monitoring of the who global code of practice on the international ...

MONITORING OF THE WHO GLOBAL CODE OF PRACTICE ON THE 

INTERNATIONAL RECRUITMENT OF HEALTH PERSONNEL 

THE PHILIPPINE MULTISTAKEHOLDER APPROACH 

A Collaboration <strong>of</strong> <strong>the</strong> Department <strong>of</strong> Health 

with <strong>the</strong> Department <strong>of</strong> Labor and 

Employment in partnership with <strong>the</strong> 

International Labour Organization 

(Philippines) and <strong>the</strong> World Health 

Organization (Philippines and Western Pacific 

Regional Office) and Multistakeholders 

Manila, June 2012

CONTENTS 

CONVENORS.............................................................................................................................. ii 

TECHNICAL and ORGANIZING COMMITTEE .............................................................................. ii 

CONSULTANT and TECHNICAL WRITER..................................................................................... ii 

FACILITATORS........................................................................................................................... iii 

SECRETARIAT............................................................................................................................ iii 

DOCUMENTORS ....................................................................................................................... iii 

MULTISTAKEHOLDERS.............................................................................................................. iii 

LIST OF FIGURES...................................................................................................................... vii 

LIST OF BOXES ......................................................................................................................... vii 

ACRONYMS..............................................................................................................................viii 

EXECUTIVE SUMMARY .............................................................................................................. x 

INTRODUCTION......................................................................................................................... 1 

THE PHILIPPINE APPROACH ...................................................................................................... 3 

SUPPLEMENTAL INFORMATION.............................................................................................. 18 

CONCLUSION........................................................................................................................... 21 

ANNEX A: Proposed Questions for Source Countries.............................................................. 23 

ANNEX B: The Philippine Worksheet....................................................................................... 24

CONVENORS 

Department <strong>of</strong> Health 

Dr. Kenneth Ronquillo, Director IV, Health Human Resources Development Bureau 

Dr. Christine Joan Co, Team Leader for Policy and Network, Planning and Standards Division 

Department <strong>of</strong> Labor and Employment 

Ms. Fely Romero, Director, Philippine Overseas Employment Administration 

International Labour Organization (Manila) 

Ms. Ca<strong>the</strong>rine Vaillancourt-‐Laflamme, Chief Technical Advisor, Decent Work Across Borders 

Project 

Ms. Jennifer Frances dela Rosa, National Program Officer, Decent Work Across Borders 

Project 

World Health Organization (Philippines) 

Dr. Soe Nyunt-‐U, WHO Representative, WHO Country Office 

Ms. Lucille Nievera,Programme Officer, WHO Country Office 

World Health Organization (Western Pacific Regional Office) 

Dr. F. Gülin Gedik, Team Leader, Human Resources for Health,WHO Western Pacific Regional 

Office 

Ms. Kathleen Fritsch, Nursing Regional Advisor, WHO Western Pacific Regional Office 

TECHNICAL AND ORGANIZING COMMITTEE 

Dr. Kenneth Ronquillo, Director IV, Health Human Resources Development Bureau 

Dr. Christine Joan Co, Team Leader for Policy and Network, Planning and Standards Division 

Ms. Ca<strong>the</strong>rine Vaillancourt-‐Laflamme, Chief Technical Advisor, Decent Work Across Borders 

Project 

Ms. Jennifer Frances dela Rosa, National Program Officer, Decent Work Across Borders 

Project 

CONSULTANT AND TECHNICAL WRITER 

ii

Ms. Maria Lourdes Rebullida, DPA 

FACILITATORS 

Dr. Kenneth Ronquillo, Department <strong>of</strong> Health 

Dr. Christine Joan Co, Department <strong>of</strong> Health 

Ms. Ca<strong>the</strong>rine Vaillancourt-‐Laflamme, ILO Manila 

Ms. Jennifer Frances dela Rosa, ILO Manila 

Ms. Maria Concepcion Sardaña, ILO Manila 

Ms.Fely Marilyn Lorenzo, DrPH, University <strong>of</strong> <strong>the</strong> Philippines Manila 

Mr. Ricardo Casco, International Organization for Migration 

Ms. Maria Lourdes Rebullida, DPA, University <strong>of</strong> <strong>the</strong> Philippines Diliman 

SECRETARIAT 

Ms. Madelyne Mabini 

Ms. Desiree Joy Granil 

DOCUMENTORS 

Dr. Carl Antonio 

Ms. April Delos Santos 

Ms. Mary Jane Demegillo 

Ms. Marjorie Dungca 

Dr. Irene Farinas 

Ms. Farrah Grace Naparan 

Mr. Jayson Aguilar 

Ms. Grace Fernando 

Ms. Georgina Ramiro 

Ms. Caridad Ulanday 

iii

Mr. Frencel Tingga 

Mr. Jeric Sagala 

MULTISTAKEHOLDERS 

Commission on Filipinos Overseas 

Ms. Elsa Florendo Commission on Higher Education 

Ms. Emily Villanueva – Descallar Department <strong>of</strong> Foreign Affairs 

Dr. Aleli Annie Grace Sudiacal 

Ms. Jeanne Bernas 

Dr. Lilibeth David 

Dr. Elizabeth Matibag 

Ms. Juanita Valeza 

Mr. Jose Sandoval 

Ms. Geraldine Labayani 

Ms. Milagros Oliva 

Dr. Marco Valeros 

Dr. Rhyan Gallego 

Ms. Vivian Tornea 

Atty. Bulyok Nilong 

Ms. Luisa Reyes 

DOH-‐Bureau <strong>of</strong> International Health Cooperation 

DOH -‐ Health Policy Development and Planning Bureau 

DOLE -‐ Bureau <strong>of</strong> Local Employment 

DOLE -‐ Bureau <strong>of</strong> Working Conditions 

DOLE -‐ National Reintegration Center for OFWs 

Dr. Marissa San Jose DOLE – Occupational Safety and Health Center 

Ms. Arlene Ruiz 

Mr. Benjamin Jose Bautista 

Mr. Arthur Philip Sevilla 

Ms. Maybelle Gorospe 

Mr. Jone Fung 

Ms. Nimfa De Guzman 

Mr. Carlos Canabera 

Mr. Pamfilo Tabu, Jr. 

Ms. Monica Ormillo 

Mr. Alvin Cloyd Dakis 

Mr. Jonathan Monis 

National Economic and Development Authority 

Philippine Overseas Employment Administration 

Technical Education Skills Development Authority 

Alliance <strong>of</strong> Young Nurse Leaders and Advocates 

International, Inc. 

Ms. Joycelynn Aman Philippine Association <strong>of</strong> Medical Technologists, Inc. 

