Инструмент национальной отчетности (2021 г.)

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Справочная информация

Hide [iBG] Принятый в 2010 г. на шестьдесят третьей сессии Всемирной ассамблеи здравоохранения (резолюция WHA63.16) Глобальный кодекс ВОЗ по практике международного найма персонала здравоохранения («Кодекс») призван углублять понимание вопросов международного найма персонала здравоохранения и укреплять регулирование этой сферы в соответствии с этическими принципами путем повышения качества данных, информации и международного сотрудничества.

В статье 7 Кодекса государствам – членам ВОЗ предлагается обмениваться информацией о международном найме и миграции работников здравоохранения. Кроме того, Генеральному директору ВОЗ поручено каждые три года представлять доклады Всемирной ассамблее здравоохранения.

В марте 2019 г. государства – члены ВОЗ завершили третий раунд представления национальной отчетности об осуществлении Кодекса. В мае 2019 г. Генеральный директор ВОЗ представил семьдесят второй сессии Всемирной ассамблеи здравоохранения доклад о ходе его осуществления (A 72/23). Кроме того, в рамках третьего раунда национальной отчетности при ведущей роли государств-членов был проведен обзор актуальности и эффективности Кодекса, который был представлен семьдесят третьей сессии ВАЗ в 2020 г. (A 73/9).

В обзоре подчеркивается, что осуществление Кодекса при обеспечении соответствующей целенаправленной поддержки и гарантий необходимо для обеспечения того, чтобы прогресс в области всеобщего охвата услугами здравоохранения в государствах-членах подкреплял, а не ставил под угрозу аналогичные достижения в других странах. В соответствии с положениями Доклада и решения WHA73(30) Секретариат ВОЗ также подготовил «Health Workforce Support and Safeguards List, 2020» (Перечень стран, которым будут полезны поддержка и гарантии, связанные с кадровыми ресурсами здравоохранения, 2020 г.).

Инструмент национальной отчетности (ИНО) представляет собой инструмент самооценки на национальной основе, предназначенный для обмена информацией и мониторинга осуществления Кодекса. ИНО позволяет ВОЗ собирать и распространять актуальные фактические данные и информацию о международном найме и миграции работников здравоохранения. Результаты четвертого раунда национальной отчетности будут представлены на семьдесят пятой сессии Всемирной ассамблеи здравоохранения в мае 2022 г. В связи с продолжающейся пандемией COVID-19 данный вариант ИНО (2021 г.) был изменен таким образом, чтобы получить дополнительную информацию относительно найма и миграции работников здравоохранения в условиях пандемии.

Крайний срок представления отчетов — 31 августа 2021 г.

Если по техническим причинам национальные органы не смогут заполнить онлайновый опросник, ИНО можно также загрузить по следующей ссылке: http://www.who.int/hrh/migration/code/code_nri/en/. Просьба заполнить ИНО и направить его в электронной форме или в распечатанном виде по следующему адресу:

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

Отказ от ответственности. Данные и информация, собранные при помощи национального инструмента отчетности, будут помещены в открытый доступ на веб-сайте ВОЗ по окончании заседаний семьдесят пятой сессии Всемирной ассамблеи здравоохранения. Собранные количественные данные будут обновлены и доступны через онлайновую платформу национальных счетов кадров здравоохранения (http://www.who.int/hrh/statistics/nhwa/en/).
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Отказ от ответственности

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 For more information on WHO Data Policy kindly refer to http://www.who.int/publishing/datapolicy/en/
Я прочитал и понял политику ВОЗ в отношении использования данных, собранных ВОЗ в государствах-членах, и обмена ими вне контекста чрезвычайных ситуаций в области общественного здравоохранения.
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Контактная информация назначенного национального органа

Hide [q01b] Контактная информация назначенного национального органа
Страна
United States of America
Полное название учреждения:
Mara Burr and
Название назначенного национального органа:
Leandra Olson
Должность представителя назначенного национального органа:
Senior Global Health Officer, Multilateral Relations
Телефон:
+1-202-997-9107
Электронная почта:
Mara.Burr@hhs.gov,OGAMultilateral@hhs.gov,hrhinfo@who.int
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Осуществление Кодекса

