who country
assessment tool
on the uses and sources
for human resources
for health (HRH) data
600
500
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WHO Library Cataloguing-in-Publication Data
WHO country assessment tool on the uses and sources for human resources for health (HRH) data.
1.Health personnel. 2.Health manpower. 3.Evaluation studies. 4.Questionnaires. 5.Data collection. I.World Health
Organization.
ISBN 978 92 4 150428 7
(NLM Classification: W 76)
© World Health Organization 2012
All rights reserved. Publications of the World Health Organization are available on the WHO web site (www.who.int)
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The designations employed and the presentation of the material in this publication do not imply the expression of any
opinion whatsoever on the part of the World Health Organization concerning the legal status of any country, territory, city
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World Health Organization be liable for damages arising from its use.
Printed by WHO Document Production Services, Geneva, Switzerland / October 2012
who country
assessment tool
on the uses and sources
for human resources
for health (HRH) data
Human Resources for Health Unit (HRH)
Department for Health Systems Policies and Workforce (HPW)
Health Systems and Services (HSS)
Country HRIS assessment tool at institutional level
Acknowledgements
This Tool was prepared by the World Health Organization (WHO) with financial support
from the Norwegian Agency for Development Cooperation (Norad), the United States
Agency for International Development (USAID), the United States President’s Emergency
Plan for AIDS Relief (PEPFAR) and the European Union.
This tool was produced under the overall direction of Mario Dal Poz (Coordinator,
Human Resources for Health Unit, Department for Health Systems Policies and
Workforce, World Health Organization (WHO)). The primary author of the tool is:
Angelica Sousa.
We acknowledge the valuable contribution from the country human resources for
health experts from around the world, the World Health Organization and colleagues
from the Centers for Disease Control and Prevention (CDC), the United States Agency
for International Development (USAID), USAID-funded CapacityPlus and IntraHealth,
Jhpiego and others. Particular thanks to all those who contributed to the Health
Information Reference Group (HIRG) meeting in Nairobi, Kenya, 5–6 December 2011.
The following persons provided detailed comments and advice on the earlier drafts of
this tool, and raised valuable issues during its preparation: Naphtali Agata, Adam Ahmat,
Elisabeth David Joseph, John Dewdney, Yohana Diaz de Valle, Michael English, Paulo Ferrinho,
Mario Alberto Figueroa Alvarez, Jessica Gross, Neeru Gupta, Grace Irimu Thinwa, Isaac Kimani,
Rose Kiriinya, Jason Knueppel, Ramesha Krishnamurthy, Teena Kunjumen, Wuleta Lemma,
Devan Manharlal, Maurice Lenga, Bagele Mbayi, Jean Moore, Jane Mudyara, Patrick Mutinda
Mdindyo, Gideon Mutua, Evasen Naidoo, Edgar Necochea, Epiphane Ngumbu, Bernard Nkala,
Francis Ntalazi, Jacinta Nzinga, Leonardo Pereira, Elsa Reis, Patricia Riley, Jean Robson,
Xenophon Santas, Anny Sarea, Abdou Sayo Farmo, Hernan Sepulveda, Dykki Settle,
Hussein Shabani Mavunde, Eiichi Shimizu, Tungamirirai Simbini, Amani Siyam,
Gerhard Vermaak, Peter Waithaka, Kate Waldman, Keith Waters, Agnes Waudo and
Alexandra Zuber.
Page ii
Country HRIS assessment tool at institutional level
Table of contents
Background2
Objectives2
Part 1: Mapping of institutions
3
Part 2: Questionnaire
5
Questionnaire at institutional level
6
Section 1: Institution information 8
Section 2: Data collection
9
Section 3: Data reporting and use
12
Section 4: Summary of findings
14
Attachment 1: Examples of institutions that produce data on human
resources for health
15
Attachment 2: Type of data on human resources for health (question 2.10)
16
Attachment 3: Health Workforce Classification Mapping
18
Page iii
Country HRIS assessment tool at institutional level
Background
There is widespread recognition of the need for accurate, timely and effective human
resources for health data to inform the development of policies on human resources for
health in countries. However, many low and middle income countries have week information
systems that can generate data that could guide the policy dialogue to scale up the health
workforce. To respond to this crisis the World Health Organization has directed its efforts and
achievements in leading the global research agenda to support countries to strengthen their
Human Resources Information Systems (HRIS). As part of these efforts the Human Resources
for Health Unit (HRH), WHO developed the Country Assessment Tool on the sources and
uses of HRH data to conduct a diagnosis on the quality of data on HRH and the degree to
which information is used for evidence-based decision-making. This diagnostic tool contains
questions intended to gather information on the uses, type and quality of data on HRH at
institutional level in countries. This step is critical to identify strengths and weaknesses of the
current HRIS in countries. The resulting information can then be used to identify priorities
and develop strategies to strengthen the HRIS at district, regional, or national level.
The country assessment tool on the sources and uses of HRH data is an adapted version of
the instrument designed by the Capacity Project, which collects information by institution,
and the data mapping template at national level on human resources for health developed
by the HRH, WHO. The current version of the instrument has been field tested to evaluate the
uses and sources of information in Cape Verde, Guinea Bissau, Mozambique and Sao Tome
and Principe and it has recently been used in Guatemala and Rwanda to understand the
support required to assist countries to improve or develop their HRIS.
Objectives
The objectives of the instrument are to identify the list of institutions involved in producing
data on HRH and to compile comprehensive information on the uses, type and quality of
data on HRH at institutional level in countries. The tool is divided in two parts:
1.
Mapping of institutions
2.
Questionnaire at institutional level:
2.1 Identification
2.2 Data collection
2.3 Use of data
2.4 Summary of findings
Page 2
Country HRIS assessment tool at institutional level
Pa r t 1
M app i n g o f i n s t i t u t i o n s
Page 3
Country HRIS assessment tool at institutional level
Mapping exercise to identify the list of institutions
involved in producing data on HRH
A requisite step to conduct the evaluation on the uses and sources for HRH data is to
conduct a mapping of institutions to identify the institutions involved in producing data on
HRH. These institutions include ministries, licensing and registration or certification bodies,
private sector organizations and outside the health sector, population census bureaus and
statistical offices, labour departments, and others. List in the following table the institutions
identified as producers of HRH data (please refer to attachment 1 for an example of the
institutions). The institutions listed in this section will be interviewed using the questionnaire
in part 2. Attach additional sheets if more space is needed.
