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
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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
Ethiopia
Full name of institution:
Solomon
Name of designated national authority:
Solomon W/Amanuel Birru
Title of designated national authority:
Team Leader for Human Resource Planning, Monitoring and Evaluation within the HRH Directorate
Telephone number: (E.g. +41227911530 .)
+251-911489879
Email: (Please enter one email address only.)
solomon.woldeamanuel@moh.gov.et,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
Even though implementation is at early stage, using the existing mechanisms including NHWA technical working group, efforts are being exerted to initiate discussions and information sharing.
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.
No
[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.
No
[q1x6x]
1.6 Other steps:
Yes
[q1x6]
Step 1
An expert has been designated to follow and implement the code. I think this is the first step of starting national reporting on health personnel requirement
Step 2
Step 3
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
The country has developed the second Health Sector Transformation Plan (HSTP II) 2020/21-2024/25 that aspires to achieve UHC through expanding access to services and improving the provision of quality and equitable comprehensive health services at all levels. To achieve this, the plan has prioritized strengthening health workforce as a key priority/transformation agenda and focused on creating a motivated, competent and compassionate (MCC) health workforce, which will be one of the key inputs to provide quality and responsive health service. The plan emphasized to ensuring equitable distribution and availability of an adequate number and skill mix of health workers who are motivated, competent, and compassionate to provide quality health services. Ministry of Health has also developed and started implementing a five-year National Motivated, Competent and Compassionate (MCC) Health Workforce (HWF) Strategy and accompanying Implementation Guideline (2020/21-2024/25) to properly implement HWF initiatives highlighted in HSTP II. The human resource for health development directorate has been structured within the ministry of health with the intention of facilitating the production, recruiting, deployment and fair distribution of competent, motivated and compassionate health workforce to the country to provide quality of health service. To achieve this ministry of health in collaboration with development partners and individual consultant has developed a Ten Years’ HRH Strategy (2016-2025)
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
There is a dedicated human resource for health planning, monitoring and evaluation team that has been structured within the human resource for health development directorate in the ministry of health which is responsible for planning/forecasting. There are also pre-service team within the directorate is responsible to working closely with Ministry of Education (MOE) and Health Science Colleges and Universities to enhance the domestic production and education opportunities. Professional licensure requirements, new and renewal, for both domestic as well as foreign health personnel is handled by MOH- Health Professionals’ Competency Assessment and Licensure Directorate (HPCALD) using well defined and visibly posted criteria. Facilitating and increasing employment opportunities for the recently graduated health professions, is one of the major initiatives, being undertaken by the Ministry of Health (MOH). The national HRH Steering Committee is advising and supporting the ministry. Recently, a job opportunity agreement for General Practitioner is signed between stakeholders.
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)
Continuous Professional Development (CPD) within the HRDD has developed CPD Strategy and Implementation Guide and started implementation through active involvement of Health Professional Associations, Accreditor, CPD Service Provider and others. It is also possible to create system for linking CPD with license renewal
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)
There are scope of practices for some of the health professionals. Additional scopes of practices are also being developed for number health professional categories that will be finalized in the near future. There are a task shifting in some of the health professionals like Integrated Emergency Surgical Officers (IESO) who are trained and appointed to mitigate the problems arise due to lack of Gynecologist and Obstetricians.
4.3.3 Incentives (Financial and non-financial)
The proposal on incentives for the health workforce has been developed and the higher officials of the ministry of health, the ministry of civil service and the ministry of finance are being discussed on it.
4.3.4 Support (Decent and safe living and working conditions; career advancement opportunities; social recognition measures; others)
[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
Before the recruitment take place, foreign and foreign-trained health personnel are expected to fulfil procedures including presentation and authentication of required documents at MOH licensure directorate. (HPCALD).
Law/policy 2
The recruitment of foreign-trained health personnel is guide by guidelines from MOH, other recruiting institutions, Civil Service, Labour and Social Affairs and other related entities as applicable.
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:
Through the national intersectoral collaboration mechanisms including National Health workforce Accounts.
[q7x]
7. Has your country established a database or compilation of laws and regulations related to international health personnel recruitment and migration and, as appropriate, information related to their implementation?
No
Responsibilities, Rights and Recruitment Practices
[q8x]
8. Which legal safeguards and/or other mechanisms are in place to ensure that migrant health personnel enjoy the same legal rights and responsibilities as the domestically trained health workforce? Please tick all options that apply from the list below:
8.1 Migrant health personnel are recruited internationally using mechanisms that allow them to assess the benefits and risk associated with employment positions and to make timely and informed decisions regarding them
8.2 Migrant health personnel are hired, promoted and remunerated based on objective criteria such as levels of qualification, years of experience and degrees of professional responsibility on the same basis as the domestically trained health workforce
8.3 Migrant health personnel enjoy the same opportunities as the domestically trained health workforce to strengthen their professional education, qualifications and career progression
8.4 Other mechanisms, please provide details below if possible:
[q9x]
9. Please submit any other comments or information you wish to provide regarding legal, administrative and other measures that have been taken or are planned in your country to ensure fair recruitment and employment practices of foreign-trained and/or immigrant health personnel.