Hide [q1] 1. Приняла ли ваша страна меры для осуществления Кодекса?
Да
Hide [q1x1x] 1.1 Приняты меры в целях коммуникации и обмена информацией между секторами по вопросам международного найма и миграции работников здравоохранения и ознакомления с Кодексом соответствующих министерств, департаментов и учреждений на национальном и/или субнациональном уровне.
Да
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Мероприятие 1
The U.S. Government provides updates on the Code implementation and U.S. support of the voluntary nature of the principles and practices of the Code across relevant government agencies, particularly in preparation for related topics in governance meetings of the WHO and its Regional Offices. In addition, Co-National Authorities (Department of Health and Human Services (HHS), Office of the Secretary, Office of Global Affairs and Health Resources and Services Administration (HRSA), Office of Global Health) meet with stakeholders and provide to the U.S. public opportunities to inform and share comments on implementation of the Code.
Мероприятие 2
Мероприятие 3
Hide [q1x2x] 1.2 Осуществляются или рассматриваются меры по внесению изменений в законодательство или политику в соответствии с рекомендациями Кодекса.
Да
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Мероприятие 1
In the United States, there is no federal law regulating placement agencies or employment contracts overall other than those forbidding employment discrimination on the bases of race, color, sex, national origin, religion, age, disability, or genetic information in recruitment or hiring in the U.S. Rather, public authorities regulate certain aspects of private recruitment and employment contracts, as set forth in the requirements for temporary migrant labor programs. Some states have introduced or are developing legislation to expand protections that may apply to health personnel. For example, current California law includes a mandated registration program designed to regulate foreign labor contractors who perform specified recruiting and soliciting activities of foreign workers for employment in the state (http://leginfo.legislature.ca.gov/faces/billCompareClient.xhtml?bill_id=201320140SB477). A proposed rule regulating foreign labor contractors: (https://www.dir.ca.gov/dlse/regulation_detail/FLCR.html) would establish standards for the registration program that further specify who is covered by the permit requirement, set a registration fee, spell out what information must be provided on permit applications, and establish criteria for processing permit applications and permit renewals.
Мероприятие 2
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Hide [q1x3x] 1.3 Ведется учет всех агентств по найму, уполномоченных компетентными органами заниматься деятельностью в пределах их юрисдикции.
Да
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As noted previously, there is no federal law regulating placement agencies or employment contracts overall. However, the regulations for the H-2B program, for the hiring of nonimmigrants to perform nonagricultural labor or services on a temporary basis, require employers to retain their foreign worker recruitment contracts in their compliance files in the event of a Department of Labor audit or investigation. Those agreements must contain a prohibition against charging the foreign worker recruitment fees. The Department of Labor also maintains a publicly available list of agents and recruiters who are party to such contracts and the locations in which they are operating. For more information, please see: https://www.foreignlaborcert.doleta.gov/Foreign_Labor_Recruiter_List.cfm Additionally, the Department of Labor’s Office of Foreign Labor Certification’s (OFLC) makes available on its website data on Permanent Labor Certification and Temporary Nonimmigrant Labor Certifications. It includes information on labor certifications by occupation, visa category, and average wages in its State Employment-Based Labor Certification Profiles, information on STEM-related occupations in the labor certification programs, and top Country Employment-Based Immigration Profiles.
Hide [q1x4x] 1.4 Оказывается поддержка и содействие использованию агентствами по найму передовых методов, предусмотренных Кодексом.
Да
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1.4.1 Содействие использованию Кодекса частными агентствами по найму.
Although the United States does not have a federal law regulating recruitment agencies overall other than its prohibitions against employment discrimination described above, there are some safeguards in place to help combat fraudulent and unscrupulous recruitment practices. For example, current H2-B regulations generally prohibit the collection of recruitment fees or labor certification expenses and require that employers disclose to workers the terms and conditions of the job, and provide the Department of Labor copies of contracts with their recruiters, and the names and locations of all subsidiary recruiters. The Department of Labor maintains a publicly available list of agents and recruiters. Remedies for violations include reimbursement of unlawfully collected fees to workers, civil money penalties, and debarment from these programs where appropriate. In the permanent labor certification program, current regulations prohibit employers from seeking or receiving payments of any kind for any activity related to obtaining permanent labor certification, whether as an incentive or inducement to filing, or reimbursement for costs incurred in preparing or filing a permanent labor certification application. The kinds of payments that are prohibited include monetary payments, wage concessions, kickbacks, bribes, or tributes, in-kind payments, and free labor. Additionally, U.S. labor and employment laws relating to wages, working conditions, and anti-discrimination generally apply to workers in the U.S. regardless of citizenship status. Enforcing labor and employment laws for all workers can help decrease their vulnerability to various forms of exploitation, including human trafficking. It can also level the playing field for employers who meet their obligations under the law.
1.4.2 Национальные законы или политика, регулирующие этические стандарты деятельности частных агентств по найму, соответствующие принципам и статьям Кодекса.
As noted above, regulations for the H-2B program, for the hiring of nonimmigrants to perform nonagricultural labor or services on a temporary basis generally prohibit the collection of recruitment fees or labor certification expenses and require that employers disclose to workers the terms and conditions of the job, and provide the Department of Labor copies of contracts with their recruiters, and the names and locations of all subsidiary recruiters. The Department of Labor maintains a publicly available list of agents and recruiters. Remedies for violations include reimbursement of unlawfully collected fees to workers, civil money penalties, and debarment from these programs where appropriate. As noted above, federal employment discrimination laws including Title VII of the Civil Rights Act of 1964, the Age Discrimination in Employment Act of 1967, the Americans with Disabilities Act of 1990, and the Genetic Information Nondiscrimination Act of 2008 prohibit employment discrimination by recruiters and employment agencies in the U.S. Individuals who believe they have been discriminated against in violation of these laws may file a charge of discrimination with the U.S. Equal Employment Opportunity Commission to seek relief. Remedies for violations may include back pay, compensatory and punitive damages, or for age or wage discrimination claims, liquidated damages (double the back pay award).
1.4.3 Государственная или частная сертификация соблюдения этических норм частными агентствами по найму.
1.4.4 Другие меры
Hide [q1x5x] 1.5 Приняты меры для выяснения мнений заинтересованных сторон в рамках процессов принятия решений и/или для вовлечения их в мероприятия, касающиеся международного найма работников здравоохранения.
Да
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Мероприятие 1
While not focused specifically on recruitment of health personnel, the Department of Labor’s Office of Foreign Labor Certification (OFLC) periodically offers opportunities for stakeholder consultation in relation to the temporary and permanent labor programs. OFLC participated and may conduct quarterly stakeholder outreach and engagement, at which stakeholders may raise questions or issues on any of the programs the Office administers. In addition, when promulgating regulations, proposed rules are submitted for public notice and comment and the agency must respond to public comments received during the notice and comment period when issuing the final rule.
Мероприятие 2
Мероприятие 3
Hide [q1x6x] 1.6 Другие шаги:
Нет
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Партнерства, техническое сотрудничество и финансовая поддержка

