WP 4 Workshop

Applicability of the WHO Global Code of Practice on the International Recruitment of Health Personnel

Experience of the Republic of Moldova on Bilateral Agreements

Lisbon, 16th June 2014

Dr. Eugenia Berzan MoH, Republic of Moldova

Republic of Moldova is a Collaborating Partner of the EU Joint Action on Health Workforce Planning and Forecasting

being represented by the - Ministry of Health

- and subordinated National Center on Health Management that hosts the

South-eastern Europe Regional Health Development Center on Human Resources for Health 

(SEE Observatory on HRH)

Country Profile Republic of Moldova is located in South-Eastern Europe

Area -33,843 km2 Population (2012): 3,559

million (http://www.statistica.md/)

Rural population (% of total population-/2012)- up to 58%

GDP (2012): US $ 7,253 billion (http://data.worldbank.org/country/moldova )

GDP per capita in PPP terms (2012): US $3,368 (http://data.worldbank.org/indicator/NY.GDP.PCAP.PP.CD)

Poverty rate (2012) - 16.6 % (http://www.worldbank.org/en/country/moldova/ overview

Human Development Index (2012) – 0,66 (http://hdr.undp.org/sites/default/files/Country-Profiles/MDA.pdf)

Gender Inequality Index (2012) – 0,303

(http://hdr.undp.org/sites/default/files/Country- Profiles/MDA.pdf)

EU (2011)-345,8

Republic of Moldova (2012)- 282,62

Physicians per 100 000 population

Source: WHO/Europe, European HFA Database

Defining Some Indicators on Human Resources for Health

EU (2011)-79,65

Republic of Moldova (2012)- 52,17

Family Doctors (General Practitioners) per 100 000 population

Source: WHO/Europe, European HFA Database

Source: WHO/Europe, European HFA Database

EU (2011)-835,91

Republic of Moldova (2012)- 641,86

Nurses per 100 000 population

WHO Global Code of Practice on the International Recruitment of Health Personnel

Bilateral Agreements in the WHO Global Code

“Member States should use the Code as a guide when entering into bilateral, and/or regional and/or multilateral agreements, to promote international cooperation and coordination of international recruitment of health personnel. Such arrangements should take into account the needs of developing countries and countries with economies in transition through the adoption of appropriate measures…”

( WHO Code of Practice, Article 5.2 )

WHO Global Code of Practice on the International Recruitment of Health Personnel

Commitment assumed at the National Level to implement the WHO Global

Code of Practice with reference to Bilateral Agreements

One of the Government of the Republic of Moldova Action Plan 2013-2014 provisions stipulates:

“to intensify bilateral dialogue with States where exist the presence of the largest Moldovan Diaspora populations, signing bilateral agreements in the field of social protection of migrants, as well as health, education, labor migration etc. ”

The delegation of the Republic of Moldova, attested the intention of country to pursue the signing of bilateral agreements in the field of health personnel migration, via formal negotiations – agreements that have as objectives:

•facilitation of a process for recognition of professional qualifications;•promotion of circular migration;•integration of migrant health personnel in source and destination country Health Systems;•transfer of skills, knowledge and technology;•ethical recruitment of migrant health personnel.

Attending High Level Events

WHO Policy Dialogue on International Health Workforce Mobility and Recruitment Challenges, Amsterdam, The Netherlands, 2-3 May 2013

Third Global Forum on Human Resources for Health, 10-13 November

2013, Recife, Brazil

o Being organized, under the auspices of the SEEHN Presidency of the Republic of Moldova, the event was attended by over 50 experts and participants from Austria, Bulgaria, Estonia, Romania and Slovenia, as well as all the South-Eastern Europe Health Network (SEEHN) countries.

o Highlighting the key significance of the European Commission Directive 2005/36/EC on the recognition of professional qualifications (that came into force in 2007 and being amended several times)

o And providing a better insight into the legal and practical aspects of its implementation in the EU Members States and the current state of play in the countries of the SEEHN.

