Reviewing the relevance and effectiveness of the WHO Global Code of Practice
on the International Recruitment of Health
Second meeting of the Expert Advisory Group
Relevance Synthesis
of the evidence from 1st round reporting National Reporting Instrument
(NRI) Plus the key recommendations of the JAHWPF
Dr. SALEHI ZALANI Gholamhossein
DG of HRM office, Ministry of Health and Medical Education (I.R Iran )
April2015
Two sets of data we had
- The report on the applicability of the Code in the EU
countries (Ireland, Germany and Moldova
A. Joint Action Health Workforce
Planning and Forecasting (JAHWPF)
(2013 till 2016)
-The (almost) final handbook on planning
methodologies across EU. (feasible realization of the
methods)
- Belgium, Denmark, UK, Finland, Spain and the
Netherlands.
B. National Reporting Instrument (NRI)
30th May 2012.
the data collected through the 1st round reporting on
the Code implementation The instrument is
distributed among voluntary participants (57
countries) from the WHO regions (EMRO, AFRO
,etc) GOALS, FORECASTING MODEL, DATA
SOURCES , LINK TO POLICY ACTIONS,
ORGANISATION
WHO
Global Code of Practice on the International
Recruitment of Health
The Overall Objectives
1. To synthesize the key recommendations of the JAHWPF in regard to evaluating the
Relevance of the Code articles
2. To assess the NRI country reports against the Code provisions and to see whether
specific elements can be mapped against the Relevance concept with specific country
examples where possible.
 Relevance: the extent to which the objectives, principles and articles of
the Code continue to be pertinent and can inform solutions related to
the global challenges of health personnel and health system
strengthening.
First Stage:
▪ Theme Extraction from the Code (10 Articles): 56 Main Themes
▪ Theme Extraction from the Instrument: out of 14 questions 22
themes were extracted
▪ Theme Extraction from the Handbook (7best practices) & the
Applicability Report of the Code in some EU countries (Germany,
Ireland and Moldova)
Second Stage:
▪ Accommodation of the Code themes with the Instrument themes
▪ Accommodation of the Code themes with the Handbook & the
Applicability Report themes with regard to the five dimensions of
HRH planning
(GOALS, FORECASTING MODEL, DATA
SOURCES, LINK TO POLICY ACTIONS, ORGANISATION)
Third Stage:
▪ Analysis of the extracted data and their synthesis in Focus Group
Discussions
D
Methodology
1. 1. Precise Translation of the Code
to Persian was an essential for better
understanding of its articles
2. 2. Convened an Expert Committee