[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
Diaspora health personnel are encouraged and invited to join the health workforce ensuring their fair recruitment and employment in the country.
Measure 2
They are actively involved in the national voluntary activities including provision of medical service.
Measure 3
Data on International Health Personnel Recruitment & Migration
[iq11]
Improving the availability and international comparability of data is essential to understanding and addressing the global dynamic of health worker migration.
[q11]
11. Does your country have any mechanism(s) or entity(ies) to maintain statistical records of foreign-born and foreign-trained health personnel?
No
[iQ12]
12. Data on the active stock of health personnel, disaggregated by country of training and birth
Previous data shared with WHO is available here. Please liaise with your NHWA focal point and update as relevant.
For the latest year available, consistent with the National Health Workforce Accounts (NHWA) Indicators 1-07 and 1-08, please provide information on the total stock of health personnel in your country (preferably the active workforce1), disaggregated by the country of training (foreign-trained) and the country of birth (foreign-born). Please consult with your NHWA focal point, if available, to ensure that data reported below is consistent with NHWA reporting.
Previous data shared with WHO is available here. Please liaise with your NHWA focal point and update as relevant.
For the latest year available, consistent with the National Health Workforce Accounts (NHWA) Indicators 1-07 and 1-08, please provide information on the total stock of health personnel in your country (preferably the active workforce1), disaggregated by the country of training (foreign-trained) and the country of birth (foreign-born). Please consult with your NHWA focal point, if available, to ensure that data reported below is consistent with NHWA reporting.
[q12x0]
12.1 Consolidated stock of active health personnel
This information can be provided by one of the following three options. Please choose your preferred mode of data entry:
This information can be provided by one of the following three options. Please choose your preferred mode of data entry:
Option A: Completion of the table below
[q12x1x1]
Option A: Please complete the table below
Please fill red highlighted cells.
| Total | Domestically Trained | Foreign Trained | Unknown Place of Training | National Born | Foreign Born | Source* | Year | Does the data represent active stock? | Remarks | |
|---|---|---|---|---|---|---|---|---|---|---|
| Medical Doctors | 11946 | 11946 | HRH_update 2020 Ministry of Health | 2020 | 1 | NA | ||||
| Nurses | 69824 | 69824 | HRH_update 2020 Ministry of Health | 2020 | 1 | NA | ||||
| Midwives | 20355 | 20355 | HRH_update 2020 Ministry of Health | 2020 | 1 | NA | ||||
| Dentists | 228 | 228 | HRH_update 2020 Ministry of Health | 2020 | 1 | NA | ||||
| Pharmacists | 15498 | 15498 | HRH_update 2020 Ministry of Health | 2020 | 1 | NA |
[q12x1x3]
Upload any format of documentation that provides such information (e.g. pdf, excel, word).
[q13x2]
12.2 Top 10 countries of training for foreign-trained health personnel
Please provide data on the top 10 countries of training for foreign-trained health personnel in your country. This information can be provided by one of the following two options:
Please provide data on the top 10 countries of training for foreign-trained health personnel in your country. This information can be provided by one of the following two options:
[q13x2x3]
Upload any format of documentation that provides such information (e.g. pdf, excel, word).
Please upload file
COVID-19 and Health personnel mobility
[q13]
13. Were measures undertaken at national or sub-national level in response to the COVID-19 pandemic with respect to the temporary or permanent mobility of international health personnel?
13.1 No change in national or sub-national regulation, policy or processes related to the entry or exit of foreign-trained or foreign-born health personnel
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
Regulations and processes are supportive to accommodate better mobility of temporary or permanent mobility of international health personnel.
13.3 National and/or sub-national regulation, policy or processes enacted to limit the exit of health personnel from country
13.4 Others
[q14]
14. Did you have a mechanism to monitor the inflow and outflow of health personnel to/from your country during the COVID-19 pandemic?
Inflow
Outflow
No
[q15]
15. Please list any challenges related to ethical international recruitment of health personnel during the COVID-19 pandemic
Please describe (e.g. active recruitment of ICU personnel)
Please describe (e.g. active recruitment of ICU personnel)
1st Challenge
2nd Challenge
3rd Challenge
Constraints, Solutions, and Complementary Comments
[q16]
16. Please list in priority order, the three main constraints to the ethical management of international migration in your country and propose possible solutions
| Main constraints | Possible solution /Recommendation | |
|---|---|---|
| Inadequate capacity in the implementation of the Code including applying ethical principles applicable to the international recruitment of health personnel. | Capacity building and experience sharing on how to integrate and implement ethical principles in accordance with national and subnational practices. | |
| Lack of technical as well as financial capability to assist the implementation of this Code and support health system strengthening. | International organizations, international donor and agencies to provide technical and financial support in facilitating the proper implementation of the Code. | |
| Constraints related to weak intersectoral collaboration mechanisms to promote discussion and advance cooperation on matters related to the ethical international recruitment of health personnel. | Capacity building and experience sharing on creating sound collaboration mechanism among sectoral offices and stakeholders. |
[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:
[q17x]
Other areas of support:
Support Area 1
Capacity building on NHWA implementation
Support Area 2
Capacity building on HRIS
Support Area 3
Support for policy dialogue and development
[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.
[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’.