Hide [q2x1] 2.1. Предоставляла ли ваша страна техническую или финансовую поддержку одному или нескольким государствам – членам ВОЗ, особенно из числа развивающихся стран, либо другим заинтересованным сторонам для поддержки выполнения ими Кодекса?
2.1.1 Поддержка непосредственно в целях выполнения Кодекса
2.1.2 Поддержка в целях укрепления системы здравоохранения
The U.S. Department of Health and Human Services (HHS) has been implementing cooperative agreements since 2004 through the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) programs. These programs all have specific objectives and program activities in many countries across Africa, the Caribbean, South America and Asia. The overall intent of these programs is to build human resource capacity for health (HRH) and to strengthen health systems which in turn will encourage the retention of HRH in their countries, especially in underserved communities. Examples include: 1. Strengthening Inter-Professional Education (STRIPE): STRIPE aims to strengthen inter-professional HIV treatment and care service training provided by former (FY 2010-2015) Medical Education Partnership Initiative (MEPI) and Nursing Education Partnership Initiative (NEPI) institutions and their partner facilities to ensure the ability of health professional graduates to deliver high quality, team-based, person-centered care to people with HIV (PLHIV) focusing on the transition from graduate school to practice. 2. Resilient and Responsive Health Systems Initiative (RRHS): The RRHS Initiative supports the enhancement of the capacity in the primary health care system, with a focus on health worker training, supply and quality. The purpose is to strengthen the health workforce and the national governance and coordination frameworks, and create platforms for cross-regional and initiative-wide collaborations to promote inter-professional sharing and the adoption of evidence-based practices, innovative models and educational standards in Democratic Republic of Congo, Liberia and Sierra Leone. 3. Resilient and Responsive Health Organizations Initiative (RRHO): The RRHO Initiative supports the creation of capacity building plans and the provision of technical assistance focused on building or enhancing organizational capacity in financial management, grants management, leadership and governance, personnel management, and evaluation and monitoring. The purpose is to strengthen the capacity of impact partners supported under the HRSA Resilient and Responsive Health Systems Initiative and to strengthen Human Resources for Health (HRH) in the DRC, Liberia, Sierra Leone and South Sudan. 4. International AIDS Education and Training Centers (IAETC): The IAETC program promotes sustainable health systems strengthening through engagement with partners in-country in their efforts to control the HIV/AIDS epidemic. The capacity building efforts include direct treatment including antiretroviral therapy and voluntary medical male circumcision, and capacity building in Ministries of Health including via secondment with eventual hiring by host governments. IAETC focus on strengthening human resources for health, HIV care and treatment, health information systems and data to inform testing, care, treatment, and support. 5. The International Twinning Center: This program facilitates, manages, and provides technical support for peer-to-peer institutional partnerships between organizations to strengthen health systems and human resources for the provision of quality and sustainable HIV/AIDS services. Twinning emphasizes in-service training for health and allied care providers, creating new models of care, building the capacity of professional associations, tracking the deployment of trained professionals in high-burden areas, professional exchanges and mentoring for the effective sharing of information, knowledge, and technology. 6. Quality Improvement Capacity for Impact Project (QICIP): QICIP aims to build the capacity of host country health systems to improve the effectiveness, efficiency, patient-centeredness, safety, accessibility, and equity of the services that they provide. QICIP is available to provide assistance to country teams seeking to address deficiencies arising from Site Improvement through Monitoring System (SIMS) assessments and gaps along the clinical care cascade, particularly those that represent barriers to achieving epidemic control. Using a knowledge sharing platform will help catalyze and spread successful interventions to other countries and sites. 7. Optimizing Momentum Toward Sustainable Epidemic Control (OPCON): OPCON is a five year project (FY 2018-2022) designed to support innovative, flexible and high-impact projects to improve HIV program outcomes, equity, efficiency and sustainability. It assists countries in addressing the challenges faced in reaching epidemic control, sustaining achievements, and exploring innovations to measure progress. 8. Health Workforce for the 21st Century (HW21): HW21 is another five-year HRSA initiative (FY 2018 – 2022) supporting high HIV burden countries to meet 95-95-95 goals by 2030 by building competent and confident health workers and effectively supporting governments to employ, deploy, and retain them. Project areas include human resource information systems, community health, behavioral health and social work, enhancing HIV/TB mentorship via technology and case-based learning, and health workforce modeling.
2.1.3 Поддержка в целях развития кадров здравоохранения