Mr. Noel Cadete 

Dr. Teresita Barcelo 

Philippine Nurses Association, Inc. 

iv

Ms. Leonila Ocampo 

Dr. Yolanda Robles 

Philippine Pharmacists Association 

Ms. Gayline Manalang, Jr. Philippine Physical Therapy Association, Inc 

Ms. Freyda Viesca Employers Confederation <strong>of</strong> <strong>the</strong> Philippines 

Dr. Jose Luis Danguilan Lung Center <strong>of</strong> <strong>the</strong> Philippines 

Ms. Jeanette Nora Silao 

Dr. Bernadette Hogar 

Ms. Mary Eve De Leon 

Ms. Ivy Alcantara 

Ms. Katrina Ledesma 

Dr. Jose Dante Dator 

Ms. Nimia Parale 

Manila Doctors Hospital 

Makati Medical Center 

National Kidney and Transplant Institute 

Ms. Lizel San Pedro Ospital ng Makati – Pembo 

Ms. Leonida Ventosa Ospital ng Muntinlupa 

Dr. Paulo Castro 

Mr. Horacio Apuyan 

Dr. Kiko Tranquilino 

Pasig City General Hospital 

Ms. Maria Linda Buhat Philippine Heart Center 

Pharmaceutical and Healthcare Association <strong>of</strong> <strong>the</strong> 

Philippines 

Mr. Vladimir Balbino St. Luke’s Medical Center – Quezon City 

Dr. John Jerusalem Tiongson The Medical Center 

Mr. Nestor Flores Abba Personnel Services, Inc 

Mr. Ramon Quevedo EDI-‐Staff Builders International 

Ms. Valerie Santos Health Carousel Philippines, Inc 

Ms. Marysol Ligod Innovative Manpower Services 

Ms. Ca<strong>the</strong>rine Peralta Jedegal International Manpower Services 

v

Mr. Loreto Soriano LBS Recruitment Solutions Corporation 

Ms. Marjo Miinalainen OPTEAM Global -‐ Regional Office 

Ms. Joy del Rosario PETRO -‐ FIL Manpower Services Inc. 

Mr. Victor Fernandez, Jr. 

Mr. Hernan Guanco 

Mr. Jesus Noel Litan 

Mr. Simon John Corocoto Signature HealthCARE 

Philippine Association <strong>of</strong> Service Exporters, Inc 

Ms. Joanna Katrina Magalong Transnational Services Inc. 

Mr. Josua Mata Alliance <strong>of</strong> Progressive Labor 

Ms. Suevelyn Clavite 

Mr. Abdulani Lakibul 

Confederation <strong>of</strong> Independent Union 

Mr. Julius Cainglet Federation <strong>of</strong> Filipinos Workers 

Ms. Esperanza Ocampo 

Ms. Josephine Pagsuyuin -‐ Jamon 

Ms. Annie Enriquez – Geron 

Ms. Jillian Roque 

Philippines Government Employee Alliance 

Public Services-‐Labour Independent Confederation 

vi

LIST OF FIGURES 

Figure1. Philippine Approach to Monitoring <strong>the</strong> WHO Global Code <strong>of</strong> Practice on <strong>the</strong> 

International Recruitment <strong>of</strong> Health Personnel 

LIST OF BOXES 

Box 1. The Philippine Approach: Steps in Monitoring <strong>the</strong> Implementation <strong>of</strong> <strong>the</strong> WHO Global 

Code <strong>of</strong> Practice on <strong>the</strong> International Recruitment <strong>of</strong> Health Personnel (April to May 2012) 

Box 2. DOH-‐HHRDB as Focal Unit for Monitoring Implementation <strong>of</strong> <strong>the</strong> WHO Global Code <strong>of</strong> 

Practice on <strong>the</strong> International Recruitment <strong>of</strong> Health Personnel (April to May 2012) 

Box 3. ILO Decent Work Across Borders Project: A Pilot Project for Migrant Health 

Pr<strong>of</strong>essionals and Skilled Workers (ILO Manila with European Union funding) 

vii

ACRONYMS 

AANZFTA Association <strong>of</strong> Sou<strong>the</strong>ast Asian Nations-‐Australia-‐New Zealand Free 

Trade Agreement 

ASEAN Association <strong>of</strong> Sou<strong>the</strong>ast Asian Nations 

ASEAN MRAr ASEAN Mutual Recognition Arrangement 

CFO Commission on Filipinos Overseas 

CHED Commission on Higher Education 

DFA Department <strong>of</strong> Foreign Affairs 

DILG Department <strong>of</strong> <strong>the</strong> Interior and Local Government 

DILG-‐BLGD Department <strong>of</strong> <strong>the</strong> Interior and Local Government-‐Bureau <strong>of</strong> Local 

Government Development 

DOH Department <strong>of</strong> Health 

DOH –BIHC DOH-‐Bureau <strong>of</strong> Health International Cooperation 

DOH-‐HHRDB DOH -‐Health Human Resources Development Bureau 

DOH – HPDPB DOH -‐Health Policy Development and Planning Bureau 

DOH – NCPAM DOH-‐National Center for Pharmaceutical Access & Management 

DOLE Department <strong>of</strong> Labor and Employment 

DOLE -‐ BLE DOLE-‐Bureau <strong>of</strong> Local Employment 

DOLE –BLR DOLE-‐Bureau <strong>of</strong> Labour Relations 

DOLE – BWC DOLE -‐Bureau <strong>of</strong> Working Conditions 

DOLE – ILS DOLE -‐Institute <strong>of</strong> Labor Studies 

DOLE – NRCO DOLE-‐National Reintegration Center for Overseas Filipino Workers 

DOLE –OSHC Department <strong>of</strong> Labor and Employment-‐Occupational Safety and 

Health Center 

DWAB Decent Work Across Borders 

HRH Human Resources for Health 

ILO Manila International Labour Organization (Manila Office) 

ILO-‐DWAB International Labour Organization-‐Decent Work Across Borders 

Project 

viii

MASEAN Medical Association <strong>of</strong> Sou<strong>the</strong>ast Asian Nations 

MDH Manila Doctors Hospital 

MRAr Mutual Recognition Arrangement 

NEDA National Economic and Development Authority 

OWWA Overseas Workers Welfare Administration 

PEOS Pre-‐Employment Orientation Seminar 

PDOS Pre-‐Departure Orientation Seminar 

PHC Philippine Heart Center 

PNA Philippine Nurses Association, Inc. 

PPhA Philippine Pharmacists Association 

PPTA Philippine Physical Therapy Association, Inc. 

POEA Philippine Overseas Employment Administration 

PRC Pr<strong>of</strong>essional Regulation Commission 

PRC-‐IAD Pr<strong>of</strong>essional Regulation Commission-‐International Affairs Division 

PSLINK Public Services-‐Labour Independent Confederation 

TESDA Technical Education Skills Development Authority 

UP-‐NIH University <strong>of</strong> <strong>the</strong> Philippines-‐National Institutes <strong>of</strong> Health 

UP-‐NIH IHPDS University <strong>of</strong> <strong>the</strong> Philippines-‐National Institutes <strong>of</strong> Health, Institute 

<strong>of</strong> Health Policy and Development Studies 

WHO World Health Organization 

WHO Philippines WHO Philippine Office 

WHO WPRO WHO Western Pacific Regional Office 

ix

EXECUTIVE SUMMARY 

The Philippines initiated a participatory multistakeholder process for <strong>the</strong> <strong>monitoring</strong> <strong>of</strong> 

implementation <strong>of</strong> <strong>the</strong> WHO Global Code <strong>of</strong> Practice on <strong>the</strong> International Recruitment <strong>of</strong> 

Health Personnel (The Code). The Department <strong>of</strong> Health (DOH) took <strong>the</strong> lead as <strong>the</strong> WHO 

designated national authority, with <strong>the</strong> Department <strong>of</strong> Labor and Employment (DOLE), and 

in partnership with <strong>the</strong> International Labour Organization (ILO Manila) and <strong>the</strong> World Health 

Organization (WHO Philippines and Western Regional Pacific Office), and local stakeholders 

from <strong>the</strong> government, trade unions, employers, recruitment agencies, and pr<strong>of</strong>essional 

associations. 