M. Bayat

S.E Mirbahaeddin

A. Shokri

S. alirezaei

F. manafi

N. bahmanziari
T
Article code
% Frequency
Article 1: Objectives
50
Article 2 – Nature and scope
0
Article 3 – Guiding principles
13
How far could the instrument
themes cover the Code themes?
 In total the instrument covers %39 of the
code themes (22 themes out of 56 code
themes)
Article 4 – Responsibilities, rights and recruitment practices
71
▪ The most focus is on article 4
Article 5 – Health workforce development and health
systems sustainability
29
Article 6 – Data gathering and research
50
Article 7 – Information exchange
50
Article 8 – Implementation of the Code
71
▪ the least frequencies respectively belong to
Article 9 – Monitoring and institutional arrangements
14
article 2 (%0), article 3-Guiding principles
67
(%13) and article 9- Monitoring and
39
institutional arrangements (%14).
Article 10 – Partnerships, technical collaboration and
financial support
Total
D
(Responsibilities, rights and recruitment
practices) with %71 and article 8
(Implementation of the Code) with %71.
T
Results from the NRI (Relevancy)
Article 7 – Information exchange
▪ Questions 11, 13, 9 D and 14 : in order to overcome global challenges (Relevancy) there is a highly
essential need for collection and share of the personnel information and recruitment laws of the countries to
WHO in a three years period of time and determining a responsible authority regarding the exchange of
migrant personnel.
Article 4 – Responsibilities, rights and recruitment practices
▪ This article is covered by questions 1, 2 parts A & B & C and question 3. This article aims at promoting
transparency of rights, obligations and expectations of stakeholders as a solution of global challenges
(Relevancy) through legal monitoring mechanisms (to assess the benefits and risks, recruiters are
obligated to individual right of the employees and provision of equal opportunities of promotion and etc) and
also compliance of stakeholders in different professions with the laws as a means of solution for the
D
ultimate goal of implementing strengthened health human resources systems and strategic plans for
education and retention of the workforce (Effectiveness)
T
Relevancy frequency of the code analyzed by the Instrument
Questions
Q1: same legal rights in terms of employment and conditions of work
Q4: entered into bilateral, regional or multilateral agreements
Q6: programs or institutions undertaking research
Q 8: steps to implement the Code
Q11: database of laws and regulations related to recruitment and
migration
Q12: technical cooperation agreement - financial assistance
Q13: mechanism or entity to maintain statistical records
Q 14: mechanism or entity to regulate or grant authorization to
practice to recruited
Total
D
Frequency Percent
49
20
25
35
90.74
37.04
46.30
64.81
11
20.37
11
33
20.37
61.11
34
62.96
27
50.46
T
Key Points
▪ The current instrument covers the code content only to some extent
(%39);
- therefore in order to accurately assess the relevancy of the code it is highly
recommended to utilize a more comprehensive instrument
For example in Article 9 (Monitoring and institutional arrangements)
most countries failed to pay attention to it
- It is one of the most important items in any plan therefore lack of proper attention to
this article may cause issues for the future implementations
▪ %50 of the countries’ measures has pertinence (is fitting) to the
code contents (perhaps had essential infrastructures for the
implementation of the codes)
▪ there seems to be a non-uniform status among the countries. For
instance
- %71 of the participant had laws for equal rights and same working conditions
- %20 of countries had establishment of information database for laws and regulations and
agreements on technical and financial cooperation (referring to articles 7 and 10 which
have substantial role in general cooperation of countries in international recruitment)
Final note
▪ While this study examines the Relevancy of the code to some
extent, there are some limitations to results generalization, to name
a few:
- countries responded some questions in form of Yes or No, theme extraction of these
measures was problematic.
- it is not determined if the implemented measures of the participating countries are
initiated after or before the time when the code was notified.
- Only 39 percentage of the Code themes were covered by the instrument, therefore
having a comprehensive analysis is unlikely
Handbook Synthesis
How far could the EU HWP measures cover the
Code themes?
code
Total Frequency
Article 1: Objectives
4
40%
Article 2 – Nature and scope
7
70%
Article 3 – Guiding principles
2
20%
2
20%
8
80%
4
40%
Article 7 – Information exchange
5
50%
Article 8 – Implementation of the Code
Article 9 – Monitoring and institutional
arrangements
1
10%
0
0%
8
80%
Article 4 – Responsibilities, rights and
recruitment practices
Article 5 – Health workforce
development and health systems
sustainability
Article 6 – Data gathering and
research
Article 10 – Partnerships, technical
collaboration and financial support
T
How far could the EU docs depict the Relevency of Code themes?
Total Frequency
percentage
code
Article 1: Objectives
Article 2 – Nature and scope
Article 3 – Guiding principles
3
7
0
75%
100%
0%
Article 4 – Responsibilities, rights and
recruitment practices
1
50%
Article 5 – Health workforce development and
health systems sustainability
2
25%
Article 6 – Data gathering and research
0
0%
Article 7 – Information exchange
4
80%
Article 8 – Implementation of the Code
0
0%
Article 9 – Monitoring and institutional
arrangements
0
0%
1
13%
18
44%
Article 10 – Partnerships, technical collaboration
and financial support
total
T