USAID support countries develop a health workforce to help achieve global goals for controlling the HIV/AIDS epidemic, prevent child and maternal deaths and combat infectious disease threats, and supporting country goals for achieving Universal Health Coverage (UHC). Technical assistance is provided through standalone central and bilateral awards that have helped garner greater comprehensive focus and learning on strengthening countries’ institutional capacity for planning, development, allocation and management of the health workforce. In certain programmatic contexts, USAID support includes provision of HRH remuneration to fill critical staffing gaps impeding immediate service delivery needs that can be utilized to expand the overall health workforce through transition of staff to permanent employment within the country's health system. In addition, health workforce interventions such as skills building and performance support including use of innovations and technologies such as digital health, are widely integrated into broader programming. USAID works to leverage its broader development strengths across health, education, economic growth, and democracy, human rights and governance to advance health workforce reforms across countries. USAID has worked with countries across the globe to support health workers to meet demands of COVID-19 and protect our collective decades of gains in health. This has included ensuring health worker safety through provision of adequate PPE and infection, prevention and control compliance, support for expanding new modes of service delivery to maintain essential services while responding to COVID-19, and protection including support for wellness, and health worker COVID-19 vaccination.
2.1.4 Поддержка не оказывалась
2.1.5 Другие области поддержки:
Hide [q2x1oth] 2.1.5 Другие области поддержки:
Область поддержки 1
Additional relevant efforts include: HRH2030 Program: Global Flagship HRH project launched (2015-2021) and aligned to WHO Global Health Workforce Strategy priorities with focus on health worker employment for health and inclusive economic growth. Follow-on to legacy Capacity and CapacityPlus awards with exclusive focus on robust health workforce strengthening. HRH2030 has helped over 30 low- and middle-income countries develop the health workforce needed to prevent maternal and child deaths, support the goals of Family Planning 2020, control the HIV/AIDS epidemic, and protect communities from infectious diseases. The project focuses on four areas: increasing health worker productivity and performance; increasing the number, skill mix and competency of the health workforce; strengthening HRH/HSS leadership and governance, and building sustainability of investment in the health workforce.
Область поддержки 2
The USAID One Health Workforce (2019-2024) - Next Generation (OHW-NG) project: promotes global health security by empowering One Health university networks in Africa and Southeast Asia to build the human resources and bolster the workforce competencies for more effective disease surveillance and control. Working in 17 countries in Africa and Southeast Asia, OHW-NG develops and delivers sustainable One Health educational offerings, promotes One Health research capacity, and contributes to USAID’s implementation of the Global Health Security Agenda’s Human Resources Action Package.
Область поддержки 3
Integrating Community Health Collaboration: USAID plays a central role in the advancing community health worker formalization through the Integrating Community Health multi-agency collaboration (USAID, UNICEF, BMGF). USAID, in collaboration with UNICEF, has invested in catalytic partnerships among governments, trusted non-governmental partners, and communities to operationalize national policy and systems reform focusing on CHWs as an entry point, in alignment with the WHO CHW Guidelines. USAID contributes to the ongoing intra- and cross-country learning and created a virtual community of practice for over twenty countries including key focus countries Bangladesh, Democratic Republic of the Congo, Haiti, Kenya, Liberia, Mali, and Uganda. USAID is working closely with the Global Financing Facility (GFF) in over 36 countries to ensure quality essential services for women, children, and adolescents. This includes a focus on health systems strengthening and human resources for health (HRH). The GFF supports initiatives to address human resources for health bottlenecks including technical assistance, analytics, peer to peer learning, and innovative approaches to training and job aids. Country Investment Cases focus on strengthening HRH through the scale-up of clinical mentorship, staff recruitment, and training. In addition, the GFF supports an increase in district level capacity to drive improvements in RMNCAH outcomes and service provider capacity by establishing skills hubs. The GFF has also recently announced a new Essential Health Grants initiative in five countries (Rwanda, Mozambique, Central African Republic, Liberia, and Honduras) with over $87 million in investments that includes a focus on health workforce planning, management, and community health workers.
Hide [q2x2] 2.2. Получала ли ваша страна техническую или финансовую поддержку со стороны одного или нескольких государств – членов ВОЗ, Секретариата ВОЗ или других заинтересованных сторон для поддержки выполнения Кодекса?
2.2.1 Поддержка непосредственно в целях выполнения Кодекса
2.2.2 Поддержка в целях укрепления системы здравоохранения
2.2.3 Поддержка в целях развития кадров здравоохранения
2.2.4 Поддержки не оказывалось
2.2.5 Другие направления поддержки:
Hide [q2x2oth] 2.2.5 Другие направления поддержки:
Область поддержки 1
No assistance has been received. However, the PEPFAR Twinning Program administered through HRSA provides opportunities for information sharing amongst peers and institutions addressing HIV/AIDS related Human Resources for Health.
Область поддержки 2
Область поддержки 3
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Партнерства, техническое сотрудничество и финансовая поддержка