The process benefited <strong>the</strong> fact that <strong>the</strong> ILO, with <strong>the</strong> financial support <strong>of</strong> <strong>the</strong> European 

Union, is implementing a project called Decent Work Across Borders: A Pilot project for 

Migrant Health Pr<strong>of</strong>essionals and Skilled Workers (DWAB).The project is implemented 

through a partnership with DOLE, trade union and employers organizations and o<strong>the</strong>r 

relevant partners. It provided <strong>the</strong> opportunity to work with <strong>the</strong> DOH on <strong>the</strong>ir common 

concern for ethical recruitment <strong>of</strong> human resources for health (HRH). 

The ILO DWAB hosted an initial meeting on <strong>the</strong> 29 th <strong>of</strong> March 2012, which was attended by 

representatives <strong>of</strong> <strong>the</strong> four organizing committee members —<strong>the</strong> DOH, DOLE, ILO and WHO 

Philippines and WPRO. In this meeting, organizers discussed <strong>the</strong> WHO Global Code <strong>of</strong> 

Practice on <strong>the</strong> International Recruitment <strong>of</strong> Health Personnel, also known as <strong>the</strong> Code, and 

its National Reporting Instrument. This meeting mapped <strong>the</strong> terms <strong>of</strong> <strong>the</strong>ir collaborative 

engagement to assist <strong>the</strong> DOH in <strong>monitoring</strong> <strong>the</strong> Code using a participatory approach, 

tapping on <strong>the</strong> ILO experience to work through social partners. 

The organizers ventured into <strong>the</strong> preparation <strong>of</strong> a Philippine Monitoring Worksheet for 

multistakeholders to provide supplementary data and clarificatory statements. This 

worksheet, which stakeholders were asked to complete, included <strong>the</strong> WHO National 

Reporting Instrument questions and linked those to <strong>the</strong> statements from <strong>the</strong> Code. The 

worksheet also included a column for stakeholders to add supplementary information and 

clarification on <strong>the</strong>ir responses. The worksheet also provided <strong>the</strong> opportunity for 

stakeholders to propose improvements to <strong>the</strong> wording <strong>of</strong> <strong>the</strong> questions included in <strong>the</strong> 

national reporting instrument. 

With <strong>the</strong> logistical support <strong>of</strong> <strong>the</strong> DOH and ILO, <strong>the</strong> Philippines convened introductory 

briefings in April 2012, for <strong>the</strong> stakeholders (governments, trade unions, hospitals, 

pr<strong>of</strong>essional organizations and recruitment agencies) to present and discuss <strong>the</strong> provisions 

<strong>of</strong> <strong>the</strong> WHO Code, to orient <strong>the</strong>m on <strong>the</strong> completion <strong>of</strong> <strong>the</strong> WHO National Reporting 

Instrument and Philippine worksheet, and obtain <strong>the</strong>ir commitment to participate in <strong>the</strong> 

<strong>monitoring</strong> process. The stakeholders were encouraged to consult <strong>the</strong>ir constituents in 

completing <strong>the</strong> worksheet. 

x

Stakeholders were asked to send <strong>the</strong>ir completed worksheet electronically before <strong>the</strong> 

organizers convened a first multi stakeholder meeting as to allow <strong>the</strong> collection <strong>of</strong> 

information and consolidation <strong>of</strong> responses per stakeholder group. 

The 1 st Multistakeholder Participatory Assessment Workshop was convened on 17 May 

2012. Each group <strong>of</strong> stakeholder ga<strong>the</strong>red to discuss and clarify <strong>the</strong> consolidated data in 

separate sessions. The plenary session that followed allowed clarification <strong>of</strong> responses 

across stakeholder groups. The meeting lasted one full day. 

The 2 nd Multistakeholders Participatory Assessment Workshop on 30 May 2012 focused on 

<strong>the</strong> consolidated draft country report that presented <strong>the</strong> Philippine situation and <strong>the</strong> 

stakeholders’ perspectives. 

The different stakeholders described <strong>the</strong> Philippines as a source country, that is, a sending 

country <strong>of</strong> migrant health personnel ra<strong>the</strong>r than as a destination country, that is a receiving 

country. It is from this perspective that <strong>the</strong>y responded to <strong>the</strong> items in <strong>the</strong> WHO National 

Reporting Instrument. In this light, it was suggested that <strong>the</strong> WHO develop an additional 

instrument that would better capture <strong>the</strong> perspective existing in source and destination 

countries with regards to health personnel migration. 

The perspectives <strong>of</strong> <strong>the</strong> five stakeholders groups indicated <strong>the</strong> nuances <strong>of</strong> <strong>the</strong> Philippine 

experiences as a source or sending country for health personnel with respect to bilateral and 

multilateral agreements that have been forged between <strong>the</strong> Philippines and o<strong>the</strong>r countries. 

Philippine policies and programs are geared at <strong>the</strong> promotion and protection <strong>of</strong> <strong>the</strong> rights 

and welfare <strong>of</strong> Filipino migrant health personnel, including raising awareness through pre-‐ 

employment and pre-‐departure orientation seminars for migrants and through continuous 

orientation for and performance evaluation <strong>of</strong> recruitment agencies. The Philippines also 

established a re-‐integration center for returning Filipino migrants. 

While <strong>the</strong> Philippine is signatory to <strong>the</strong> ASEAN Mutual Recognition Arrangements (MRArs) 

for <strong>the</strong> health pr<strong>of</strong>essions <strong>of</strong> Dentistry, Medicine, and Nursing, <strong>the</strong>se have not been made 

operational as <strong>of</strong> yet. There are restrictions arising from <strong>the</strong> 1987 Philippine Constitution 

(which does not allow foreign workers to work in <strong>the</strong> country) and contradictions in <strong>the</strong> 

provisions <strong>of</strong> o<strong>the</strong>r laws and policies on receiving foreign health pr<strong>of</strong>essionals. For <strong>the</strong>se 

reasons, <strong>the</strong> Philippine is not yet a destination for foreign health pr<strong>of</strong>essionals. Foreign 

health pr<strong>of</strong>essionals found in <strong>the</strong> Philippines are trainees such as medical residents or under 

an exchange visitors program and under limited <strong>practice</strong> <strong>of</strong> pr<strong>of</strong>ession for <strong>the</strong> conduct <strong>of</strong> 

medical missions for delivery <strong>of</strong> health services in crisis or emergency situations, researchers 

and teachers. 