No.
Page 4
Name of the institution/agency
Country HRIS assessment tool at institutional level
Pa r t 2
questionnaire
Page 5
Country HRIS assessment tool at institutional level
Questionnaire at institutional level
This questionnaire is intended to be applied in different institutions which produce data on
HRH based on the mapping exercise previously conducted by the interviewer to identify the
list of institutions involved in producing data on HRH.
Instructions for using the interview tool
This section will provide guidance on how to conduct the interview on the evaluation of
the uses and sources for HRH data at institutional level.
1 Role of the interviewer
The interviewer is responsible for asking questions, answering the respondent’s queries,
recording answers and editing the completed questionnaire. The interviewer must check
that the respondent has understood the questions by using interviewing techniques,
such as neutral probes, clarification and appropriate feedback, and determine whether
the answer given is appropriate. Listening to what the respondent is communicating,
both verbally and nonverbally, ensuring that the information is correct. The interviewer
must set the pace of the interview and keep the respondent focused and interested.
The atmosphere should be comfortable and pleasant at all times.
Before going to the field, the interviewer must know the questionnaire and how it is to be
administered. A thorough preparation as well as extensive practice will guarantee that this
is achieved.
2 Role of respondent
The role of the respondent is to cooperate with the interviewer and follow instructions.
The respondent must listen to questions attentively without interrupting, take time
before answering, and try to give an accurate and complete response as much as possible.
The respondent should ask for clarifications whenever a question seems unclear and ask the
interviewer to repeat or rephrase it. Trying to answer an unclear question is likely to lead to
an incorrect response.
3 Introduction to the interview
The interviewer must clearly communicate the objectives of the survey to the respondent.
Knowing what is expected of the person will contribute to the accuracy in responses.
The interviewer should establish a good rapport by introducing himself and the survey well.
Make a good impression
1.
You are a professional interviewer from a legitimate and reputable organization.
2.
The questionnaire is for gathering data for important, worthwhile research.
3.
The respondent’s participation is vital to the success of the research.
4.
The responses given will be confidential and will only be used for research purposes.
Respondents will have to sign an informed consent form, which explains about the
survey and what will be expected of them.
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Country HRIS assessment tool at institutional level
The interviewer can use the following introduction or decide which one works best.
Example of introduction:
“Hello my name is … and I work for … The reason I am contacting you is because we are
conducting a survey on health workforce in your country and I would like to ask you a few
questions. Let me assure you that whatever information you tell us will not be disclosed to
anyone and will only be used for research purposes”.
Make a good interview start
1.
You should be pleasant and assertive, and make the respondent feel at ease.
2.
You should know the questionnaire thoroughly and be well prepared to answer
any questions.
3.
You should speak slowly and clearly to set the tone for the interview.
4.
You should adapt your introduction to the respondent, as different respondents
require different amounts of information.
5.
You should be motivated and interested in the interview.
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Country HRIS assessment tool at institutional level
Section 1: Institution information
Make a separate copy of the questionnaire for each institution that is being surveyed.
1.1 Date(s) of assessment:
1.2Institution:
1.3 Department name:
1.4 Type of institution (select only one):
A Ministry of Health
B Other ministries (specify):
C Subregional health agency (e.g. district health office)
D Health professional regulatory body
E Other para-public agencies (e.g. military, police, social security)
F Worker unions/associations
G Nongovernmental or not-for-profit agency providing health services to
the public
H Private-for-profit agency providing health services to the public
I Training institutions for health professionals
J Research institutions
K Labour organizations
L Other (specify):
Complete the following information for every person participating in completion of this
questionnaire. Attach additional sheets if more space is needed.
Name
Page 8
Job title or role
Telephone No.
(incl. country code)
Email address
Country HRIS assessment tool at institutional level
Section 2: Data collection
Make a separate copy of Section 2 of the questionnaire for each type of data on human
resources for health collected in this institution.
2.1 Indicate the type of data on human resources for health collected in this institution
on a routine basis.
A Student enrolment
B Pre-service training in health-related fields (e.g. graduates)
C In-service training of health professionals
D Health professional licensing
E Health professional registration
F Staff in a health facility
G Payroll
H Retired/discharged
I Performance evaluation
J Leave management
K Planning and budget
L Other (specify):
2.2 How often is this data collected?
A Daily
B Weekly
C Monthly
D At least once a year
E In the last 1 to 2 years
F Within the last 3 to 5 years
G Not updated within the last 5 years
2.3 On which sectors of the health workforce do you collect this data? Check all options
that apply.
A Public
B Private-for-profit
C Semi-private
D Nongovernmental or not-for-profit organization
E Para-public agency (e.g. military, police, social security)
F Health training institution
G Other (specify):
Page 9
Country HRIS assessment tool at institutional level
2.4 How are the data collected? Check all options that apply.
A Paper forms
B Electronic files (specify, e.g. Microsoft Excel, Word, etc.):
C Mixed media (paper and electronic) (specify, e.g. Microsoft Excel, Word, etc.):
D Other (specify):
2.5 How are the data compiled into a database or information system?
A Paper
B Electronic (e.g. spreadsheet, database, or other)
C None
2.6 Once compiled, are the data of health workers mapped and disseminated using
a standard classification for purpose of statistical comparability with other data
sources relevant to labour market analysis? Check all options that apply.
A National classification of occupation
B Common definitions from the Ministry of Health
C International standard classification of occupations
D International classification of education
E None
F Other (specify):
2.7 Are the data of health workers disaggregated by occupational category?
A 21 or more occupational categories
B 15 to 20 occupational categories
C 4 to 14 occupational categories
D Fewer than 4 categories
E Not disaggregated
2.8 Are the data of health workers disaggregated by the following characteristics?
Check all options that apply.