Hide [q3] 3. Заключала ли ваша страна или ее субнациональные правительства двусторонние, многосторонние или региональные соглашения и/или договоренности в сфере международного найма и миграции работников здравоохранения?
Нет
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Подготовка кадров здравоохранения и стабильность систем здравоохранения

Hide [q4] 4. Стремится ли ваша страна удовлетворить свои потребности в области кадров здравоохранения с помощью персонала, подготовленного внутри страны, в частности, путем принятия мер по подготовке, удержанию и обеспечению стабильности кадровых ресурсов здравоохранения, соответствующих конкретным условиям вашей страны, в том числе в областях, где ощущается наибольшая потребность?
Да
Hide [q4x1x] 4.1 Принимаемые меры по подготовке кадровых ресурсов здравоохранения
Да
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4.1.1 Организация подготовки
4.1.2 Повышение качества подготовки
4.1.3 Усиление регулирования
U.S. Department of Health and Human Services (HHS), Centers for Medicare and Medicaid Services (CMS) implements the Graduate Medical Education (GME) Program (Sections 1886(d) and 1886(h) of the Social Security Act). This Medicare program pays teaching hospitals to train residents in approved graduate medical education (GME) programs. Approved GME programs for which Medicare pays consist of residents in allopathic and osteopathic medicine, podiatry, and dentistry. The HHS Health Resources and Services Administration (HRSA), Bureau of Health Workforce (BHW) implements programs and activities to train the next generation of diverse health care providers to deliver inter-professional care to underserved populations through its grants to U.S. health professions schools and training programs (Title VII of the Public Health Service Act). Title VII programs support educational institutions in the development, improvement, and operation of educational programs for primary care physicians, physician assistants, dentists and dental hygienists. Other sections also support community-based training and faculty development to teach in primary care specialties training. Programs include the Geriatrics Workforce Enhancement Programs, Oral Health Training Programs, and Primary Care Training and Enhancement Programs.HRSA’s Bureau of Health Workforce also implements nursing programs (Title VIII of the Public Health Service Act) with the goal to better prepare nurses to provide care for underserved populations. These programs work to improve U.S. nursing education, practice, retention, diversity and faculty development. Advanced Nursing Education Programs aim to increase the size of the advance nursing workforce trained to practice as primary care clinicians and to provide high-quality team-based care. Nurse Education, Practice, Quality and Retention Programs aim to expand the nursing pipeline, promote career mobility, enhance nursing practice, increase access to care and inter-professional clinical training and practice, and support retention.
4.4 Другие
Hide [q4x2x] 4.2 Принимаемые меры по обеспечению стабильности * кадровых ресурсов здравоохранения
Да
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4.2.1 Планирование/прогнозирование кадровых потребностей
4.2.2 Расширение потенциала по подготовке и выпуску кадров внутри страны
4.2.3 Увеличение возможностей трудоустройства
4.2.4 Организация международного найма работников здравоохранения
The United States spends billions of dollars in both public and private funds each year on education and training of the health workforce. Since the U.S. health care system is constantly changing and preparing new providers requires long lead times, it is critical to have high quality projections to ensure a workforce of sufficient size and skills capable of meeting the nation’s health care needs. The HHS’ National Center for Health Workforce Analysis (NCHWA) collects and analyzes health workforce data and information in order to provide national and state policy makers, researchers, and the public with information on health workforce supply and demand. NCHWA also evaluates the effectiveness of HRSA’s workforce investments. NCHWA models supply and demand of health professionals across a range of health occupations, and makes health workforce information available through reports and online databases. The primary health workforce educational and training investments are described in Response 4.1.
Другое
Hide [q4x3x] 4.3 Принимаемые меры в отношении неравномерного географического распределения и удержания работников здравоохранения*
Да
Hide [q4x3]
4.3.1 Образование (образовательные учреждения в недостаточно обслуживаемых районах; учащиеся из недостаточно обслуживаемых районов; соответствующие темы в программах образования/повышения квалификации; другие аспекты)
HHS HRSA’s Bureau of Health Workforce implements: The Centers of Excellence (COE) Program: The COE provides grants to health professions schools and other public and nonprofit health or educational entities to serve as innovative resource and education centers for the recruitment, training and retention of underrepresented minority (URM) students and faculty. These award recipients also focus on facilitating faculty and student research on health issues particularly affecting URM groups. In FY 2021, the COE Program supported over 600 students and 500 faculty who participated in research on minority health-related issues. The Scholarships for Disadvantaged Students (SDS) Program: Authorized in 1989, SDS provides grants to eligible health professions and nursing schools for use in awarding scholarships to students from disadvantaged backgrounds who have financial need, many of whom are underrepresented minorities (URMs). The program also connects students to retention services and activities that support their progression through the health professions pipeline program. Between 2014 and 2019, SDS trained 12,356 students. One hundred percent (100%) of students across all five years were from environmentally, economically, or educationally disadvantaged backgrounds; sixty-four (64%) percent were underrepresented minorities. The Health Careers Opportunity Program (HCOP): The National HCOP Academies provides individuals from economically and educationally