The responses and discussions around <strong>the</strong> WHO National Reporting Instrument and <strong>the</strong> 

Philippine Monitoring Worksheet surfaced many challenges for <strong>the</strong> Philippines as a source 

country. The supplementary worksheet and <strong>the</strong> multistakeholder process were pursued to 

document <strong>the</strong> gaps in <strong>the</strong> WHO instrument using a source country perspective. 

The Philippines endeavored to contribute its experience with regard to <strong>the</strong> participatory 

<strong>monitoring</strong> <strong>of</strong> <strong>the</strong> Code as a good <strong>practice</strong> in <strong>the</strong> <strong>global</strong> efforts to raise awareness <strong>of</strong> and 

xi

address ethical recruitment <strong>of</strong> health personnel. Much more than <strong>the</strong> contribution <strong>of</strong> a full 

and very detailed country report to <strong>the</strong> WHO, <strong>the</strong> process led by <strong>the</strong> DOH and DOLE, with 

<strong>the</strong> ILO and WHO proved to be a very efficient channel to raise <strong>the</strong> awareness <strong>of</strong> <strong>the</strong> 

importance <strong>of</strong> ethical recruitment <strong>of</strong> health personnel across a wide range <strong>of</strong> stakeholders. It 

created momentum to pursue activities on this matter and seek to continuously improve 

systems regarding <strong>the</strong> migration <strong>of</strong> health personnel. The process <strong>the</strong> country underwent in 

<strong>the</strong> past months will be captured into a “good <strong>practice</strong> sheet” which <strong>the</strong> Philippines is keen 

to share with <strong>the</strong> WHO and <strong>the</strong> ILO, member countries and o<strong>the</strong>r organizations that seek to 

promote ethical recruitment <strong>of</strong> health personnel. 

xii

MONITORING OF THE WHO GLOBAL CODE OF PRACTICE ON 

THE INTERNATIONAL RECRUITMENT OF HEALTH PERSONNEL 

THE PHILIPPINE MULTISTAKEHOLDER APPROACH 

INTRODUCTION 

Reaching a landmark decision on 21 May 2010 at <strong>the</strong> Sixty-‐third World Health Assembly 

(WHA), <strong>the</strong> 193 Member States <strong>of</strong> <strong>the</strong> World Health Organization (WHO) adopted <strong>the</strong> WHO 

Global Code <strong>of</strong> Practice on <strong>the</strong> International Recruitment <strong>of</strong> Health Personnel(The Code).This 

marks a historic milestone in <strong>the</strong> <strong>global</strong> efforts since 2004 to develop a <strong>code</strong> <strong>of</strong> <strong>practice</strong> that 

addresses health workforce migration, given <strong>the</strong> observed critical shortage in health 

personnel and weakened health systems experienced by some 57 source countries identified 

by WHO. The Code promotes voluntary principles and <strong>practice</strong>s for ethical recruitment <strong>of</strong> 

health personnel, considering <strong>the</strong> rights, obligations and expectations <strong>of</strong> source countries, 

destination countries and migrant health personnel. It intends to serve as a reference for 

Member States in establishing or improving <strong>the</strong> legal and institutional framework required 

for international recruitment <strong>of</strong> health personnel and in <strong>the</strong> formulation <strong>of</strong> bilateral 

agreements and o<strong>the</strong>r international legal instruments. The WHA recommends that <strong>the</strong> Code 

be a core component <strong>of</strong> bilateral agreements, and national, regional and <strong>global</strong> responses to 

health personnel migration and health systems streng<strong>the</strong>ning, particularly in developing 

countries, and countries with economies in transition. The Code is expected to facilitate and 

promote international discussion as it poses as a guide for Member States to work with 

various stakeholders (such as health personnel, recruiters, employers, health pr<strong>of</strong>essional 

organizations, and o<strong>the</strong>r organizations). 

Among <strong>the</strong> guiding principles, <strong>the</strong> Code asserts that <strong>the</strong> “health <strong>of</strong> all is fundamental to <strong>the</strong> 

attainment <strong>of</strong> peace and security,” for which individuals and states should render fullest 

cooperation. Member states, recruiters, employers, and stakeholders are enjoined to 

observe <strong>the</strong> voluntary international principles on ethical recruitment <strong>of</strong> health personnel to 

mitigate negative effects and maximize positive effects on health systems worldwide, for 

both source and destination countries, and upon <strong>the</strong> health personnel <strong>the</strong>mselves. 

The Code provides for <strong>the</strong> designation <strong>of</strong> a national authority responsible for 

implementation (Article 7.3). Fur<strong>the</strong>rmore, <strong>the</strong> Code enjoins <strong>the</strong> participation <strong>of</strong> 

international development organizations in rendering assistance to member countries. 

It was planned that <strong>the</strong> implementation <strong>of</strong> <strong>the</strong> Code would be monitored for <strong>the</strong> first time in 

2012 and <strong>the</strong>reafter every three years. The first round <strong>of</strong> national and <strong>global</strong> data will be 

used for <strong>the</strong> WHO Director-‐General’s report to <strong>the</strong> 2013 WHA to assess effectiveness and 

determine necessary improvements to <strong>the</strong> Code’s implementation and <strong>monitoring</strong>. 

Responding to <strong>the</strong> call for <strong>the</strong> national <strong>monitoring</strong> <strong>of</strong> <strong>the</strong> Code, <strong>the</strong> Department <strong>of</strong> Health-‐ 

Health Human Resources for Health Bureau (DOH-‐HHRDB) initiated multistakeholder 

consultations with <strong>the</strong> Department <strong>of</strong> Labor and Employment (DOLE) and in partnership with 

1

<strong>the</strong> International Labour Organization (ILO Manila) and <strong>the</strong> World Health Organization 

(Philippines) and <strong>the</strong> Western Pacific Regional Office (WPRO), and participation <strong>of</strong> local 

stakeholder organizations. 

The ILO is <strong>the</strong> UN specialized agency which seeks <strong>the</strong> promotion <strong>of</strong> social justice and 

internationally recognized human and labour rights. It operates through social dialogue 

between governments, trade union and employers’ organizations. The ILO is <strong>the</strong> only United 

Nations agency with a constitutional mandate to protect migrant workers. In 2011, <strong>the</strong> ILO 

received funding from <strong>the</strong> European Union to implement an initiative called “Decent Work 

Across Borders (DWAB): A Pilot project for Migrant Health Pr<strong>of</strong>essionals and Skilled 

Workers”. The 3-‐year project seeks to better understand schemes in line with circular 

migration <strong>of</strong> skilled and health pr<strong>of</strong>essionals in three member countries, namely: India, 

Philippines and Vietnam. Considering <strong>the</strong> relevance <strong>of</strong> <strong>the</strong>ir endeavors to international 

health workforce migration, <strong>the</strong> ILO, and its government partner DOLE were instrumental in 

bringing <strong>the</strong>ir tripartite constituents to collaborate with <strong>the</strong> DOH in <strong>monitoring</strong> <strong>the</strong> WHO 

Global Code <strong>of</strong> Practice. 