A Gender
B Age or age group
C Urban/rural
D State, province or other geographical delineation
E Country where health training was completed
F Country of birth
G Current status in the national health workforce (type of contract, temporary,
probation, permanent)
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Country HRIS assessment tool at institutional level
H Public/private sector
I Graduates of all health training institutions
J Professionals who left the health sector (e.g. death, retirement, career change,
leaving the country)
K Marital status
L Other (specify in question 2.9)
2.9 Provide a short description on additional data relevant to human resources for
health analysis collected in this dataset:
2.10 List the type of data on human resources for health collected in this Institution
(please refer to attachment 2 and check all options that apply).
2.11Indicate which of the following population based surveys have been used to
complement the data on human resources for health collected by this institution?
Check all options that apply.
A Population census
B Labour force surveys
C Health facility survey
D Other (specify):
E None
2.12 List of printed or electronic documents received during interview(s) (e.g.vacancy
notices, sample employment contract, payroll stubs, employee continuing education
brochures, graduation booklet, sample position description and others). Catalogue
appropriately.
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Country HRIS assessment tool at institutional level
Section 3: Data reporting and use
3.1 Is there a plan for monitoring and evaluation of human resources for health
strategic objectives?
A Yes, implemented
B Yes, not fully implemented
C Plan is being developed
D No
3.2 Do you have a standard set summary of data or set of reports that you
produce regularly?
A Yes
B No
C Unsure
3.3 Who are the principal users of the data and/or reports? Check all options that apply.
A Ministry of Health
B Other ministries (specify):
C Other agencies (e.g. social security, parliament)
D Districts health offices
E Health facilities
F Private sector management
G Nongovernmental or not-for-profit organization
H Health professional regulatory bodies
I General public
J Central statistical office
K Health training institutions
L Research institutions
M Unkown
N Other (specify):
O None
3.4 In what format do you disseminate the data and/or reports? Check all options
that apply.
A Paper-based documents
B Electronic-based spreadsheet
C Electronic document
D Online access
E None
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Country HRIS assessment tool at institutional level
3.5 How often are these data and/or reports produced?
A At least once a year
B In the last 1 to 2 years
C Within the last 3 to 5 years
D Not produced within the last 5 years
3.6 How have the national data on human resources been used in the last five years?
Check all options that apply.
A Advocating for funds
B Influencing policies
C Workforce planning
D Human resources management
E Health professional qualification
F Education and training
G Other (specify):
H Not used
3.7 Is the national data on human resources used to support human resources for health
planning, development and management processes at all levels? Check all options
that apply.
A National
B Subnational
C International
D Regional
E Other (specify):
F Not used
3.8 What strategies are needed to improve the use of human resources data in practical
decision-making?
Other comments
Page 13
Page 14
How often is this data collected?
On which sectors of the health workforce do you collect this data?
How are the data collected?
How are the data compiled into a database or information system?
Once compiled, are the data of health workers mapped and disseminated using a standard
classification for purpose of statistical comparability with other data sources relevant to
labour market analysis?
Are the data of health workers disaggregated by occupational category?
Are the data of health workers disaggregated by the following characteristics?
2.2
2.3
2.4
2.5
2.6
2.7
2.8
Is there a plan for monitoring and evaluation of human resources for health
strategic objectives?
Do you have a standard set summary of data or set of reports that you produce regularly?
Who are the principal users of the data and/or reports?
In what format do you disseminate the data and/or reports?
How often are these data and/or reports produced?
How have the national data on human resources been used in the last five years?
Is the national data on human resources used to support human resources for health
planning, development and management processes at all levels?
3.1
3.2
3.3
3.4
3.5
3.6
3.7
2.11 Indicate which population based surveys have been used to complement
the data on human resources for health collected by the institution.
Indicate the type of data on human resources for health collected in this institution on a
routine basis.
2.1
(e.g. MoH)
Institution 1
Institution 2
Institution 3
Institution 4
Institution 5
Institution 6
Complete the following information for every institution participating in completion of this questionnaire, indicating the acronym (e.g. Ministry of
Health – MoH) below the institution row as shown in the first column as an example. Attach additional sheets if more space is needed.
Section 4: Summary of findings
Country HRIS assessment tool at institutional level
Country HRIS assessment tool at institutional level
Attachment 1
Examples of institutions that could produce data on
human resources for health
The table below gives some examples of institutions that may collect data on HRH as well
as a brief description of what kind of data could be produced by these institutions.
Institution/agency
Type of data on HRH
National Institute of Statistics
Number of health workers (occupation) by public/private sector
Ministry of Defence
Number of military health workers (head counts)
Ministry of Health
Number of health workers (head counts)
Ministry of Finance
Payroll information of all public functionaries
Migration Office
Records of all categories of migrant health workers
Ministry of Labour
Number of health workers (head counts)
Ministry of Interior
Administrative records of health workers (head counts)
Medical Council
Registry of public, private and foreign doctors
Nurse Council
Registry of public, private and foreign nurses
Nurse Association
Registry of public, private and foreign nurses
School of Medicine
Records of medical students
School of Nursing
Records of staff and students from nursing school
School of Midwifery
Records of staff and students from midwifery school
School of technicians on health
Records of staff and students from health technicians
Regional health centres
Records of health workers at the regional level
Other health workers associations
Registry of public, private and foreign health workers
Labour unions
Registry of public, private and foreign health workers
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Country HRIS assessment tool at institutional level
Attachment 2
Type of data on human resources for health (question 2.10)
Please check all options that apply and complete them if necessary. Please refer to the
definitions from the Health Workforce Classification Mapping in attachment 3.
Health workers
Health professionals
Generalist medical practitioner/primary care medical doctors
Specialist medical practitioner
Nursing professional
Midwifery professional
Traditional and complementary medicine professional
Paramedical practitioner or clinical officer
Dentist
Pharmacist
Environmental and occupational health and hygiene professional
Physiotherapist
Dietician and nutritionist
Audiologist and speech therapist
Optometrist and ophthalmic optician
Health professional (not elsewhere classified) – please specify:
Health associate professionals
Medical imaging and therapeutic equipment operator
Medical and pathology laboratory technician
Pharmaceutical technician and assistants
Medical and dental prosthetic technician
Nursing associate professional/nursing assistant
Obstetrics/midwifery associate professional/midwife assistant
Traditional and complementary medicine associate professional/complementary medicine technician
Dental assistant and therapist
Medical records and health information technician
Community health worker
Dispensing optician
Physiotherapy technician and assistants
Medical assistant
Environmental and occupational health inspector and associates
Ambulance worker/emergency medical technician
Health associate professional (not elsewhere classified) – please specify:
Other health associate professionals
Health service manager
Health care assistant/nursing aide
Home-based personal care worker or other home care aide
Other health service providers (not elsewhere classified) – please specify:
Page 16
Mark
Country HRIS assessment tool at institutional level
Attachment 2 (continuation)
Fill in all training fields which apply to you and, if necessary, complete them.
