institutions. (5) To increase the standardized practice training bases for general practitioners. So that the trained general practitioners can contact and spend much time on the grassroots as soon as possible, and enhance their sense of identity for the primary health institutions.
4.3.3 Incentives (Financial and non-financial)
(1) To improve the professional title promotion system for primary health professionals, to adopt proper evaluation standards and paper and foreign language no longer as the preconditions for primary health professionals to apply for professional titles. (2) To establish allowances for health professionals working in hardship and remote areas and subsidies for working in township level. (3) To allow the primary health institutions to use a certain proportion of the balance of medical revenue and expenditure for personnel distribution, set up the general practitioners’ subsidy and the contracted service fees of family doctors are mainly used for team rewards to motivate the health professionals at grassroot level.
4.3.4 Support (Decent and safe living and working conditions; career advancement opportunities; social recognition measures; others)
(1) In 2018 Chinese government has established the China’s Medical Workers' Day to advocate noble spirit of giving priority to saving lives with total devotion and ultimate love and encourage the whole society to respect and care medical workers. Meanwhile by publicizing the health workers’ touching story, the Most Beautiful Doctor selection, China's Good Doctor and China's Good Nurse selection, medical films and televisions to display the positive image of the doctors and nurses as angels in white to the public.
Hide [q4x4x] 4.4 Other relevant measures
No
Hide [q5] 5. Are there specific policies and/or laws that guides international recruitment, migration and integration of foreign-trained health personnel in your country?
Yes
Hide [q5x1] 5.1 Please provide further information in the box below:
Law/policy 1
Since 2016, China has successively revised policies such as the Interim Administration Provision for the Foreign Doctors’ Short-term Medical Practice in China (revised for the 2nd time) and Administration Provision for the Foreign Doctors’ Medical Practice in China (Draft for comments) to further standardize the management system of medical practice by foreign doctors in China and strictly enforce the admission mechanism.
Law/policy 2
In 2008, the Ministry of Commerce, together with the Ministry of Foreign Affairs, the Ministry of Health and other 12 ministries and commissions, established the human resources development foreign aid cooperation and contact mechanism, which was upgraded to an inter-ministerial coordination mechanism in 2011 to close the cooperation in different fields.
Law/policy 3
Hide [q6x] 6. Recognizing the role of other government entities, does the Ministry of Health have processes (e.g. policies, mechanisms, unit) to monitor and coordinate across sectors on issues related to the international recruitment and migration of health personnel?
No
Hide [q7x] 7. 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
Hide [q7x1x]

7.1.a Please provide further information in the box below.

Interim Administration Provision for the Foreign Doctors’ Short-term Medical Practice in China - Measures for the Administration of Qualification Certification of Doctors and Nurses Going Abroad (Trial) - Measures for the Administration of Foreign Aid
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7.1.b Please upload any format of documentation that provides such information (e.g. pdf, excel, word)

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Responsibilities, Rights and Recruitment Practices

Hide [q8x] 8. Which legal safeguards and/or other mechanisms are in place to ensure that migrant health personnel enjoy the same legal rights and responsibilities as the domestically trained health workforce? Please tick all options that apply from the list below:
8.1 Migrant health personnel are recruited internationally using mechanisms that allow them to assess the benefits and risk associated with employment positions and to make timely and informed decisions regarding them
8.2 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
8.3 Migrant health personnel enjoy the same opportunities as the domestically trained health workforce to strengthen their professional education, qualifications and career progression
8.4 Other mechanisms, please provide details below if possible:
Hide [q9x] 9. Please submit any other comments or information you wish to provide regarding legal, administrative and other measures that have been taken or are planned in your country to ensure fair recruitment and employment practices of foreign-trained and/or immigrant health personnel.

Hide [q10x] 10. Regarding domestically trained/ emigrant health personnel (diaspora) working outside your country, please submit any comments or information on measures that have been taken or are planned in your country to ensure their fair recruitment and employment practices, as well as difficulties encountered
Measure 1
N/A
Measure 2
Measure 3
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Data on International Health Personnel Recruitment & Migration

Hide [iq11] Improving the availability and international comparability of data is essential to understanding and addressing the global dynamic of health worker migration.
Hide [q11] 11. Does your country have any mechanism(s) or entity(ies) to maintain statistical records of foreign-born and foreign-trained health personnel?
No
Hide [iQ12] 12. Data on the active stock of health personnel, disaggregated by country of training and birth
Previous data shared with WHO is available here. Please liaise with your NHWA focal point and update as relevant.