disadvantaged backgrounds an opportunity to develop the skills needed to successfully compete for, enter, and graduate from schools of health professions or allied health professions. The National HCOP Academies provide a variety of academic and social supports to individuals from disadvantaged backgrounds through formal academic and research training, programming, and student enhancement or support services that can include tailored academic counseling and highly focused mentoring services, student financial assistance in the form of scholarships and stipends, financial planning resources, and health care careers and training information. In Academic Year 2019-2020, the National HCOP Academies supported 174 training programs and activities to promote interest in the health professions among prospective, disadvantaged students. In total, HCOP grantees reached 2,841 disadvantaged trainees across the country through structured programs.
4.3.2 Регулирование (обязательное заключение трудовых договоров; стипендии и субсидии на образование в рамках договоров о целевом обучении; расширение сферы практики; перераспределение обязанностей; квалификационная структура; другие аспекты)
The programs listed in response 4.3.3 have a requirement for the beneficiaries to work in shortage areas such as rural areas for specified period of time. For example, the Nurse Corps Loan Repayment Program requires beneficiaries to work at least two years in either a critical shortage facility located in an area lacking enough health professionals or an eligible nursing school as nurse faculty. Similarly, the National Health Service Corps Loan Repayment Program requires a 2-year commitment of service at an approved health facility.
4.3.3 Стимулы (финансовые и нефинансовые)
HRSA’s Bureau of Health Workforce, National Health Service Corps (NHSC) Scholarship and Loan Repayment Programs provide financial, professional and educational resources to medical, dental, and mental and behavioral health care providers who bring their skills to areas of the U.S. with limited access to health care. Since 1972, the Corps has helped build healthy communities by connecting these primary health care providers to areas of the country where they are needed most. Today, 16,229 NHSC members are providing culturally competent care to more than 15.7 million people at 18,548 NHSC‐approved health car sites in urban, rural, and frontier areas. In addition, more than 1,527 students, residents, and health providers in the Corps pipeline are in training and preparing to enter practice. HRSA’s Bureau of Health Workforce also administers the NURSE Corps program to provide nurses nationwide the opportunity to turn their passion for service into a lifelong career through scholarship and loan repayment programs. NURSE Corps helps to build healthier communities in urban, rural and frontier areas by supporting nurses and nursing students committed to working in communities with inadequate access to care. The NURSE Corps Loan Repayment and Scholarship Programs have helped critical shortage facilities meet their urgent need for nurses since 2002. Today, more than 1,843 NURSE Corps nurses are providing care where they are needed most and an additional 603 NURSE Corps scholarship recipients will begin their service once they complete their training.
4.3.4 Поддержка (достойные и безопасные условия жизни и труда; возможности карьерного роста; меры по повышению общественного признания; другие аспекты)
Many of the grants provided to rural providers are aimed at empowering them to provide more benefits to their work force and improve their well-being. For example, the Nurse Education, Practice, Quality, and Retention Program (NEPQR) Grants strive for retention through continuous professional development programs that promote nurses’ career advancement, enhancing communication and collaboration among nurses and promoting nurses’ involvement in the organizational decision making of the health facilities. Recently, an estimated $103 million in American Rescue Plan funding over a three-year period is allocated with the aim of reducing burnout and promoting mental health of the health workforce. The funding helps health care organizations to establish and sustain a culture of wellness among the health and public safety workforce and to support training efforts to build resiliency for those at the beginning of their health careers. These investments, which take into special consideration the needs of rural and medically underserved communities, aim to limit burnout, stress, depression and suicide and promote resiliency among the workforce during the COVID-19 pandemic and beyond.
Hide [q4x4x] 4.4 Другие соответствующие меры
Нет
Hide [q5] 5. Имеется ли в вашей стране конкретная политика и/или законы в отношении международного найма, миграции и интеграции работников здравоохранения, получающих квалификацию за рубежом?
Нет
Hide [q6x] 6. С учетом роли других правительственных ведомств, имеются ли у Министерства здравоохранения инструменты (например, стратегии, механизмы, особое подразделение) для мониторинга и координации между различными секторами вопросов, связанных с международным наймом и миграцией работников здравоохранения?
Да
Hide [q6x1] 6.1 Если да, просьба предоставить дополнительную информацию в таблице ниже.
The HRSA National Center for Health Workforce Analysis (NCHWA) is a national resource for health workforce research, information, and data. NCHWA analyzes the supply, demand, distribution, and education of the U.S. health workforce. HRSA also partners with various organizations undertaking research, data collection and monitoring in health personnel migration such as: • Commission on Graduates of Foreign Nursing Schools (CGFNS) International • Alliance for international Ethical Recruitment Practices • Education Commission on Foreign Medical Graduates • American Medical Association • Association of American Medical Colleges National Council of State Boards of Nursing
Hide [q7x] 7. Создана ли в вашей стране база данных или свод информации о законах и нормах в области международного найма и миграции работников здравоохранения и, соответственно, об их применении?
Нет
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Обязанности, права и порядок найма