As an initial step to <strong>monitoring</strong> <strong>the</strong> Code’s implementation, <strong>the</strong> Philippines took a unique 

approach by engaging crucial partners and stakeholders in <strong>the</strong> process <strong>of</strong> clarifying <strong>the</strong> 

elements <strong>of</strong> <strong>the</strong> <strong>monitoring</strong> instrument, and sharing perspectives across organizations and 

stakeholders group to help shape <strong>the</strong> national scenario on <strong>the</strong> Code. To guide <strong>the</strong> process, 

<strong>the</strong> DOH operationally defined <strong>the</strong> migrant health personnel as “any health worker <strong>who</strong> has 

last held employment in a foreign country, or <strong>who</strong>se qualification for employment was 

obtained in a foreign country.” The Philippine approach engaged <strong>the</strong> government, 

employers, recruitment agencies, trade unions, pr<strong>of</strong>essional organizations in a 

multistakeholder consultative process consistent with <strong>the</strong> <strong>practice</strong>s <strong>of</strong> <strong>the</strong> collaborating 

entities—DOH and DOLE, ILO and WHO in <strong>the</strong> Philippines. 

This report is a supplement to <strong>the</strong> on-‐line submission <strong>of</strong> <strong>the</strong> Philippine National Reporting 

Instrument (submitted electronically on 31 May 2012). It aims to present <strong>the</strong> wider 

perspectives <strong>of</strong> different stakeholders concerned with <strong>the</strong> ethical recruitment <strong>of</strong> health 

personnel. 

The report is structured to respect <strong>the</strong> flow <strong>of</strong> topics and questions as <strong>of</strong>fered in <strong>the</strong> 

National Reporting Instrument. Fur<strong>the</strong>r, this report also included discussions on <strong>the</strong> aspect 

<strong>of</strong> <strong>the</strong> Code that were not included in <strong>the</strong> National Reporting Instrument as those were 

deemed important by <strong>the</strong> organizers. As a result, additional questions were added to<strong>the</strong> 

Philippine worksheet, which allowed <strong>the</strong> stakeholders to possibly assess <strong>the</strong> entirety <strong>of</strong> <strong>the</strong> 

Code’s implementation. The report concludes with <strong>the</strong> highlights <strong>of</strong> <strong>the</strong> discussion. Annex A 

presents <strong>the</strong> Philippines’ stakeholders’ suggestions in view <strong>of</strong> a revised national reporting 

instrument which would take in <strong>the</strong> perspective <strong>of</strong> source countries. 

2

THE PHILIPPINE APPROACH 

Through <strong>the</strong> ILO DWAB project, and with agreement <strong>of</strong> <strong>the</strong> DOH as <strong>the</strong> lead agency for 

<strong>monitoring</strong> <strong>of</strong> <strong>the</strong> Code , a participatory, multistakeholder process was designed in order to 

bring around this important issues a wide range <strong>of</strong> stakeholders and opinions(Box 1). 

Box 1. The Philippine Approach: Steps in Monitoring <strong>the</strong> Implementation <strong>of</strong> <strong>the</strong> WHO 

Global Code <strong>of</strong> Practice on International Recruitment <strong>of</strong> Health Personnel (April to 

May 2012) 

1. ILO’s initiative in hosting <strong>the</strong> 29 March 2012 meeting <strong>of</strong> four partner organizations -‐DOH, 

DOLE, ILO Manila, WHO Philippines and WPRO. 

2. Development <strong>of</strong> <strong>the</strong> Philippine framework and approach (Figure 1). 

3. Development <strong>of</strong> <strong>the</strong> Philippine <strong>monitoring</strong> worksheet for multistakeholder (inclusive <strong>of</strong> <strong>the</strong> 

WHO National Reporting Instrument, explanatory notes on <strong>the</strong> WHO Code and WHO User’s 

Guide on <strong>the</strong> Code, and worksheet sections for supplementary data and clarification from 

stakeholder respondents (Annex B); and stipulation <strong>of</strong> <strong>the</strong> operational definition <strong>of</strong> migrant 

health personnel (DOH definition). 

4. Planning and organizing for <strong>the</strong> <strong>monitoring</strong> process by ILO and DOH, including logistics for 

orientation sessions on <strong>the</strong> Code, data collection, data processing, and multistakeholder’s 

consultative meetings. 

5. Multiple meetings for stakeholders’ orientation on <strong>the</strong> WHO Code National Reporting 

Instrument and <strong>the</strong> Philippine worksheet; and, for stakeholders’ commitment to participate 

in <strong>the</strong> data collection and consultations. 

6. Multistakeholders’ submission <strong>of</strong> completed worksheet. 

7. Consolidation <strong>of</strong> accomplished worksheets. 

8. 1st Multistakeholder Meeting was conducted on <strong>the</strong> basis <strong>of</strong> <strong>the</strong> consolidated data and draft 

country report. 

9. 2nd Multistakeholder Meeting was conducted for validation <strong>of</strong> <strong>the</strong> draft country report. 

10. Online submission <strong>of</strong> WHO National Reporting Instrument on 31 May 2012. 

11. Submission <strong>of</strong> full report on <strong>the</strong> Monitoring <strong>of</strong> <strong>the</strong> WHO Global Code <strong>of</strong> Practice on <strong>the</strong> 

International Recruitment <strong>of</strong> Health Personnel: The Philippine Multistakeholder Approach in 

June 2012. 

12. Preparation <strong>of</strong> a good <strong>practice</strong> sheet documenting <strong>the</strong> entire participatory process in line 

with <strong>the</strong> <strong>monitoring</strong> <strong>of</strong> <strong>the</strong> Code and submission to <strong>the</strong> WHO and ILO in July 2012. 

The ILO DWAB hosted <strong>the</strong> initial meeting on <strong>the</strong> 29 th <strong>of</strong> March 2012, which was attended by 

representatives <strong>of</strong> <strong>the</strong> four partner organizations—<strong>the</strong> DOH, DOLE, ILO and WHO Philippines 

and WPRO. In this meeting, partners discussed <strong>the</strong> Code and its National Reporting 

Instrument, and mapped <strong>the</strong> terms <strong>of</strong> <strong>the</strong>ir collaborative engagement to assist <strong>the</strong> DOH in 

<strong>monitoring</strong> <strong>the</strong> Code. It was agreed <strong>the</strong>n that much value would be added to <strong>the</strong> report by 

inviting a wide range <strong>of</strong> stakeholders to <strong>the</strong> table. It was also agreed that, such an open and 

participative process would raise awareness and interest <strong>of</strong> <strong>the</strong> issue <strong>of</strong> ethical recruitment 

and <strong>the</strong> Code itself. The ILO <strong>of</strong>fered its experience in dealing with social partners to <strong>the</strong> 

benefit <strong>of</strong> <strong>the</strong> <strong>monitoring</strong> <strong>of</strong> <strong>the</strong> Code. As <strong>the</strong> ILO main governmental partner and agency 

3

esponsible to manage international migration in <strong>the</strong> Philippine, <strong>the</strong> DOLE was also keen to 

take part in <strong>the</strong> process. 

The DOH as <strong>the</strong> national authority responsible for <strong>the</strong> <strong>monitoring</strong> <strong>of</strong> <strong>the</strong> Code dynamically 

took <strong>the</strong> lead in <strong>the</strong> process. The WHO Philippines and WPRO’s support was instrumental in 

linking <strong>the</strong> Philippines efforts to <strong>the</strong> WHO in Geneva. (Box 2). 