(SE – secondary education; PS – post-secondary non-tertiary education; TE – tertiary
education)
Field of education
Medicine
Types of education programmes
SE
PS
TE
Medicine
Nursing
Nursing and midwifery
Midwifery
Assistant nursing
Assistant midwifery
Dental studies
Dentistry
Pharmacy
Clinical/medical services
Physiotherapy
Optometry
Medical/health
services
Medical technology
Ambulance service
Environmental health
Social work
Occupational health
Other fields associated with health – please specify:
Page 17
Page 18
ISCO
code
2211
Occupation
group
Generalist
medical
practitioners
Generalist medical doctors (including family and primary care doctors) diagnose,
treat and prevent illness, disease, injury, and other physical and mental impairments and
maintain general health in humans through application of the principles and procedures
of modern medicine. They plan, supervise and evaluate the implementation of care and
treatment plans by other health care providers. They do not limit their practice to certain
disease categories or methods of treatment, and may assume responsibility for the provision
of continuing and comprehensive medical care to individuals, families and communities.
Definition
Medical doctor (general), medical
officer (general), physician (general),
general practitioner, family medical
practitioner, primary health care
physician, district medical doctor,
resident medical officer specializing in
general practice
Examples of occupations
classified here
Occupations included in this category require completion of a university-level degree in basic
medical education plus postgraduate clinical training or equivalent. Medical interns who
have completed their university education in basic medical education and are undertaking
postgraduate clinical training are included here. Although in some countries “general practice”
and “family medicine” may be considered as medical specializations, these occupations should
always be classified here.
Notes
Health professionals
Health professionals study, advise on or provide preventive, curative, rehabilitative and promotional health services based on an extensive body of theoretical and factual knowledge in diagnosis and treatment of disease and other health problems. They may conduct
research on human disorders and illnesses and ways of treating them, and supervise other workers. The knowledge and skills required are usually obtained as the result of study at a higher educational institution in a health-related field for a period of 3–6 years
leading to the award of a first degree or higher qualification.
The classification of health workers maps occupation categories into five broad groupings: health professionals, health associate professionals,
personal care workers in health services, health management and support personnel, and other health service providers not elsewhere classified.
This mapping gives guidelines on how health workers are to be classified into the most detailed groups, with examples of occupations included
and excluded, for purposes of statistical delineation, description and analysis. It is intended to serve as a model to facilitate communication about
health occupations, to enhance comparability of data on health workers within and across countries and over time, and to make it possible for data
and information on health workers obtained from different sources to be produced in a form which can be useful for research as well as for decisionmaking and action-oriented activities. It is recognized that the full complexity and dynamics of national health labour markets may not be captured.
The classification of health workers is largely based on the International Standard Classification of Occupations (ISCO, 2008 revision), a system for
classifying and aggregating occupational information obtained by means of population censuses and other statistical surveys, as well as from
administrative records. The classification uses a hierarchical structure of occupational titles and codes, essentially reflecting the distinction of subgroups
of the health workforce according to assumed differences in skill level and skill specialization required to fulfil the tasks and duties of jobs. The ISCO
tool is intended both for statistical users and for client oriented users, and is the basis for many national occupational classifications.
Attachment 3
Health Workforce Classification Mapping
Country HRIS assessment tool at institutional level
ISCO
code
2212
Occupation
group
Specialist
medical
practitioners*
Paediatrician, neonatologist
Psychiatrist, child psychiatrist,
gerontopsychiatrist, neuropsychiatrist
Specialist medical doctor in cardiology,
dermato-venerology, forensic medicine,
gastroenterology, haematology,
immunology, infectious disease,
internal medicine, neurology,
occupational medicine, oncology,
radiology, rehabilitative medicine,
respiratory medicine, urology
Specialist medical doctor in general
surgery, accident and emergency
medicine, anaesthesiology,
intensive care, neurological surgery,
ophthalmology, orthopaedics,
otolaryngology, paediatric surgery,
plastic surgery, thoracic surgery,
vascular surgery
Doctors in paediatrics and related specialties focusing on the prevention, diagnosis and
treatment of health problems in infants, children and adolescents.
Doctors in psychiatric specialties and related branches focusing on the study and
treatment of mental illness and behavioural disorders.
Doctors in the medical group of specialties and related branches (not elsewhere
classified) focusing on the diagnosis, management and non-surgical treatment of
health problems.
Doctors in the surgical group of specialties and related branches (not elsewhere
classified) focusing on the treatment of health problems with surgery.
Doctors in specialties not elsewhere classified includes medical doctors in specialist
practice excepting obstetric, gynaecological, paediatric, psychiatric, surgical or medical
specialties as classified elsewhere.
Gynaecologist, obstetrician
Medical doctors by specialty groupings
Specialist physician (internal medicine),
surgeon, anaesthetist, cardiologist,
emergency medicine specialist,
ophthalmologist, gynaecologist,
obstetrician, paediatrician, pathologist,
preventive medicine specialist,
psychiatrist, radiologist, resident
medical officer in specialist training
Examples of occupations
classified here
Doctors in obstetric and gynaecological specialties and related branches focusing on
the care of the reproductive system of women including before, during and after pregnancy
and childbirth.
*
Specialist medical practitioners diagnose, treat and prevent illness, disease,
injury and other physical and mental impairments using specialized testing, diagnostic,
medical, surgical, physical and psychiatric techniques, through application of the principles
and procedures of modern medicine. They plan, supervise and evaluate the implementation
of care and treatment plans by other health care providers. They specialize in certain disease
categories, types of patient or methods of treatment, and may conduct medical education
and research activities in their chosen areas of specialization.