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 workforce1), disaggregated by the country of training (foreign-trained) and the country of birth (foreign-born). Please consult with your NHWA focal point, if available, to ensure that data reported below is consistent with NHWA reporting.
Hide [q12x0] 12.1 Consolidated stock of active health personnel
This information can be provided by one of the following three options. Please choose your preferred mode of data entry:
Option A: Completion of the table below
Hide [q12x1x1] Option A: Please complete the table below
Please fill red highlighted cells.
Total Domestically Trained Foreign Trained Unknown Place of Training National Born Foreign Born Source* Year Does the data represent active stock? Remarks
Medical Doctors 4080000 4080000 China’s health statistics in 2021 2020 1 The data comes from the yearbook of China's health statistics in 2021. The data are real health personnel who have completed corresponding medical education and training in China and obtained corresponding professional qualifications. Some of them have the experience of going abroad for professional training.)
Nurses 4710000 4710000 China’s health statistics in 2021 2020 1 Includes midwives. The data comes from the yearbook of China's health statistics in 2021. The data are real health personnel who have completed corresponding medical education and training in China and obtained corresponding professional qualifications. Some of them have the experience of going abroad for professional training.)
Midwives NA
Dentists 280000 280000 China’s health statistics in 2021 2020 1 The data comes from the yearbook of China's health statistics in 2021. The data are real health personnel who have completed corresponding medical education and training in China and obtained corresponding professional qualifications. Some of them have the experience of going abroad for professional training.)
Pharmacists 500000 500000 China’s health statistics in 2021 2021 1 The data comes from the yearbook of China's health statistics in 2021. The data are real health personnel who have completed corresponding medical education and training in China and obtained corresponding professional qualifications. Some of them have the experience of going abroad for professional training.)
Hide [q12x1x3] Upload any format of documentation that provides such information (e.g. pdf, excel, word).
Hide [q13x2] 12.2 Top 10 countries of training for foreign-trained health personnel
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:
Hide [q13x2x3] Upload any format of documentation that provides such information (e.g. pdf, excel, word).
Please upload file
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COVID-19 and Health personnel mobility

Hide [q13] 13. Were measures undertaken at national or sub-national level in response to the COVID-19 pandemic with respect to the temporary or permanent mobility of international health personnel?
13.1 No change in national or sub-national regulation, policy or processes related to the entry or exit of foreign-trained or foreign-born health personnel
13.2 National and/or sub-national regulation, policy or processes enacted to ease entry and integration of foreign-trained or foreign-born health personnel
13.3 National and/or sub-national regulation, policy or processes enacted to limit the exit of health personnel from country
13.4 Others
Hide [q14] 14. Did you have a mechanism to monitor the inflow and outflow of health personnel to/from your country during the COVID-19 pandemic?
Inflow
Outflow
No
Hide [q15] 15. Please list any challenges related to ethical international recruitment of health personnel during the COVID-19 pandemic

Please describe (e.g. active recruitment of ICU personnel)
1st Challenge
2nd Challenge
3rd Challenge
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Constraints, Solutions, and Complementary Comments

Hide [q16] 16. 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 solution /Recommendation
Lack of systematic databases and statistics on international migration of health manpower Establish and improve the database and information exchange mechanism of international migration of health manpower
Lack of international exchange of health manpower flow information Use the Code to promote the establishment of an international exchange platform for health human mobility
Hide [q17] 17. Is there any specific support your country requires to strengthen implementation of the Code?
17.1 Support to strengthen data and information
17.2 Support for policy dialogue and development
17.3 Support for the development of bilateral/multi-lateral agreements
17.4 Other areas of support:
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.
For Q3, Our first medical aid team was sent out in 1963, and that was the start time. The duration of each agreement varies from one medical team to another, with some being valid for two years and extended for two years and some not extended for five years. The agreements roll on a regular basis, making it difficult to determine when they will end.
Hide [q18x1] Please upload any supporting files
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Thank You

Hide [iThank] You have reached the end of the National Reporting Instrument - 2021. You may go back to any question to update your answers or confirm your entry by clicking ‘Submit’.