Box 2. DOH-‐HHRDB as Focal Unit for WHO Global Code <strong>of</strong> Practice on <strong>the</strong> International 

Recruitment <strong>of</strong> Health Personnel 

1. HHRDB is <strong>the</strong> designated focal unit <strong>of</strong> <strong>the</strong> DOH as <strong>the</strong> national responsible authority for <strong>the</strong> 

WHO Code <strong>monitoring</strong>. 

2. HHRDB is <strong>the</strong> Secretariat <strong>of</strong> <strong>the</strong> Human Resources for Health (HRH) Network Philippines, a 

multi-‐sectoral organization <strong>of</strong> government agencies and non-‐government organizations that 

have HRH-‐related mandates. 1 

The ILO is implementing <strong>the</strong> “DWAB project: A Pilot project for Migrant Health Pr<strong>of</strong>essionals 

and Skilled Workers” in <strong>the</strong> Philippines, as well as in India and Vietnam, for which <strong>the</strong> WHO 

Global Code <strong>of</strong> Practice is relevant. (Box 3). 

Box 3. ILO DWAB: A Pilot Project for Migrant Health Pr<strong>of</strong>essionals and Skilled 

Workers(ILO Manila) 

The International Labour Organization (ILO) is <strong>the</strong> United Nations’ international organization 

responsible for drawing up and overseeing international labour standards. It is <strong>the</strong> only 

'tripartite' United Nations agency that brings toge<strong>the</strong>r representatives <strong>of</strong> governments, 

employers and workers to jointly shape policies and programs promoting Decent Work for 

All. 

The ILO has a constitutional mandate to protect migrant workers, and this mandate has been re-‐ 

affirmed by <strong>the</strong> 1944 Declaration <strong>of</strong> Philadelphia and <strong>the</strong> 1998 ILO Declaration on Fundamental 

Principles and Rights at Work. It has been dealing with labour migration issues since its inception in 

1919. It has pioneered international Conventions to guide migration policy and protection <strong>of</strong> migrant 

workers. All major sectors <strong>of</strong> <strong>the</strong> ILO -‐ standards, employment, social protection and social dialogue -‐ 

are relevant to labour migration within its overarching framework <strong>of</strong> Decent Work for All. ILO adopts 

a rights-‐based approach to labour migration and promotes tripartite participation in migration policy. 

In 2006, <strong>the</strong> ILO adopted its Multilateral Framework on International Migration. Fur<strong>the</strong>r, <strong>the</strong> ILO has 

adopted 2 conventions (and associated recommendations) focusing specifically on migration issues. 

1. Convention No 97 – Migration for Employment Convention (1949) 

2. Recommendation No 86 – Migration for Employment Recommendation (1949) 

3. Convention No 143 – Migrant Workers Convention (1975) 

4. Recommendation No 151 – Migrant Workers Recommendation (1975) 

The Philippines joined <strong>the</strong> ILO in 1948. As <strong>of</strong> January 2012, <strong>the</strong> Philippines had ratified 33 

conventions, including <strong>the</strong> 8 fundamental conventions on freedom <strong>of</strong> association and 

collective bargaining (C87, C98), forced labour (C29, C105), discrimination (C100, C111) and 

child labour (C138, C182) Fur<strong>the</strong>r, <strong>the</strong> Philippines has ratified <strong>the</strong> 2 migrant specific 

conventions (C97, C143). 

1 http://dev1.doh.gov.ph/node/1069 

4

The ILO Decent Work Across Borders (DWAB) project: A Pilot project for Migrant Health Pr<strong>of</strong>essionals 

and Skilled Workers, a European Union funded project, seeks to better understand schemes in line 

with circular migration <strong>of</strong> health pr<strong>of</strong>essionals. This will be done by engaging governments, trade 

unions, and employers organizations around <strong>the</strong> 3 main objectives: 

1. To streng<strong>the</strong>n mechanisms <strong>of</strong> policy dialogue among stakeholders 

2. To streng<strong>the</strong>n employment services for healthcare pr<strong>of</strong>essionals and skilled workers 

3. To enhance labour market information system with regards to <strong>the</strong> migration <strong>of</strong> healthcare 

pr<strong>of</strong>essionals and skilled workers 

Through this project, <strong>the</strong> ILO seeks to foster an approach to migration that benefits <strong>the</strong> migrant 

workers, <strong>the</strong> source and destination countries within a rights-‐based framework for labour migration 

management. The project focuses its activities on three Asian countries with significant outflows <strong>of</strong> 

health pr<strong>of</strong>essionals and skilled workers for foreign employment, namely: <strong>the</strong> Philippines, India, and 

Viet Nam. 

Under <strong>the</strong> DWAB project, <strong>the</strong> ILO is looking at ethical recruitment <strong>practice</strong>s <strong>of</strong> private recruitment 

agencies to include and incorporate <strong>the</strong> guidelines on <strong>the</strong> ethical recruitment <strong>of</strong> health care 

pr<strong>of</strong>essionals and skilled workers adopted by <strong>the</strong> World Health Organization and provision <strong>of</strong> <strong>the</strong> ILO 

Convention 181 on Private Employment Agencies as well as <strong>the</strong> ILO Multilateral Framework on labour 

migration. 

The four partners developed <strong>the</strong> Philippine framework that underlies <strong>the</strong> unique Philippine 

approach to <strong>the</strong> <strong>monitoring</strong> process. The Philippine approach (Figure 1) expresses <strong>the</strong> 

dynamics <strong>of</strong> institutional collaboration on ethical international recruitment to sustain <strong>the</strong> 

local health workforce, to streng<strong>the</strong>n local health systems, and to ensure decent work across 

borders among health pr<strong>of</strong>essionals. The DOH and <strong>the</strong> DOLE are at <strong>the</strong> forefront as <strong>the</strong> 

responsible government agencies with <strong>the</strong> World Health Organization and <strong>the</strong> International 

Labour Organization as members <strong>of</strong> <strong>the</strong> United Nations system in charge <strong>of</strong> international 

agreements relevant to health personnel migration. Though <strong>the</strong>se organizations have 

different core orientations-‐-‐ health and labour, <strong>the</strong>ir collaboration is anchored on <strong>the</strong> 

common goal <strong>of</strong> ensuring ethical recruitment <strong>of</strong> health personnel. 

Considering <strong>the</strong> WHO National Reporting Instrument, and issues <strong>of</strong> its relevance and 

appropriateness to <strong>the</strong> unique national situation-‐-‐that <strong>of</strong> an exclusively source country-‐-‐<strong>the</strong> 

partners ventured into <strong>the</strong> preparation <strong>of</strong> a specific Philippine <strong>monitoring</strong> worksheet for 

various stakeholders to provide supplementary data and clarificatory statements. This 

Philippine <strong>monitoring</strong> worksheet for stakeholders to complete includes <strong>the</strong> WHO National 

Reporting Instrument, linked to <strong>the</strong> specific articles <strong>of</strong> <strong>the</strong> Code, and 2 additional columns 

for stakeholders to add supplementary information, and clarify <strong>the</strong>ir responses. 

