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
Iran (Islamic Republic of)
Full name of institution:
Alireza
Name of designated national authority:
Ministry of Health and medical education
Title of designated national authority:
Head of the centre for Health HR research
Telephone number: (E.g. +41227911530 .)
09120712912
Email: (Please enter one email address only.)
alirezamirzasadeghi@yahoo.com,hrhinfo@who.int
Implementation of the Code
[q1]
1. Has your country taken steps to implement the Code?
Yes
[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.
Yes
[q1x1]
Action 1
Actions have been done, however so far, the Code has not been publicized.
Action 2
Action 3
[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.
Yes
[q1x2]
Measure 1
Translation of the code of practice to Farsi
Measure 2
planning to distribute to all the related sectors under ministry of health to be considered in the recruitment of the health workforce.
Measure 3
[q1x3x]
1.3 Records are maintained on all recruiters authorized by competent authorities to operate within their jurisdiction.
No
[q1x4x]
1.4 Good practices, as called for by the Code, are encouraged and promoted among recruitment agencies.
No
[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.
Yes
[q1x5]
Measure 1
The code of practice will be distributed to the different stakeholders and communicated with them to consider its content in the recruitment and maintenance of the health workforce.
Measure 2
Measure 3
[q1x6x]
1.6 Other steps:
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?
No
[q3xUploadx1]
[q3xUploadx2]
[q3xUploadx3]
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)
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)
Conducting a centralized distribution of doctors and dentists based on indicators such as locality and gender
4.3.3 Incentives (Financial and non-financial)
Designing a national project for “Determining the solutions for improving the distribution and retention of general and specialized physician in the country” with the cooperation of all medical universities and specialized deputies of the Ministry of Health
4.3.4 Support (Decent and safe living and working conditions; career advancement opportunities; social recognition measures; others)
Designing a national project on” Determining the status of the active human resources of the health sector based on all public and private through the census in six major including general practitioner, specialist, nurse, midwife, dentist and pharmacist)
[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?
Yes
[q5x1]
5.1 Please provide further information in the box below:
Law/policy 1
• According to the Labor laws and regulations of Iran, all foreign nationals who wish to work in Iran must obtain a work permit from the Ministry of Labor.
Law/policy 2
• All of foreign educated people in health related disciplines, which are volunteers to work in other ministries, must be approved by the Ministry of Health’s graduated department and these persons are allowed to work in the health field after Verification of their Degrees.
Law/policy 3
[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?
Yes
[q6x1]
6.1 Please provide further information in the box below:
All of foreign educated people in health related disciplines must be approved by the Ministry of Health’s graduated department and these persons are allowed to work in the health field after Verification of their Degrees.
[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
[q7x1x]
7.1.a Please provide further information in the box below.
The rules related to the recruitment and use of international workforce are collected and maintained in different ministries and organizations including:
1- Laws related to employment and payment of salaries in the database of the Ministry of Health's Directorate of Human Resources at the address:
http://karkonan.behdasht.gov.ir
2-Laws related to the assessment of overseas qualifications, national tests for graduates abroad, the transfer of Iranian students from universities and higher education institutions abroad to universities and colleges of medical sciences and health services of the country, the regulations of the non-Iranian people's Participation in grade exams including medical Specialist, sub-Specialist and fellowships, Specialized and Advanced Specialist Dentistry, and Postgraduate and Ph.D. Ph.D Degrees in Basic Sciences, Health, Pharmacy), on the health ministry department of graduates Website at:
http://edd.behdasht.gov.ir
3-Laws and regulations regarding the employment of foreign nationals and the issuance of entry visas and work permits on the website of the Ministry of Co-operation, Labor and Social Welfare at the address:
https://www.mcls.gov.ir/fa/doulat/khadamat/shenasnameh
https://www.mcls.gov.ir/fa/lawlist
[q7x2x]
7.1.b Please upload any format of documentation that provides such information (e.g. pdf, excel, word)
Upload document:
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.