Hide [q8x] 8. Какие существуют правовые гарантии и/или другие механизмы для обеспечения того, чтобы работники здравоохранения – мигранты пользовались теми же юридическими правами и несли те же обязанности, что и кадры здравоохранения, подготовленные внутри страны? Просьба отметить галочкой все применимые варианты в приведенном ниже списке :Spanish
8.1 Международный наем работников здравоохранения – мигрантов осуществляется с использованием механизмов, которые дают им возможность взвесить преимущества и риски, связанные с трудоустройством, и принять своевременное и обоснованное решение.
8.2 Наем, продвижение по службе и оплата труда работников здравоохранения – мигрантов осуществляются исходя из таких объективных критериев, как уровень квалификации, продолжительность трудового стажа и степень профессиональной ответственности, на равных основаниях с кадрами здравоохранения, подготовленными внутри страны.
8.3 Работники здравоохранения – мигранты пользуются такими же возможностями для продолжения своего профессионального образования, повышения квалификации и карьерного роста, что и кадры здравоохранения, подготовленные внутри страны.
8.4 Другие механизмы, просьба по возможности привести подробные сведения:
Hide [q9x] 9. Просьба представить другие комментарии или информацию о юридических, административных и других мерах, принятых или запланированных в вашей стране для обеспечения принципа справедливости в отношении работников здравоохранения, получивших квалификацию за рубежом и/или являющихся иммигрантами, в процессе найма и трудовой деятельности.
Additional information for 8.1. The Department of Labor requires employers who are bringing workers to the United States temporarily on an H-1B visa to provide the workers with a copy of the Labor Condition Application (LCA) no later than when the worker reports to work. The LCA informs the foreign worker of the wage to be paid, the job title, period of intended employment, and place of employment. The LCA also informs the worker of how to file a complaint alleging misrepresentation of material facts or failure to comply with the terms listed on the LCA. The Department of Labor also requires employers who are bringing in H-2B temporary workers to provide the workers with a copy of the job order no later than when the worker applies for the visa, in a language understood by the worker, as necessary or reasonable. The H-2B job order informs the foreign worker of the job duties, period of employment, wage to be paid, any training that will be available, deductions that will be made, and how the employer will provide or pay for the cost of the worker’s transportation, among other things. Additionally, the U.S. State Department has several resources available for certain individuals traveling to the United States as temporary workers or students informing them of their legal rights and protections: https://travel.state.gov/content/travel/en/us-visas/visa-information-resources/rights.html There are no specific laws or policies for internationally recruited or trained health personnel. The U.S. federal labor and employment laws generally apply to all workers, and agencies across the federal government, such as the Department of Homeland Security, the Equal Employment Opportunity Commission, the Department of Labor, and the National Labor Relations Board frequently work together to coordinate enforcement of federal law. Additional information for 8.2. The H-1B program requires that employers first file a Labor Condition Application (LCA) with the Secretary of Labor attesting that the wage paid to the foreign worker is the higher of the actual wage rate (the rate the employer pays to all other individuals with similar experience and qualifications who are performing the same job), or the prevailing wage (a wage that is predominantly paid to workers in the same occupational classification in the area of intended employment at the time the application is filed). Similarly, H-1B employers must provide foreign workers working conditions based on the same criteria as those the employer offers to its U.S. workers, such as hours, shifts, vacation periods, and benefits. In addition, the employer must provide to its U.S workers notice of the filing of the LCA. Employers wishing to bring in foreign health personnel on a permanent basis must usually obtain a labor certification from the Department of Labor determining that there are not sufficient U.S. workers who are able, willing, qualified, and available in the area of intended employment and that the employment of a foreign worker will not adversely affect the wages and working conditions of workers in the U.S. similarly employed. One of the methods utilized by the Department of Labor to ensure that the wages and working conditions are not affected is to require the employer to offer at least the prevailing wage to all U.S. workers during its labor market test and then to the foreign worker upon receipt of his or her permanent residency. An employer is not required to file a labor certification application with the Department of Labor for those foreign workers (including professional nurses and physical therapists) who qualify under the Department’s Schedule A. In those cases, an employer must attach its labor certification application to the immigrant worker petition it files directly with the Department of Homeland Security. Employers who are interested in employing H-2B temporary workers must obtain a labor certification from the Department of Labor. Among other requirements, they must offer and pay the H-2B worker no less than the highest of the prevailing wage, the applicable Federal minimum wage, the State minimum wage, or local minimum wage during the entire period of the approved H-2B labor certification. Additional information on 8.3. Foreign workers do not necessarily have the same education and training opportunities as national workers, as some federal funding streams have limitations on the non-U.S. citizen individuals that can access them. However, migrant health personnel may enroll in private educational courses the same as the domestically trained health workforce, and employer-provided training may be provided to domestic and migrant health personnel equally.
Hide [q10x] 10. Просьба представить комментарии или информацию о мерах, принятых или запланированных в вашей стране для обеспечения равных прав работников здравоохранения, получивших квалификацию внутри страны/эмигрантов, работающих за пределами страны, при найме на работу и в процессе трудовой деятельности, а также о возникающих в этой связи трудностях
Мероприятие 1
N/A
Мероприятие 2
Мероприятие 3
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Данные о международном найме и миграции работников здравоохранения