The term 'multistakeholders' refers to <strong>the</strong> participating organizations that were grouped into 

five stakeholder groups, namely: 

• government institutions with migration related functions 

• hospitals as employers <strong>of</strong> health personnel 

• health pr<strong>of</strong>essional associations 

• trade unions 

• recruitment agencies 

5

Figure 1. Philippine Approach to Monitoring <strong>the</strong> WHO Global Code on 

International Recruitment <strong>of</strong> Health Personnel 

Promotion <strong>of</strong> 

Health 

Sustain Health 

Workforce to 

streng<strong>the</strong>n health 

systems 

Ethical 

Recruitment 

Ethical 

Recruitment 

Stakeholders: 

Governments, Employers, Trade Unions, Recruitment agencies, Pr<strong>of</strong>essional Organizations 

Promotion <strong>of</strong> 

Decent Work 

Decent Work 

Across Borders 

for health 

pr<strong>of</strong>essionals 

With <strong>the</strong> logistical arrangements <strong>of</strong> <strong>the</strong> DOH and ILO, <strong>the</strong> Philippines convened briefing 

meetings for <strong>the</strong> different stakeholders to discuss <strong>the</strong> WHO Code, to orient <strong>the</strong>m on <strong>the</strong> 

completion <strong>of</strong> <strong>the</strong> WHO National Reporting Instrument and Philippine worksheet, and obtain 

<strong>the</strong>ir commitment to participate in <strong>the</strong> <strong>monitoring</strong> process. 

The process continued with <strong>the</strong> collection <strong>of</strong> completed worksheets from <strong>the</strong> stakeholders 

and <strong>the</strong> consolidation, by <strong>the</strong> consultant, <strong>of</strong> responses per stakeholder group. 

The 1 st Multistakeholders Participatory Assessment Workshop was convened on 17 May 

2012. Each group <strong>of</strong> stakeholder ga<strong>the</strong>red to discuss and clarify <strong>the</strong> consolidated data in 

separate and parallel sessions. The plenary session that followed allowed cross-‐sectoral 

clarification <strong>of</strong> responses. 

A 2 nd Multistakeholders Participatory Assessment Workshop conducted on 30 May 2012 

focused on <strong>the</strong> draft country report presenting <strong>the</strong> Philippine situation and <strong>the</strong> stakeholder 

perspectives’ per item in <strong>the</strong> Code. 

The <strong>monitoring</strong> experience proved to be worthwhile in eliciting <strong>the</strong> issues and concerns <strong>of</strong> 

<strong>the</strong> Philippines with respect to <strong>the</strong> status <strong>of</strong> implementation <strong>of</strong> <strong>the</strong> Code in <strong>the</strong> country. The 

Philippine approach optimized <strong>the</strong> use <strong>of</strong> <strong>the</strong> WHO instrument as stimulus for cross-‐sectoral 

and multi-‐sectoral discussion on issues relevant to <strong>the</strong> Philippine’s implementation <strong>of</strong> <strong>the</strong> 

Code. 

The WHO National Reporting Instrument could be improved to appropriately reflect 

conditions in both source and destination countries <strong>of</strong> migrant health personnel. On <strong>the</strong> 

o<strong>the</strong>r hand, <strong>the</strong> data and discussions surfaced some challenges for <strong>the</strong> Philippines to better 

implement <strong>the</strong> provisions contained in <strong>the</strong> Code. 

6

MULTISTAKEHOLDER PERSPECTIVES ON MONITORING THE CODE 

The five groups <strong>of</strong> stakeholders (government, hospitals; pr<strong>of</strong>essional associations; 

recruitment agencies; and trade unions) used a mix <strong>of</strong> methods, particularly key informant 

interviews, document review (policy instruments cited), and observation through <strong>the</strong>ir 

various engagements. 

This section presents <strong>the</strong> responses <strong>of</strong> <strong>the</strong> stakeholders and emerging general patterns with 

regards to <strong>the</strong> implementation <strong>of</strong> <strong>the</strong> WHO Code in <strong>the</strong> Philippines. The information is 

organized in such a manner that it follows <strong>the</strong> series <strong>of</strong> questions included in <strong>the</strong> WHO 

National Reporting instrument. 

1. Legal rights and responsibilities <strong>of</strong> equally qualified and experienced 

migrant health personnel and domestically trained health workforce in 

terms <strong>of</strong> employment and conditions <strong>of</strong> work. 

In responding to <strong>the</strong> WHO reporting instrument, <strong>the</strong> Philippines defined <strong>the</strong> migrant health 

personnel as one <strong>who</strong> has last held employment in a foreign country or <strong>who</strong>se qualification 

for employment was obtained in a foreign country. The Philippines is considered as a source 

country <strong>of</strong> migrant health personnel. It is not considered yet as a destination country for 

migrant health personnel. Hence, <strong>the</strong> matter <strong>of</strong> “equality in <strong>the</strong> legal rights and 

responsibilities <strong>of</strong> qualified and experienced migrant health personnel and domestically 

trained health workforce in terms <strong>of</strong> employment conditions <strong>of</strong> work”, is not applicable to 

<strong>the</strong> current Philippine situation. 

The government agencies among <strong>the</strong> members <strong>of</strong> HRH Network Philippines clarified <strong>the</strong> 

Philippine situation regarding <strong>the</strong> legal rights and responsibilities <strong>of</strong> equally qualified and 

experienced migrant health personnel vis-‐a-‐vis Filipino health pr<strong>of</strong>essionals in <strong>the</strong> 

Philippines. Though <strong>the</strong> Philippines is signatory to <strong>the</strong> ASEAN Mutual Recognition 

Arrangements (MRArs) on Medical Practitioners (2009), on Dental Practitioners (2009), and 

on Nursing Services (2006), such regional arrangements have not been implemented to 

allow <strong>the</strong> entry into <strong>the</strong> Philippines <strong>of</strong> foreign migrant health workers. 

The 1987 Philippine Constitution provides for <strong>the</strong> “sustained development <strong>of</strong> a reservoir <strong>of</strong> 

national talents...”, <strong>who</strong>se <strong>practice</strong> in <strong>the</strong> Philippines has been limited to Filipino citizens in 

22 health pr<strong>of</strong>essions and sub pr<strong>of</strong>essions, including medicine, allied pr<strong>of</strong>essions, medical 

technology, midwifery, nursing, nutrition and dietetics, optometry, pharmacy, physical and 

occupational <strong>the</strong>rapy, radiologic and x-‐ray technology, and veterinary medicine (1987 

Philippine Constitution Article XII Sections 10 and 14; Executive Order No. 584). 

