National Reporting Instrument 2021
Background
[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/).
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
Disclaimer
[disclaim]
For more information on WHO Data Policy kindly refer to http://www.who.int/publishing/datapolicy/en/
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
Designated National Authority Contact Details
[q01b]
Contact information:
Country
Djibouti
Full name of institution:
Noura
Name of designated national authority:
Noura Abdi Farah
Title of designated national authority:
Director of Planning and International Cooperation
Telephone number: (E.g. +41227911530 .)
+253 77 83 37 34
Email: (Please enter one email address only.)
noura.abdi@gmail.com,hrhinfo@who.int
Implementation of the Code
[q1]
1. Has your country taken steps to implement the Code?
No
Partnerships, Technical Collaboration and Financial Support 1/2
[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:
[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:
Partnerships, Technical Collaboration and Financial Support 2/2
[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
[q3xTitle]
Title of Agreement
| Title | Web-link to agreement | Upload the full text of the agreement | |
|---|---|---|---|
| Agreement 1 | NA (the options available for the validity period are not applicable so dummy entries have been made to proceed to the next question.) | ||
| Agreement 2 | NA (the options available for the validity period are not applicable so dummy entries have been made to proceed to the next question) | ||
| Agreement 3 | NA (the options available for the validity period are not applicable so dummy entries have been made to proceed to the next question.) | ||
| Agreement 4 | |||
| Agreement 5 |
[q3xUploadx1]
[q3xUploadx2]
[q3xUploadx3]
[q3xUploadx4]
[q3xUploadx5]
[q3xTOA]
If you cannot share the full text of the agreement please fill :
| Type of Agreement | Coverage | |
|---|---|---|
| NA (the options available for the validity period are not applicable so dummy entries have been made to proceed to the next question.) (SQ001) | Bilateral (A1) | National (A1) |
| NA (the options available for the validity period are not applicable so dummy entries have been made to proceed to the next question) (SQ002) | Bilateral (A1) | National (A1) |
| NA (the options available for the validity period are not applicable so dummy entries have been made to proceed to the next question.) (SQ003) | Bilateral (A1) | National (A1) |
| (SQ004) | ||
| (SQ005) |
[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): | |
|---|---|---|---|---|---|---|---|---|
| NA (the options available for the validity period are not applicable so dummy entries have been made to proceed to the next question.) | 1 | 1 | 1 | 1 | 1 | |||
| NA (the options available for the validity period are not applicable so dummy entries have been made to proceed to the next question) | 1 | 1 | 1 | 1 | 1 | |||
| NA (the options available for the validity period are not applicable so dummy entries have been made to proceed to the next question.) | 1 | 1 | 1 | 1 | 1 | |||
[q3xCHP]
Categories of Health Personnel (check all that apply)
| Doctors | Nurses | Midwives | Dentists | Pharmacists | Other (include details as necessary) : | |
|---|---|---|---|---|---|---|
| NA (the options available for the validity period are not applicable so dummy entries have been made to proceed to the next question.) | 1 | 1 | ||||
| NA (the options available for the validity period are not applicable so dummy entries have been made to proceed to the next question) | 1 | |||||
| NA (the options available for the validity period are not applicable so dummy entries have been made to proceed to the next question.) | 1 | |||||
[q3xCHPOth]
Categories of Health Personnel (Please specify:)
NA (the options available for the validity period are not applicable so dummy entries have been made to proceed to the next question.)
Medical students
NA (the options available for the validity period are not applicable so dummy entries have been made to proceed to the next question)
Faculty of Medicine
NA (the options available for the validity period are not applicable so dummy entries have been made to proceed to the next question.)
Paramedics (training)
[q3xVP]
Validity period
| From: | To: | |
|---|---|---|
| NA (the options available for the validity period are not applicable so dummy entries have been made to proceed to the next question.) (SQ001) | 2020 (2020) | 2022 (A29) |
| NA (the options available for the validity period are not applicable so dummy entries have been made to proceed to the next question) (SQ002) | 2010 (2010) | 2022 (A29) |
| NA (the options available for the validity period are not applicable so dummy entries have been made to proceed to the next question.) (SQ003) | 2020 (2020) | 2022 (A29) |
| (SQ004) | ||
| (SQ005) |
[q3xCN]
Countries that are involved
NA (the options available for the validity period are not applicable so dummy entries have been made to proceed to the next question.)
Cuba
NA (the options available for the validity period are not applicable so dummy entries have been made to proceed to the next question)
Tunisia
NA (the options available for the validity period are not applicable so dummy entries have been made to proceed to the next question.)
Morocco, Tunisia, Algeria and Mali
[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: | |
|---|---|---|---|---|---|---|---|
| NA (the options available for the validity period are not applicable so dummy entries have been made to proceed to the next question.) | 1 | ||||||
| NA (the options available for the validity period are not applicable so dummy entries have been made to proceed to the next question) | 1 | ||||||
| NA (the options available for the validity period are not applicable so dummy entries have been made to proceed to the next question.) | 1 | ||||||
[q3xSYCOth]
Signatory of the agreement from your country (Please specify:)
NA (the options available for the validity period are not applicable so dummy entries have been made to proceed to the next question.)