Sub regional TAIEX Workshop on "Harmonization and Mutual Recognition of Health Professionals' Qualifications in Europe”

Chisinau, 18-19 June 2013

Establishing a Cross-Sector Working Group

At the initiative of the MoH, based on nomination letters presented on behalf of all national key stakeholders, a Cross-Sector Working Group was established in July 2013, to cooperate in developing and initiating the negotiations on the draft bilateral framework agreement in the field of health personnel migration, including representatives of:

-Ministry of Health-Ministry of Education-Ministry of Labor, Social Protection and Family-Ministry of Foreign Affairs and European Integration-Bureau for Diaspora Relations-National Agency for Employment-Bureau for Migration and Asylum-National Center for Health Management-State University of Medicine and Pharmacy-National College of Medicine and Pharmacy

Draft Bilateral Agreement Development Negotiation Skills Development

(within technical meetings and workshops held during 2013-2014)

Draft Bilateral Agreement Development

• Draft agreement was developed based on the innovative comprehensive Model Bilateral Agreement I

(reflected in „Innovations in Cooperation: a guidebook on bilateral agreements to address health worker migration”, which is strongly correlated to all WHO Code of Practice provisions)

• Being adjusted by the Cross-Sector Working Group, based on the Moldovan practice in concluding and implementing bilateral treaties in the field of labor migration and social protection of migrants

(Bilateral Agreements in force on Social Protection of Migrants - with Bulgaria, Portugal, Romania, Luxembourg, Austria, Estonia, Czech Republic, Belgium)

(Bilateral Agreements in force on Labor Migration - with Russian Federation, Ukraine, Belarus, Azerbaijan, Italy, Israel)

• And being approved by Government Decision No.936 dated 22 November 2013

(Serves as a basis for starting the dialog on negotiations in the area of migration of health professionals with Partners from the destination countries of Moldovan health workers)

Draft

Intergovernmental Framework Agreement

in the field of Health Personnel

Migration

•Preamble

•Definitions

•Objectives

•Recruitment Standards

•Employment Standards

•Migration and Development

•Implementation and Monitoring

•Dispute Resolution, Entry into Force, Amendment, Denouncement

Draft Intergovernmental

Framework Agreement

in the field of Health Personnel Migration

Draft Agreement Structure

The List of Countries to start the Dialog with

Considering:

• the Extended Migration Profile of the Republic of Moldova

• results from the most recent studies of priority destinations of health professionals migrating from the Republic of Moldova

• and trends in international (especially European) migration flows

a number of 19 countries to start the dialog regarding negotiation of the Draft Intergovernmental Framework Agreement in the field of Health Personnel Migration with, were selected, including:

• Romania• Republic of Italy• Kingdom of Spain• Portuguese Republic• Federal Republic of Germany• State of Israel• French Republic• United Kingdom of Great Britain and Northern Ireland • Republic of Turkey• Republic of Bulgaria etc

List of countries, to start the dialog with, being as well approved by Government Decision No.936 dated 22 November 2013

Report developed and published in 2012 with EU and IOM support

2014 UP TO DATE…

Prioritization of the List of Countries to start the negotiations with on draft agreement during 2014

Invitations to launch negotiations, addressed via diplomatic channels to Partners from:

• Republic of Italy• Kingdom of Spain• Portuguese Republic• Federal Republic of Germany• State of Israel

The Dialog has recently been started with Partners from Federal Republic of Germany on priorities for cooperation in the field of health personal migration

In the process of strengthening it's capacity to manage the migration of health professionals, the Republic of Moldova, has benefited

since 2011 from a significant technical support

provided by WHO Regional Office for Europe & WHO Country Office, based on valuable financial assistance provided by European Union

within "Better managing the mobility of health professionals in the Republic of Moldova“ Project

Partners for Development Support

THANK YOU !