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UK restricts health workers recruitment

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By Abraham Adekunle

WHO health workforce support and safeguards list puts Nigeria on the red list.

The government of the United Kingdom has placed Nigeria on the red list of countries that should not be actively targeted for recruitment by health and social care employers. The only exception to this situation is when there is a government-to-government agreement between the two countries. The World Health Organization (WHO) draws the red list, where Nigeria has been placed, from its health workforce support and safeguards list. This list, which was released about a month ago, comprises 55 countries that face the most pressing health workforce challenges related to universal health coverage.

Specifically, these countries have a density of doctors, nurses and midwives below the global median as well as a universal health coverage service index below a certain threshold. For instance, while the WHO recommends one doctor to every 600 people, Nigeria’s doctor-to-patient ratio is one doctor to 8,000 people. The disclosure of the restriction is contained in the updated information titled, “Code of Practice for the international recruitment of Health and Social Care Personnel in England,” which is available on the website of the UK government.

The listed countries are to be prioritized for health personnel development.

According to the Expert Advisory Group on the Global Code of Practice on the International Recruitment of Health Personnel (the Code), countries with the most pressing health workforce needs related to universal health coverage should be identified, and support and safeguards targeted at them. The advisory group further urged leading destination countries and development partners, including other entities interested in providing health workforce related support and safeguards, to commit multi-year flexible funds towards implementation of the Code as a global public good.

This fourth progress report noted that the negative health, economic and social impact of COVID-19, alongside the increasing demand for health and care workers in high-income countries, might be increasing vulnerabilities within countries already suffering from low health workforce densities. The UK government in the updated information said that country identification follows the methodology contained in the 10-year review of the relevance and effectiveness of the WHO global code of practice on the International Recruitment of Health Personnel.

Ethical recruitments are still permitted and Nigeria can make amber list.

It is also stated in the official document that if an agreement is put in place between a partner country (and the UK), which restricts recruiting organizations to the terms of the agreement, the country is added to the amber list. Meanwhile, the code of practice also states that ethical recruitment is determined by the country from which the individual is resident in, rather than the nationality of the individual or their original country of training. In other words, if a health worker is a national of a red-list country but does not reside there or in another red-list country, the restrictions do not apply.

Countries that are not on either the red or amber lists are to be considered “green” countries and active recruitment is permitted where there is a government-to-government agreement with the UK in place. The amber countries where international recruitment is only permitted in compliance with the terms of the governments agreement are Kenya and Nepal. If the Federal Government of Nigeria can have an agreement with the UK, the country will be bumped to the amber list.

Governments agreement also comes with certain restrictions.

Active recruitment is permitted from green-graded countries where there is a government-to-government agreement with the UK in place for international health and care workforce recruitment. However, this agreement may set parameters, implemented by the country of origin, for how UK employers, contracting bodies, recruitment organizations, agencies, and collaborations recruit. These organizations are encouraged to recruit on the terms of the agreement between governments. Green-graded countries with a government-to-government agreement for managing international health and care workforce recruitment are India, Malaysia, Philippines, and Sri Lanka.

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