- According to the existing guidelines has provided conditions to the continuing education of Iranian students studying abroad who are applying for continuing their education at the universities of medical sciences in the country According to the guideline of the transfer of Iranian students from universities and higher education institutions abroad to medical universities and faculties and International facilitate of Iran)
-According to the existing guidelines, education of non-Iranian nationals in post-graduate courses is possible.
In order to expand the scientific and cultural relations of the Islamic Republic of Iran with other countries, especially Islamic countries, and to provide facilities for better identification of the Islamic revolution, non-Iranian nationals can educate in medical related postgraduate degrees. Other goals of this regulation are:
* The expansion of scientific and cultural relations of the Islamic Republic of Iran with other countries of the world
* Supporting young people susceptible to Islamic countries
* Helping to grow and develop healthcare in Islamic countries and developing countries
* Training of committed professionals in order to contribute to the scientific self-sufficiency of Islamic countries
[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
For Iranians who travel abroad, they will be issued a work certificate with the approval of the office of international relations upon their request.
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?
Yes
[q11x1]
Please describe
All foreign-trained health personnel, whether domestic- born, or foreign-born, to use their educational qualifications in Iran, are obliged to submit their documents to the Foreign Graduate Assessment Office for evaluation and assessment and their statistic recorded by this office.
However, the information related to foreign-born is not complete and is not exactly collected.
[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 | 82,714 | 73,095 | 1,502 | 8,117 | 82,124 | 590 | professional register (I.R.I Medical Council) | 2018 | 1 | no |
| Nurses | 133,657 | Health Human Resource Research and studies Center survey | 2018 | 1 | no | |||||
| Midwives | 36,211 | 35,501 | 15 | 695 | 36,166 | 45 | professional register (I.R.I Medical Council) | 2018 | 1 | no |
| Dentists | 20,407 | 16,358 | 2,108 | 1,941 | 20,209 | 198 | professional register (I.R.I Medical Council) | 2018 | 1 | no |
| Pharmacists | 19,011 | 17,459 | 469 | 1,083 | 18,862 | 149 | professional register (I.R.I Medical Council) | 2018 | 1 | no |
[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
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
The lack of access to accurate information on the status of the Iranian workforce working in Iran or abroad as well as the foreign workforce employed in the country due to the lack of update human resources’ data banks
2nd Challenge
Issues related to the sustainability and maintenance of human health in deprived areas and their fair distribution in the country
3rd Challenge
The difficulty of changing the rules and regulations, or the formulation of new laws to implement code or achieve its objectives
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 | |
|---|---|---|
| The lack of access to accurate information on the status of the Iranian workforce working in Iran or abroad as well as the foreign workforce employed in the country due to the lack of update human resources’ data banks and problems related to the integration of information in various sectors | Strengthening HR systems and databases. In this regard, it is required plans for completing the information and assessing the status of the current active work force. Therefore, on it is on the agenda, the implementation of the projects to determine the status of the distribution of human resources at the health sector and the designing of the health human resources observatory system are under development. | |
| Issues related to the sustainability and maintenance of human health in deprived areas and their fair distribution in the country | Currently, Identify solutions to improve the distribution and sustainability of manpower is on the agenda through designing a project to determine the status of retention of physicians in deprived and underserved areas and considering the factors affecting it, along with considering the feasibility of the proposed recommendations of the World Health Organization and other successful countries in this field and localization these recommendations. | |
| The difficulty of changing the rules and regulations, or the formulation of new laws to implement code or achieve its objectives | Collect sufficient evidence and data to justify the need to change the rules and regulations and obtain the support of stakeholders and authorities to change the rules and regulations. |
[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 the last two years, with the acute conditions caused by the outbreak of corona in the country and numerous peaks of the disease, the main focus in the Iranian health system has been to ensure sufficient power supply for health centers and has not been able to implement enough measures to implement the provisions of the employment code. It may even be said that there is an increase in the departure of key health forces from the country compared to previous years, but no accurate and recorded statistics are available in this regard.
[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’.