国家报告文书（2021年）

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背景

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

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

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

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

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

提交报告的截止日期为2021年8月31日。

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

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

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

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

Hide [q01b] 联系方式
國家
United States of America
机构全称：
Mara Burr and
国家指定主管部门名称：
Leandra Olson
国家指定主管部门头衔：
Senior Global Health Officer, Multilateral Relations
电话：
+1-202-997-9107
电子邮件：
Mara.Burr@hhs.gov,OGAMultilateral@hhs.gov,hrhinfo@who.int
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《守则》的实施

Hide [q1] 1. 贵国是否采取了步骤实施《守则》？（
是
Hide [q1x1x] 1.1 已采取行动，跨部门交流和分享卫生人员国际招聘和移徙信息，并在国家和/或国家以下地区相关部委、部门和机构宣传《守则》。
是
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行动 1
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.
行动 2
行动 3
Hide [q1x2x] 1.2 已经采取或考虑采取措施，参照《守则》的建议，修改法律或政策。
是
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措施 1
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.
措施 2
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Hide [q1x3x] 1.3 对主管当局批准在其管辖范围内工作的所有招聘者进行登记。
是
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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 如《守则》所要求，鼓励和提倡招聘机构的良好行为。
是
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1.4.1 在私营招聘机构中推广《守则》。
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 按照《守则》的原则和条款，要求私营招聘机构的行为符合伦理的国内法律或政策。
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 对私营招聘机构符合伦理的行为进行公共或私人认证。
1.4.4 其它
Hide [q1x5x] 1.5 已采取措施，在决策过程中与利益攸关方协商，并/或推动它们参与卫生人员国际招聘相关活动。
是
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措施 1
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.
措施 2
措施 3
Hide [q1x6x] 1.6 其它步骤：
否
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伙伴关系、技术合作和财政支持

Hide [q2x1] 2.1. 贵国是否向一个或多个世卫组织会员国，尤其是发展中国家，或其他利益攸关方提供了技术或财政援助以支持实施《守则》？
2.1.1 促进实施《守则》的特别支助
2.1.2 支持加强卫生系统
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 支持卫生人员发展
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 没有提供支持
2.1.5 其它领域的支持：
Hide [q2x1oth] 2.1.5 其它领域的支持：
支持领域 1
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.
支持领域 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.
支持领域 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. 贵国是否得到一个或多个世卫组织会员国、世卫组织秘书处或其他利益攸关方的技术或财政援助，支持实施《守则》？
2.2.1 促进实施《守则》的特别支助
2.2.2 支持加强卫生系统
2.2.3 支持卫生人员发展
2.2.4 没有得到支持
2.2.5 其它领域的支持：
Hide [q2x2oth] 2.2.5 其它领域的支持：
支持领域1
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.
支持领域2
支持领域3
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伙伴关系、技术合作和财政支持

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

Hide [q4] 4. 贵国是否努力利用本国培训的卫生人员满足其卫生人员需要，并为此采取措施，包括在有最大需要的领域教育、留用和维持符合本国国情的卫生人力？
是
Hide [q4x1x] 4.1 卫生人力教育措施
是
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4.1.1 管理生产
4.1.2 改善教育质量
4.1.3 加强监管
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 其它
Hide [q4x2x] 4.2 确保卫生人力可持续性*的措施
是
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4.2.1 人力计划/预测
4.2.2 增加国内生产和教育机会
4.2.3 增加就业机会
4.2.4 管理卫生人员国际招聘
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.
其它
Hide [q4x3x] 4.3 处理卫生工作者地域分布不均和留用问题的措施*
是
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4.3.1 教育（缺少卫生服务地区的教育机构；缺少卫生服务地区的学生；教育/职业发展规划中的相关专题；其它）
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 监管（强制性服务协议；附有服务协议的奖学金和教育津贴；扩大从业范围；任务转移；技能组合；其它）
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 激励措施（财政和非财政）
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 支助（体面、安全的生活和工作条件；职业发展机会；社会承认措施；其它）
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 其它相关措施
否
Hide [q5] 5. 5. 贵国是否制定了专门政策和/或法律，用于指导在外国接受培训的卫生人员国际招聘、移徙和融入工作？
否
Hide [q6x] 6. 认识到其它政府实体的作用，卫生部是否有相关方式（如政策、机制、机构）在卫生人员国际招聘和移徙问题上进行跨部门监测和协调？
是
Hide [q6x1] 6.1 如果回答“是”，请在下框中提供进一步信息。
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. 贵国是否就卫生人员的国际招聘和移徙建立了数据库，或汇编了法律法规，以及适当时与实施情况相关的信息？
否
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责任、权利和招聘做法