Hide [iq11] Повышение доступности и международной сопоставимости данных имеет важное значение для понимания глобальной динамики миграции работников здравоохранения и решения связанных с ней проблем.
Hide [q11] 11. Есть ли в вашей стране какие-либо механизмы или организации по ведению статистической отчетности о кадрах здравоохранения, родившихся или получивших квалификацию за рубежом?
Да
Hide [q11x1] Просьба указать:
The Department of Health and Human Services Health Resources and Services Administration partners with various health professional licensing organizations (American Medical Association) to assist with the data for health personnel whose professional qualification was obtained oversees.
Hide [iQ12] 12. Данные о контингенте активных кадровых ресурсов здравоохранения в разбивке по стране получения квалификации и стране рождения
Данные, ранее направленные в ВОЗ, размещены здесь. Просьба связаться с вашим координатором по НСКРЗ и обновить их соответствующим образом.

В соответствии с показателями 1-07 и 1-08 национальных счетов кадровых ресурсов здравоохранения (НСКРЗ) просьба привести информацию об общей численности работников здравоохранения в вашей стране (желательно численность активно работающих 1) в разбивке по стране получения квалификации («получивших квалификацию за рубежом») и стране рождения («родившихся за рубежом») за последний год, по которому имеются данные. Просьба проконсультироваться с вашим координатором по НСКРЗ, если он имеется, для обеспечения того, чтобы представленные ниже данные соответствовали отчетности по НСКРЗ.
Hide [q12x0] 12.1 Совокупная численность активных кадровых ресурсов здравоохранения
Эта информация может быть представлена в одном из трех возможных форматов. Просьба выбрать предпочтительный для вас вариант ввода данных:
Вариант B: Скачать документ в формате Excel с существующими данными и загрузить его на сайт с обновленными данными
Hide [q12x1x2] Вариант B: Скачать документ в формате Excel с существующими данными и загрузить его на сайт с обновленными данными
Пожалуйста, загрузите файл
Hide [q12x1x3] Загрузить на сайт документы любого формата, содержащие необходимую информацию (например, pdf, Excel, Word)
US Responses- 12.1 and 12.2
No comment
Hide [q13x2] 12.2 Десять стран, на которые приходится наибольшее количество работников здравоохранения, получивших квалификацию за рубежом
Просьба предоставить данные в отношении 10 стран, на которые приходится наибольшее количество работников здравоохранения в вашей стране, получивших квалификацию за рубежом. Эта информация может быть представлена в одном из двух возможных форматов:
Hide [q13x2x3] Загрузить на сайт документы любого формата, содержащие необходимую информацию (например, pdf, Excel, Word)
Пожалуйста, загрузите файл
US Response 12.1 and 12.2
No comment
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COVID-19 и мобильность работников здравоохранения

Hide [q13] 13. Принимались ли на национальном или субнациональном уровне в ответ на пандемию COVID-19 меры в отношении временной или постоянной международной мобильности работников здравоохранения?
13.1 Отсутствие изменений в национальном или субнациональном регулировании, политике или процедурах, связанных с въездом или выездом работников здравоохранения, получивших квалификацию или родившихся за рубежом
13.2 Введены в действие национальные и/или субнациональные нормативные акты, политика или процедуры для облегчения въезда и интеграции работников здравоохранения, получивших квалификацию или родившихся за рубежом
13.3 Введены в действие национальные и/или субнациональные нормативные акты, политика или процедуры, нацеленные на ограничение оттока кадров здравоохранения из страны
United States Citizenship and Immigration Services (USCIS) introduced temporary policy changes regarding the full-time work requirement for certain foreign medical graduates and the provision of telehealth services by those foreign medical graduates in light of the evolving Public Health Emergency concerning the COVID-19 pandemic. These changes were made in order to address situations in which an H-1B foreign medical graduate is temporarily unable to work full-time due to quarantine, illness, travel restrictions, or other consequences of the pandemic during the declared Public Health Emergency period, and USCIS officers will not consider such a failure to work full-time to be a failure to fulfill the terms of their contract under INA 214(l)(2)(B), as a matter of policy. DHS regulations are silent as to whether foreign medical graduates in select programs may provide telehealth services to meet their service requirement; USCIS has therefore decided to interpret the regulations as providing flexibility to those foreign medical graduates to allow them to provide telehealth services during the Public Health Emergency. See the USCIS Policy Memorandum, Temporary Policy Changes for Certain Foreign Medical Graduates During the COVID-19 National Emergency, for more information.
13.4 Другие меры
Hide [q14] 14. Был ли у вас механизм мониторинга притока в вашу страну и оттока из нее работников здравоохранения во время пандемии COVID-19?
Приток
Отток
Нет
Hide [q15] 15. Просьба перечислить любые сложные задачи, связанные с соблюдением этических принципов при международном найме работников здравоохранения во время пандемии COVID-19

Просьба указать (например, активное привлечение медперсонала отделений интенсивной терапии)
Задача 1
Lack of regulation on recruitment in foreign countries
Задача 2
Lack of knowledge by migrants of their rights and what they can expect during recruitment
Задача 3
Unethical recruiters who aim to exploit/abuse migrant workers
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Ограничения, решения и дополнительные комментарии

Hide [q16] 16. Просьба перечислить в порядке приоритетности три основных препятствия в области управления международной миграцией в вашей стране с соблюдением этических принципов и предложить возможные решения:
Основные препятствия Возможные решения/рекомендации
N/A
Hide [q17] 17. Требуется ли вам какая-либо конкретная поддержка для более эффективного осуществления Кодекса?
17.1 Поддержка для повышения качества данных и информации
17.2 Поддержка для налаживания политического диалога и выработки политики
17.3 Поддержка для подготовки двусторонних/многосторонних соглашений
17.4 Другие области поддержки:
Hide [q18] 18. Просьба представить другие дополнительные комментарии или материалы относительно международного найма и миграции работников здравоохранения, которые касались бы осуществления Кодекса.

Hide [q18x1] Просьба указать ИЛИ загрузить на сайт
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Спасибо

Hide [iThank] Вы достигли конца срока действия Национального инструмента отчетности - 2021 г. Вы можете вернуться к любому вопросу, чтобы обновить свои ответы, или подтвердить свой ввод, нажав «Отправить».