Definition
It is of significance to countries and stakeholders to be able to distinguish the different
categories of specialist medical practitioners. For purposes of international comparability,
where data pertaining to specialist medical practitioners are reported and classified by medical
specialty, they should be mapped to these groupings. Each specialist should only be counted
once, according to the main area of practice (or, if this information is not available, the last
specialty registered).
Occupations included in this category require completion of a university-level degree in basic
medical education plus postgraduate clinical training in a medical specialization (except
general practice) or equivalent. Resident medical officers training as specialist practitioners
(except general practice) are included here. Although in some countries “stomatology” may be
considered as a medical specialization, stomatologists should be included under “Dentists”–
2261. Medical research professionals who participate in biomedical research using living
organisms and do not undertake clinical practice should be excluded from here (classified
under “Life science professionals”1).
Notes
Country HRIS assessment tool at institutional level
Page 19
Page 20
Midwifery professionals plan, manage, provide and evaluate midwifery care services
before, during and after pregnancy and childbirth. They provide delivery care for reducing
health risks to women and newborn children according to the practice and standards of
modern midwifery, working autonomously or in teams with other health care providers.
They may conduct research on midwifery practices and procedures, and implement
midwifery education activities in clinical and community settings.
Traditional and complementary medicine professionals examine patients and
prevent and treat illness, disease, injury and other physical, mental and psychosocial
ailments by applying knowledge, skills and practices acquired through extensive study
of the theories and experiences originating in specific cultures. They research, develop
and implement treatment plans using applications such as acupuncture, ayurvedic,
homoeopathic and herbal medicine.
2222
2230
2240
2261
2262
Midwifery
professionals
Traditional and
complementary
medicine
professionals
Paramedical
practitioners
Dentists
Pharmacists
Pharmacists store, preserve, compound and dispense medicinal products. They counsel
on the proper use and adverse effects of drugs and medicines following prescriptions issued
by medical doctors and other health professionals. They contribute to researching, testing,
preparing, prescribing and monitoring medicinal therapies for optimizing human health.
Dentists (including dental surgeons and related) diagnose, treat and prevent diseases,
injuries and abnormalities of the teeth, mouth, jaws and associated tissues by applying
the principles and procedures of modern dentistry. They use a broad range of specialized
diagnostic, surgical and other techniques to promote and restore oral health.
Paramedical practitioners (including clinical officers and related) provide advisory,
diagnostic, curative and preventive medical services more limited in scope and complexity
than those carried out by medical doctors. They work autonomously or with limited
supervision of medical doctors, and perform clinical, therapeutic and surgical procedures
for treating and preventing diseases, injuries, and other physical or mental impairments
common to specific communities.
Nursing professionals provide treatment, support and care services for people who
are in need of nursing care due to the effects of ageing, injury, illness or other physical or
mental impairment, or potential risks to health, according to the practice and standards of
modern nursing. They assume responsibility for the planning and management of the care
of patients, including the supervision of other health care workers, working autonomously
or in teams with medical doctors and others in the practical application of preventive and
curative measures in clinical and community settings.
2221
Nursing
professionals
Definition
ISCO
code
Occupation
group
Hospital pharmacist, industrial
pharmacist, retail pharmacist,
dispensing chemist
Dentist, dental practitioner, dental
surgeon, endodontist, oral and
maxillofacial surgeon, oral pathologist,
orthodontist, paedodontist,
periodontist, prosthodontist,
stomatologist
Clinical officer, primary care paramedic,
advanced care paramedic, surgical
technician, Feldsher
Acupuncturist, Ayurvedic practitioner,
Chinese herbal medicine practitioner,
homeopath, naturopath,
Unani practitioner
Professional midwife
Professional nurse, specialist nurse,
nurse practitioner, clinical nurse,
district nurse, operating theatre nurse,
public health nurse, nurse anaesthetist,
nurse educator
Examples of occupations
classified here
Occupations included in this category normally require completion of university-level
training in theoretical and practical pharmacy, pharmaceutical chemistry or a related field.
Pharmacologists and related professionals who study living organisms are excluded from here
(classified under “Life science professionals”1).
Occupations included in this category normally require completion of university-level
training in theoretical and practical dentistry or a related field. Although in some countries
“stomatology” and “dental, oral and maxillofacial surgery” may be considered as medical
specializations, occupations in these fields should always be classified here.
Occupations included in this category normally require completion of tertiary-level training
in theoretical and practical medical services. Workers providing services limited to emergency
treatment and ambulance practice are classified under “Ambulance workers” – 3258.
This category includes occupations for which competent performance requires an extensive
understanding of the benefits and applications of traditional and complementary therapies,
developed as the result of extended formal study of these techniques as well as human
anatomy and elements of modern medicine. Practitioners working in the singular application
of approaches to herbal medicines, spiritual therapies or manual therapeutic activity are
excluded from here.
This category includes occupations for which competent performance usually requires formal
training at a higher educational institution in midwifery. The distinctions between nursing and
midwifery professionals and associate professionals should be made on the basis of the nature
of the work performed in relation to this definition. The qualifications held by individuals or
that predominate in the country are not the main factor in making this distinction, as training
arrangements for nurses and midwives vary widely between countries and have varied over
time within countries.
This category includes occupations for which competent performance usually requires formal
training at a higher educational institution in nursing. The distinction between nursing and
midwifery professionals and associate professionals should be made on the basis of the nature
of the work performed in relation to this definition. The qualifications held by individuals or
that predominate in the country are not the main factor in making this distinction, as training
arrangements for nurses and midwives vary widely between countries and have varied over
time within countries.
Notes
Country HRIS assessment tool at institutional level
Dieticians and nutritionists assess, plan and implement programs to enhance the impact Dietician, clinical dietician, food service
of food and nutrition on human health. They may conduct research, assessments and
dietician, nutritionist, public health
education to improve nutritional levels among individuals and communities.
nutritionist, sports nutritionist
Audiologists and speech therapists evaluate, manage and treat physical disorders
Audiologist, speech therapist, speech
affecting human hearing, speech communication and swallowing. They prescribe corrective pathologist, language therapist
devices or rehabilitative therapies for hearing loss, speech disorders, and related sensory and
neural problems. They plan hearing screening programs and provide counselling on hearing
safety and communication performance.
