Transcript Code of Practice - Action for Global Health

Code of Practice:
Toward Implementation
Eric B. Williams
Health Workforce Advocacy Initiative
Physicians for Human Rights
Outline
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Introduction to HWAI
Realities and Tensions
Timeline
What is the Code of Practice?
Approved Code
Norway Example
Considerations on Implementation
Health Workforce Advocacy Initiative
(HWAI)
• Established in 2007
• Currently supported by the Global Health Workforce Alliance
• International civil society coalition
• Core focus areas:
– Right to health
– Adequate financing (new and sustained)
– Empowering civil society
• Focus on health workers to strengthen health systems
• All people should have access to skilled, motivated and supported
health workers.
• Physicians for Human Rights serves as the secretariat
Realities and Tensions
• Global shortage of health personnel – in
developed and developing nations
– Ethiopia vs. Washington DC
– Half of all trained doctors in Ghana lost 604 (1993-2002)
– U.S. health reform more 32 million people
• Aging populations and increased demand
• Challenge: “between two fundamental rights”
Health workers have the right to migrate
❷ People from source countries have a right to health
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Timeline
WHA57.19: Member States call for
Cod e of Practice (2004, WHA)
International Code of Marketing of
Breastmilk Substitutes (1981, WHA)
6 years
29 years (1981 – 2010)
Code Implementation
Global Code of Practice on the International
Recruitment of Health Personnel (2010, WHA)
What is the Code of Practice?
“Global Code of Practice on the International Recruitment of Health Personnel”
• Voluntary (non-binding)
• Ethical principles to address health worker movement
Code Structure
Objectives (Article 1)
Nature and Scope (Article 2)
Guiding Principles (Article 3)
Responsibilities, rights, recruitment
practices (Article 4)
Health Workforce Development and
health systems sustainability
(Article 5)
Data Gather and Research (Article 6)
Information Exchange (Article 7)
Implementation of the Code
(Article 8)
Monitoring and Institutional
Arrangement (Article 9)
Partnerships, technical assistance
and financial support (Article 10)
Code Intact, yet important edits
Three examples:
1. From “should” to “encourage”
2. Article 11.4 Voluntary financial mechanisms supportive of efforts
of developing countries and countries with economies in
transition to strengthen health systems, including health
personnel development, should be explored.
3. Article 9.2 (8.2) Member States should establish and maintain an
effective legal and administrative framework at the local and
national level, as appropriate, to give effect to the code.
Article 8.2 (9.2) Member States are encouraged to incorporate
the Code into applicable laws and policies.
Norway Example
• Norway will strengthen efforts to analyze and plan future
national health personnel needs
• Plans will be prepared showing how Norway is to obtain
the necessary health personnel. The plan shall be updated
regularly on the basis of new data and changes in needs
and conditions
• Compliance with the plan shall be monitored
• Main rule is that Norway shall fund the training of the
health workers who work within the country’s borders
• Norwegian employers shall not actively recruit health
workers in countries that lack health workers. Nor shall
recruitment firms or others who do this be used by
Norwegian employers
Implementation
• Greater awareness around Code
• Greater civil society engagement
• National data collection
– “Report card” for data measures on key indicators
– Is there a way to include both public and private
sectors under one reporting rubric?
– How can licensure data be used to track health
workers?
Implementation (continued)
• Under-employment of health workers in source
countries
• Address issues of conditionalities
• Prepare data sharing and systems for first data
report for 2012 (Article 7.2c)
• Work with governments to identify national
authority that will report on Code implementation
• Identify new and sustained financial resources to
support Code implementation and monitoring
THANK YOU / GRACIAS