Hide [q8x] 8. 有哪些法律保障措施和/或其它机制来确保移徙卫生人员与在国内接受培训的卫生人员享有同样权利和负有同样责任？请从下表中勾选所有适用选项：
8.1 利用相关机制对移徙卫生人员进行国际招聘，此类机制有助于他们评估就业岗位上的利益和风险，并及时作出关于就业的知情决定
8.2 移徙卫生人员在与于国内接受培训的卫生人力平等的基础上，依据资历、工作年限和专业责任程度等客观标准获得雇用、提升和报酬
8.3 移徙卫生人员与在国内接受培训的卫生人力在加强专业教育、资历和职业发展方面拥有同等机会
8.4 其它机制，可能时请详述：
Hide [q9x] 9. 请本着自己的意愿，提交任何其它评论或信息，说明贵国已经采取或计划采取哪些法律、行政和其它措施，以确保对在外国接受培训和/或移民卫生人员的公平招聘和就业做法。
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. 关于在贵国境外工作的在国内接受培训/移居国外的卫生人员（移民），请提交任何评论或信息，说明贵国已经采取或计划采取哪些措施来确保对其公平招聘和就业做法，以及遇到哪些困难。
措施1
N/A
措施2
措施3
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卫生人员国际招聘和移徙数据

Hide [iq11] 提高数据的可得性和国际可比较性对于理解和处理全球卫生工作者移徙的动态至关重要。
Hide [q11] 11. 贵国是否有任何机制或实体负责保存在外国出生或接受培训的卫生人员的统计资料？
是
Hide [q11x1] 请描述：
The 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. 活跃卫生人员储备数据，按培训国和出生国分类
先前与世卫组织分享的数据可在这里查阅。请与贵国的国家卫生人力账户归口单位联系，并更新相关信息。

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

Hide [q13] 13. 是否在国家或国家以下层面采取了与国际卫生人员临时或永久流动有关的COVID-19大流行应对措施？
13.1 与在外国接受培训或在外国出生的卫生人员入境或出境相关的国家或地方法规、政策或程序没有变化
13.2 为方便在外国接受培训或在外国出生的卫生人员入境和融入制定的国家和/或地方法规、政策或程序
13.3 为限制外国卫生人员入境制定的国家和/或地方法规、政策或程序
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 其它
Hide [q14] 14. 在COVID-19大流行期间，贵国是否有监测卫生人员流入/流出贵国的机制？
流入
流出
没有
Hide [q15] 15. 请列出在COVID-19大流行期间与符合伦理的卫生人员国际招聘相关的任何挑战

请描述（如主动招聘重症监护室人员）
第一项挑战
Lack of regulation on recruitment in foreign countries
第二项挑战
Lack of knowledge by migrants of their rights and what they can expect during recruitment
第三项挑战
Unethical recruiters who aim to exploit/abuse migrant workers
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限制、解决办法和补充评论

Hide [q16] 16. 请按照优先顺序，列举贵国对国际移徙进行符合伦理的管理的三个主要限制因素，并提出可能的解决办法：
主要限制因素 可能的解决办法/建议
N/A
Hide [q17] 17. 贵国是否需要特别支持来加强《守则》的实施？
17.1 支持加强数据和信息
17.2 支持政策对话和发展
17.3 支持制定双边/多边协议
17.4 其它领域的支持：
Hide [q18] 18. 请本着自己的意愿，就卫生人员的国际招聘和移徙，提交与《守则》的实施相关的任何其它补充评论或材料。

Hide [q18x1] 请描述或上传
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