2265
2266
2267
2269
Dieticians and
nutritionists
Audiologists
and speech
therapists
Optometrists
and ophthalmic
opticians
Health
professionals
not elsewhere
classified
Chiropractor, osteopath, podiatrist,
occupational therapist, recreational
therapist, arts therapist, dance and
movement therapist
This category includes occupations for which competent performance usually requires
formal training at a higher educational institution in a health related field. Although in some
jurisdictions chiropractic and osteopathic are considered to have the attributes of medical
specialties, practitioners in these disciplines should always be classified here.
This category includes occupations for which competent performance usually requires formal
training at a higher educational institution in optometry, orthoptics or a related field.
This category includes occupations for which competent performance usually requires formal
training at a higher educational institution in audiology, speech pathology, clinical language
sciences or a related field.
This category includes occupations for which competent performance usually requires formal
training at a higher educational institution in food and nutritional science, nutrition education,
dietetics, or a related field.
This category includes occupations for which competent performance usually requires formal
training at a higher educational institution in physiotherapy or a related field.
This category includes occupations for which competent performance usually requires formal
training at a higher educational institution in environmental or occupational health and safety,
or a related field. Professionals who assess, plan and implement programmes to monitor or
control the impact of human activities on the environment are excluded from here (classified
under “Life science professionals”1).
Notes
ISCO
code
3211
Occupation
group
Medical imaging
and therapeutic
equipment
technicians
Medical imaging and therapeutic equipment technicians test and operate
radiographic, ultrasound and other medical imaging equipment to produce images of
body structures for the diagnosis and treatment of injury, disease and other impairments.
They may administer radiation treatments and monitor patients” conditions under the
supervision of a radiologist or other health professional.
Definition
Diagnostic medical radiographer,
medical radiation therapist, magnetic
resonance imaging technologist,
nuclear medicine technologist,
mammographer, sonographer
Examples of occupations classified here
This category includes occupations for which competent performance usually requires formal
training in medical technology, radiology, sonography, nuclear medical technology or a
related field.
Notes
Health associate professionals
Health associate professionals perform technical and practical tasks to support diagnosis and treatment of illness, disease, injuries and impairments, and to support implementation of health care, treatment and referral plans usually established by medical, nursing
and other health professionals. Appropriate formal qualifications are often an essential requirement for entry to these occupations; in some cases relevant work experience and prolonged on-the-job training may substitute for the formal education.
This group covers health professionals not classified elsewhere such as chiropractors,
osteopaths, podiatrists, occupational therapists, recreational therapists and other
professionals providing diagnostic, preventive, curative and rehabilitative health services.
Optometrists and ophthalmic opticians provide diagnosis, management and treatment Optometrist, ophthalmic optician,
services for disorders of the eyes and visual system. They counsel and advise on eye care and orthoptist
safety, and prescribe optical aids or other therapies for visual disturbance.
Physiotherapist, geriatric physical
therapist, orthopaedic physical
therapist, paediatric
physical therapist
Physiotherapists assess, plan and implement rehabilitative programs that improve or
restore human motor functions, maximize movement ability, relieve pain syndromes,
and treat or prevent physical challenges associated with injuries, diseases and other
impairments. They apply a broad range of physical therapies and techniques such as
movement, ultrasound, heating, laser and other techniques. They may develop and
implement programmes for screening and prevention of common physical ailments
and disorders.
2264
Environmental health officer,
occupational health and safety adviser,
occupational hygienist, radiation
protection adviser
Examples of occupations classified here
Physiotherapists
Definition
Environmental and occupational health and hygiene professionals assess, plan
and implement programs to recognize, monitor and control environmental factors that
can potentially affect human health, to ensure safe and healthy working conditions, and to
prevent disease or injury caused by chemical, physical, radiological and biological agents or
ergonomic factors.
ISCO
code
Environmental
2263
and occupational
health and
hygiene
professionals
Occupation
group
Country HRIS assessment tool at institutional level
Page 21
Midwifery associate professionals provide basic health care and advice before,
during and after pregnancy and childbirth. They provide advice to women, families and
communities on birth and emergency plans, breastfeeding, infant care, family planning and
related topics; monitor health status during pregnancy and childbirth; and implement care,
treatment and referral plans usually established by medical, midwifery and other health
professionals.
Traditional and complementary medicine associate professionals prevent, care
for and treat physical and mental illnesses, disorders and injuries using herbal and other
therapies based on theories and experiences originating in specific cultures. They administer
treatments using traditional techniques and medicaments, either acting independently
or according to therapeutic care plans established by a traditional medicine or other
health professional.
3213
3214
3221
3222
3230
Pharmaceutical
technicians and
assistants
Page 22
Medical
and dental
prosthetic
technicians
Nursing
associate
professionals
Midwifery
associate
professionals
Traditional ad
compementary
medicine
associate
professionals
Nursing associate professionals provide basic nursing and personal care
for people in need of such care due to effects of ageing, illness, injury, or other physical or
mental impairment. They provide health advice to patients and families; monitor patients’
conditions; and implement care, treatment and referral plans usually established by
medical, nursing and other health professionals.
Medical and dental prosthetic technicians design, fit, service and repair medical and
dental devices and appliances following prescriptions or instructions established by a health
professional. They may service a wide range of support instruments to correct physical
medical or dental problems such as neck braces, orthopaedic splints, artificial limbs, hearing
aids, arch supports, dentures, and dental crowns and bridges.
Pharmaceutical technicians and assistants perform a variety of tasks associated
with dispensing medicinal products under the guidance of a pharmacist or other health
professional. They inventory, prepare and store medications and other pharmaceutical
compounds and supplies, and may dispense medicines and drugs to clients and instruct on
their use as prescribed by health professionals.
Medical and pathology laboratory technicians perform clinical tests on specimens of
bodily fluids and tissues in order to get information about the health of a patient or cause
of death. They test and operate equipment such as spectrophotometers, calorimeters and
flame photometers for analysis of biological material including blood, urine and spinal fluid.