NA
NA (the options available for the validity period are not applicable so dummy entries have been made to proceed to the next question)
NA
NA (the options available for the validity period are not applicable so dummy entries have been made to proceed to the next question.)
[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: | |
|---|---|---|---|---|---|---|---|
| NA (the options available for the validity period are not applicable so dummy entries have been made to proceed to the next question.) | 1 | ||||||
| NA (the options available for the validity period are not applicable so dummy entries have been made to proceed to the next question) | 1 | ||||||
| NA (the options available for the validity period are not applicable so dummy entries have been made to proceed to the next question.) | 1 | ||||||
[q3xSPCOth]
Signatory of the agreement from the partner country (ies) (Please specify:)
NA (the options available for the validity period are not applicable so dummy entries have been made to proceed to the next question.)
NA
NA (the options available for the validity period are not applicable so dummy entries have been made to proceed to the next question)
NA
NA (the options available for the validity period are not applicable so dummy entries have been made to proceed to the next question.)
[q3xCOP]
Does the agreement explicitly reference the Code?
NA (the options available for the validity period are not applicable so dummy entries have been made to proceed to the next question.)
No
NA (the options available for the validity period are not applicable so dummy entries have been made to proceed to the next question)
No
NA (the options available for the validity period are not applicable so dummy entries have been made to proceed to the next question.)
No
[q3xPAP]
Does the agreement reflect the code’s principles and practices?
NA (the options available for the validity period are not applicable so dummy entries have been made to proceed to the next question.)
Yes
NA (the options available for the validity period are not applicable so dummy entries have been made to proceed to the next question)
Yes
NA (the options available for the validity period are not applicable so dummy entries have been made to proceed to the next question.)
Yes
Health Workforce Development and Health System Sustainability
[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
[q4x1x]
4.1 Measures taken to educate the health workforce
Yes
[q4x1]
4.1.1 Manage production
4.1.2 Improve quality of education
4.1.3 Strengthen regulation
4.4 Others
[q4x2x]
4.2 Measures taken to ensure the sustainability* of the health workforce
Yes
[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
Other
[q4x3x]
4.3 Measures taken to address the geographical mal-distribution and retention of health workers*
Yes
[q4x3]
4.3.1 Education (Education institutions in underserved areas; students from under-served areas; relevant topics in education/professional development programmes; others)
Health policies now encourage health personnel to serve in the regions and inner cities.
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)
For all new recruitment of personnel, it is mandatory to serve in the underserved areas.
4.3.3 Incentives (Financial and non-financial)
Yes, there are incentives for those serving in the regions and underserved areas.
4.3.4 Support (Decent and safe living and working conditions; career advancement opportunities; social recognition measures; others)
Only for physicians, and particularly for the Medical Chief Officer.
[q4x4x]
4.4 Other relevant measures
No
[q5]
5. Are there specific policies and/or laws that guides international recruitment, migration and integration of foreign-trained health personnel in your country?
No
[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
[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?
No
Responsibilities, Rights and Recruitment Practices
[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:
[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.
A proposed plan for the development of human resources for health in Djibouti
[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
A proposed plan for the development of human resources for health in Djibouti
Measure 2
Measure 3
Data on International Health Personnel Recruitment & Migration
[iq11]
Improving the availability and international comparability of data is essential to understanding and addressing the global dynamic of health worker migration.
[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
[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.
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.
[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:
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
[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 | 201 | NA | 2021 | 1 | Includes 36 specialists | |||||
| Nurses | 521 | NA | 2021 | 1 | NA | |||||
| Midwives | 284 | NA | 2021 | 1 | NA | |||||
| Dentists | 21 | NA | 2021 | 1 | NA | |||||
| Pharmacists | 18 | NA | 2021 | 1 | NA |
[q12x1x3]
Upload any format of documentation that provides such information (e.g. pdf, excel, word).
[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:
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:
[q13x2x3]
Upload any format of documentation that provides such information (e.g. pdf, excel, word).
Please upload file
COVID-19 and Health personnel mobility
[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
No specific measures
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
[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
[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)
Please describe (e.g. active recruitment of ICU personnel)
1st Challenge
2nd Challenge
3rd Challenge
Constraints, Solutions, and Complementary Comments
[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 | |
|---|---|---|
| Fluidity | Border (firmness) | |
| Economy | Regional and international aid | |
| Epidemiological risk | Management (epidemiological investigation) |
[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:
[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.
In Q3, The agreement with Tunisia started in 2007. The information on validity period of the agreements are not available so dummy years have been provided to proceed to other questions.
We highly appreciate this opportunity and look forward to your support. Thank you
[q18x1]
Please upload any supporting files
Thank You
[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’.