3212
Medical and
pathology
laboratory
technicians
Definition
ISCO
code
Occupation
group
Acupuncture technician, Ayurvedic
technician, bonesetter, herbalist,
homeopathy technician, scraping and
cupping therapist, village healer,
witch doctor
Assistant midwife, traditional midwife
Assistant nurse, enrolled nurse,
practical nurse
Medical appliance technician, orthotist,
orthotic technician, prosthetist,
prosthetic technician,
denturist, dental technician
Pharmaceutical technician,
pharmaceutical assistant, dispensing
technician
Medical laboratory technician,
medical laboratory assistant, blood
bank technician, cytology technician,
pathology technician
Examples of occupations
classified here
This category includes occupations for which competent performance requires knowledge
and skills acquired through relatively short periods of education and training, or informally
through the traditions and practices of the communities where they originated. Faith healers,
who treat human ailments through spiritual therapies, without using herbal therapies or
other medicaments or physical treatments, are excluded from here (classified under “Religious
associate professionals”). Occupations that provide therapy using traditional forms of massage
and the application of pressure, such as acupressure and shiatsu therapists, are classified under
“Physiotherapy technicians and assistants” – 3255.
This category includes occupations for which competent performance requires knowledge and
skills in routine and emergency midwifery care acquired through formal or informal training.
The criteria for inclusion of individuals in this category should be made on the basis of the
nature of the work performed in relation to this definition, and not the qualifications held
by individuals or that predominate in the country. Traditional and lay midwives, who provide
basic pregnancy and birthing care and advice based primarily on experience and knowledge
acquired informally through the traditions and practices of the communities where they
originated, are included here. Birth assistants, who provide emotional support and general
care and advice to women and families during pregnancy and labour, are excluded from here
(classified under “Personal care workers in health services”).
This category includes occupations for which competent performance usually requires
knowledge and skills obtained as the result of study in nursing; in some cases, extensive on
the-job training may substitute for the formal education formal. The criteria for inclusion of
individuals in this category should be made on the basis of the nature of the work performed
in relation to this definition, and not the qualifications held by individuals or that predominate
in the country.
Occupations included in this category normally require some medical, dental and anatomical
knowledge obtained through formal training. Technicians who construct and repair precision
medical and surgical instruments are excluded from here (classified under “Trade workers”1).
Occupations included in this category normally require knowledge and skills in pharmaceutical
services as obtained through formal training. Pharmacology technicians and related associate
professionals who work with living organisms are excluded from here (classified under
“Life science technicians”1).
This category includes occupations for which competent performance usually requires formal
training in biomedical science, medical technology or a related field. Technicians who conduct
laboratory tests on living organisms should be classified under “Life science technicians”.
Forensic science technicians, who perform clinical tests to aid in the investigation of crimes,
should be classified under “Physical and engineering science technicians”1.
Notes
Country HRIS assessment tool at institutional level
ISCO
code
3253
3254
3255
3256
Community
health workers
Dispensing
opticians
Physiotherapy
technicans and
assistants
Medical
assistants
Environmental
3257
and occupational
health
inspectors and
associates
3252
Medical records
and health
information
technicians
Dental assistants 3251
and therapists
Occupation
group
Physiotherapy technician, physical
rehabilitation technician, acupressure
therapist, electrotherapist,
hydrotherapist, massage therapist,
shiatsu therapist
Dispensing optician, contact lens
optician
Community health worker, community
health aide, community health
promoter, village health worker
Medical records technician, health
information clerk, medical records
analyst, medical records unit supervisor,
clinical coder, disease registry
technician
Dental assistant, dental hygienist,
dental therapist
Examples of occupations
classified here
Environmental and occupational health inspectors and associates investigate
the implementation of rules and regulations relating to environmental factors that can
potentially affect human health, health and safety in the workplace, and safety of
processes for the production of goods and services. They may implement and evaluate
programmes to restore or improve safety and sanitary conditions under the supervision
of a health professional.
Health inspector, food sanitation and
safety inspector, occupational health
and safety inspector, sanitarian,
sanitary inspector
Medical assistants perform basic clinical and administrative tasks to support patient
Medical assistant, clinical assistant,
care under the direct supervision of a medical practitioner or other health professional.
ophthalmic assistant
They perform routine tasks and procedures such as measuring patients’ vital signs,
administering medications and injections, recording information in medical records-keeping
systems, preparing and handling medical instruments and supplies, and collecting and
preparing specimens of bodily fluids and tissues for laboratory testing.
Physiotherapy technicians and assistants provide physical therapeutic treatments to
patients in circumstances where functional movement is threatened by injury, disease or
impairment. They fit patients for physical supportive devices and administer and monitor
manual treatments, electrical modality treatments, ultrasound and other physical therapies.
Therapies are usually provided as per rehabilitative plans established by a physiotherapist or
other health professional.
Dispensing opticians design, fit and dispense optical lenses based on a prescription from
an ophthalmologist or optometrist for the correction of reduced visual acuity. They service
corrective eyeglasses, contact lenses, low-vision aids and other optical devices.
Community health workers provide health education, referral and follow up, case
management, and basic preventive health care and home visiting services to specific
communities. They provide support and assistance to individuals and families in navigating
the health and social services system.
Medical records and health information technicians develop, implement and assess
health records processing, storage and retrieval systems in medical facilities and other
health care settings to meet the legal, professional, ethical and administrative recordskeeping requirements of health services delivery.
Dental assistants and therapists provide basic dental care services for the prevention
and treatment of diseases and disorders of the teeth and mouth, as per care plans and
procedures established by a dentist or other oral health professional. They examine patients’
mouths, teeth and related structures to assess oral health status; provide advice on dental
hygiene; perform basic or routine clinical dental procedures; and assisting dentists during
complex dental procedures.
Definition
This category includes occupations for which competent performance usually requires formal
training in sanitary sciences, occupational and institutional safety and sanitation, or a
related field.
This category includes occupations for which competent performance normally requires formal
training in health services provision. Clinical care providers with advanced training and skills
to provide independent medical diagnostic and treatment services should be classified under
“Paramedical practitioners”– 2240.
This category includes occupations for which competent performance usually requires formal
training in physical rehabilitation therapy or a related field. Fitness instructors, who teach
body movements used in fitness routines and recreational activities, are excluded from here
(classified under “Social, cultural and related associate professionals”).
This category includes occupations for which competent performance usually requires formal
training in opticianry.
Occupations included in this category normally require formal or informal
training and supervision recognized by the health and social services authorities. Providers of
routine personal care services and traditional medicine practitioners are not included here.
Occupations included in this category require knowledge of medical terminology, legal
aspects of health information, health data standards, and computer- or paper-based data
management as obtained through formal education and/or prolonged on-the-job training.
General secretarial or clerical workers are excluded from here.
This category includes occupations for which competent performance usually requires formal
training in dental hygiene, dental-assisting or a related field.
Notes
Country HRIS assessment tool at institutional level
Page 23
Page 24
3259
Health associate
professionals
not elsewhere
classified
Examples of occupations
classified here
This group covers health associate professionals not elsewhere classified including,
Respiratory therapy technician,
for instance, respiratory and anaesthesia technicians, HIV counsellors and others performing anaesthesia technician, HIV counsellor,
technical tasks and providing support for diagnostic, preventive, curative, promotional and family planning counsellor.
rehabilitative health services.
Ambulance workers provide emergency health care to patients who are injured, sick,
Ambulance officer, ambulance
infirm or otherwise physically or mentally impaired prior to and during transport to medical, paramedic, emergency medical
rehabilitation and other health care facilities. They monitor changes in health status of
technician, emergency paramedic
patients during transport and perform procedures according to protocol or emergency
medical treatment. They may patrol and provide information on first aid at large-scale
public gatherings and other events where health emergencies are more likely to occur.
Definition
This category includes occupations for which competent performance usually requires formal
training in health service provision.
Occupations included in this category normally require formal training in emergency medical
treatment, patient transport, ambulance principles and practice, or a related field. Ambulance
drivers who do not provide health care are excluded from here (classified under “Plant and
machine operators”1).
Notes
ISCO
code
1342
5321
5322
Occupation
group
Health service
managers
Health care
assistant
Home-based
personal care
workers
Health facility administrator, medical
administrator, clinical director, director
of nursing, hospital matron, community
health care coordinator, chief public
health officer
Examples of occupations
classified here
Home-based personal care workers provide routine personal care, support and
assistance with activities of daily living to persons who are in need of such care due to
effects of ageing, illness, injury, or other physical or mental condition in private homes and
other independent residential settings. They assist clients with personal, physical mobility
and therapeutic care needs, usually as per care plans established by a health professional.
Nursing aide (home), home care aide,
home birth assistant, personal care
provider
Health care assistants provide routine personal care, support and assistance with
Nursing aide (hospital or clinic), patient
activities of daily living to patients and residents in a variety of health care settings such as
care assistant, birth assistant (hospital
hospitals, clinics and residential nursing care facilities. They assist patients with personal,
or clinic), psychiatric aide
physical mobility and therapeutic care needs as per established care plans and practices, and
generally under the direct supervision of medical, nursing or other health professionals or
associate professionals.
Health service managers plan, direct, coordinate and evaluate the provision of clinical
and community health care services in hospitals, clinics, public health agencies and similar
organizations. They provide overall direction, policy standards and operational criteria for
the units they manage, including supervising and evaluating the recruitment, training
and work activities of personnel. They monitor the use of health services and resources.
They liaise with other health and welfare service providers, boards and funding bodies to
coordinate the provision of services.
Definition
Occupations included in this category generally do not require extensive health care
knowledge or training. Classified here are workers providing services in primary residential
settings including assisted-living facilities, continuing care retirement communities, and other
types of residential facilities with minimal or no on-site medical or nursing supervision. Home
birth assistants, who provide emotional support and general care and advice to women and
families during pregnancy and labour, but not delivery care to reduce health risks, are included
here. Care workers who provide care and supervision for children in residential homes and care
centres are excluded from here.
Occupations included in this category generally do not require extensive health care
knowledge or training. Classified here are workers providing services in health care settings
such as hospitals, health care facilities, rehabilitation centres, residential nursing care facilities,
and other establishments with permanent medical or nursing supervision.
The main tasks and duties for jobs in this occupational category include guiding and directing
the activities of organizations, departments and other workers, and other tasks which require
complex problem solving and decision-making based on knowledge and skills normally
obtained as the result of some combination of higher education, extensive work experience
and prolonged on-the-job training.
Notes
Other health associate professionals
Other health associate professionals include a wide range of other types of health systems personnel, such as health service managers, health economists, health policy lawyers, biomedical engineers, medical physicists, clinical psychologists, social workers, medical
secretaries, ambulance drivers, building maintenance staff, and other general management, professional, technical, administrative and support staff. Personal care workers provide direct personal care services in health care and residential settings, assist with health
care procedures, and perform a variety of other tasks of a simple and routine nature for the provision of health services. These occupations typically require relatively advanced literacy and numeracy skills, a high level of manual dexterity, and good interpersonal
communication skills.
3258
ISCO
code
Ambulance
workers
Occupation
group
Country HRIS assessment tool at institutional level
See International Standard Classification of Occupations: ISCO-08.
This group covers other categories not classifiable as participating in the formal or informal
health labour market but providing health services including, for instance, medical interns
and trainees who are providing clinical services as part of their basic medical education.
This group covers personal care workers in health services not classified elsewhere
including, for instance, dental aides, hospital orderlies, medical imaging assistants,
pharmacy aides and other providers of routine health and personal care support services.
Definition
Medical student intern, hospital
volunteer
Dental aide, first-aid attendant,
hospital orderly, medical imaging
assistant, pharmacy aide, phlebotomist,
sterilization aide
Examples of occupations
classified here
Notes
Source: Adapted from International Labour Organization, International Standard Classification of Occupations: ISCO-08 (http://www.ilo.org/public/english/bureau/stat/isco/index.htm).
1
5329
Personal care
workers in
health services
not elsewhere
classified
Other health
service providers
(not elsewhere
classified)
ISCO
code
Occupation
group
Country HRIS assessment tool at institutional level
Page 25
World Health Organization
Department of Human Resources for Health
20 avenue Appia
1211 Geneva 27
Switzerland