The access <strong>of</strong> foreign workers to <strong>the</strong> labour market is covered by <strong>the</strong> Labor Code as 

amended (Article 40 referring to <strong>the</strong> employment permit <strong>of</strong>non-‐resident aliens). 2 The health 

migrant’s right to be a member <strong>of</strong> labor organizations varies among countries; some allow 

membership as in <strong>the</strong> case <strong>of</strong> <strong>the</strong> United States as a receiving country, in some cases 

2 Article 40 <strong>of</strong> <strong>the</strong> Labor Code – Employment permit <strong>of</strong> non-‐resident aliens. 

http://www.chanrobles.com/legal4labor1.htm 

7

membership is restricted such as in <strong>the</strong> Philippines (RA 6715 Labor Code as Amended Article 

269). 3 

There are observable contradictions in Philippine laws and policies pertinent to allowing 

foreign health pr<strong>of</strong>essionals to <strong>practice</strong> in <strong>the</strong> country. Given <strong>the</strong> DOH definition <strong>of</strong> a health 

worker, <strong>the</strong>re are yet no foreign health pr<strong>of</strong>essionals practicing in <strong>the</strong> country. Currently, <strong>the</strong> 

Philippines is not a destination for foreign health pr<strong>of</strong>essionals, though it is a source country 

for health pr<strong>of</strong>essionals. 

The participating hospitals noted <strong>the</strong> involvement <strong>of</strong> foreign health workers as 

residents/trainees in hospitals;however, such medical residency does not make <strong>the</strong>m health 

workers, in <strong>the</strong> context <strong>of</strong> <strong>the</strong> DOH definition <strong>of</strong> a health worker. 

The health pr<strong>of</strong>essional associations observed <strong>the</strong> presence <strong>of</strong> foreign health pr<strong>of</strong>essionals 

in <strong>the</strong> Philippines, but only in <strong>the</strong> context <strong>of</strong> taking up medical residency,engaging in medical 

missions, and generally for training, research, and academic engagement, for a temporary 

duration, compliant with national policy restrictions. However, <strong>the</strong>re are provisions in <strong>the</strong> 

Pr<strong>of</strong>essional Regulation Commission (PRC) Modernization Act, and o<strong>the</strong>r specific laws on <strong>the</strong> 

pr<strong>of</strong>essions that need review and implementation given <strong>the</strong> WHO Code implementation. For 

intance, by virtue <strong>of</strong> Registration by Reciprocity, “foreign educated physical <strong>the</strong>rapists 

allowed to <strong>practice</strong> in <strong>the</strong> country are covered by <strong>the</strong> same law as locally educated 

pr<strong>of</strong>essionals given that requirements for reciprocity are complied with (RA 5680 Section 21 

Registration by Reciprocity). In <strong>the</strong> Nursing Act <strong>of</strong> 2002, foreigners can work in <strong>the</strong> 

Philippines given an agreement <strong>of</strong> reciprocity with <strong>the</strong> sending state.Currently, <strong>the</strong>re are no 

foreign health pr<strong>of</strong>essionals in <strong>the</strong> Philippines, given <strong>the</strong> DOH definition <strong>of</strong> a migrant health 

personnel. 

In <strong>the</strong> perspective <strong>of</strong> recruitment agencies, this particular question in <strong>the</strong> WHO reporting 

instrument does not apply to <strong>the</strong> Philippines as it is considered to be a sending country. 

Based on <strong>the</strong>ir experience, destination/receiving countries vary in policies and <strong>practice</strong>s; but 

in <strong>the</strong> case <strong>of</strong> <strong>the</strong> United States <strong>of</strong> America, Filipinos and o<strong>the</strong>r foreign migrants may find 

protection in US labor laws. 

The trade unions’ group cited <strong>the</strong> Philippine legislation, Republic Act(RA) 8042 amended by 

RA 10022 (Migrant Workers Act)Section 2 (a) (b), for <strong>the</strong> Philippineto protect <strong>the</strong> dignity <strong>of</strong> 

Filipino migrant workers, afford full protection to labor, local and overseas. With regard 

t<strong>of</strong>oreign health pr<strong>of</strong>essionals present in <strong>the</strong> Philippines under <strong>the</strong> status <strong>of</strong> trainees, <strong>the</strong>re 

are observations that somereceive even better treatment than <strong>the</strong>ir Filipino counterparts. 

2. Legal mechanisms to ensure that migrant health personnel enjoy <strong>the</strong> 

same legal rights and responsibilities as <strong>the</strong> domestically trained health 

workforce 

From <strong>the</strong> perspective <strong>of</strong> <strong>the</strong> HRH Network Philippines, certain Philippine government 

agencies, such as <strong>the</strong> Philippine Overseas Employment Administration (POEA), <strong>the</strong> DOLE-‐ 

3 Article 269 <strong>of</strong> <strong>the</strong> Labor Code – Prohibition against aliens; 

exceptions.http://www.chanrobles.com/legal4labor5.htm 

8

Philippine Overseas Labor Offices (POLOs), <strong>the</strong> Overseas Workers Welfare Administration 

(OWWA), and <strong>the</strong> PRC, respectively oversee procedures for Filipino migrant health workers 

and hiring/recruitment agencies, such as in securing appropriate employment permit, visa, 

and special permit to <strong>practice</strong> pr<strong>of</strong>ession. O<strong>the</strong>r mechanismsare bilateral agreements with 

specific stipulations with regard to migrant health pr<strong>of</strong>essionals, such as <strong>the</strong> Philippine-‐Japan 

Economic PartnershipAgreement (PJEPA), ASEAN-‐Australia-‐New Zealand Free Trade 

Agreement (AANZFTA), and <strong>the</strong> Recruitment Agreement between <strong>the</strong> Government <strong>of</strong> <strong>the</strong> 

Philippines-‐United Kingdom <strong>of</strong> Great Britain and Nor<strong>the</strong>rn Ireland. However, despite 

government agreements on initial requirements necessary to <strong>practice</strong> in a given country, 

<strong>the</strong>re have been instances when Filipino migrant health pr<strong>of</strong>essionals have had to comply 

with additional requirements that are not necessarily initially stipulated in <strong>the</strong>ir contracts. 

In Philippine hospitals, <strong>the</strong>re are foreign health pr<strong>of</strong>essionals that come to <strong>the</strong> Philippines to 

be residents, trainees, administrators, or researchers, teachers or practioners in <strong>the</strong> context 

<strong>of</strong> medical missions.These foreign health pr<strong>of</strong>essionals are compliant with <strong>the</strong> rules <strong>of</strong> <strong>the</strong> 

PRC, <strong>the</strong> Civil Service Commission (CSC), and <strong>the</strong> Bureau <strong>of</strong> Immigration (BI). 

O<strong>the</strong>r legal mechanism mentioned by <strong>the</strong> health pr<strong>of</strong>essional associations emphasized <strong>the</strong> 

provisions <strong>of</strong>various Memorandum <strong>of</strong> Agreement (MoA) and <strong>the</strong> regulations <strong>of</strong> <strong>the</strong> DOH and 

PRC that serve asguides for <strong>the</strong> conduct <strong>of</strong> medical missions in <strong>the</strong> country by foreign health 

pr<strong>of</strong>essionals. In <strong>the</strong>ir view, since <strong>the</strong> Code’s provisions have yet to befully implemented in 

<strong>the</strong> Philippines,mechanisms needed to be in place cannot still be appreciated. 

Considering <strong>the</strong> Philippines as a sending country <strong>of</strong> health pr<strong>of</strong>essionals, this WHO 

<strong>monitoring</strong> item is not applicable according to recruitment agencies. However, considering 

varying national situations, recruiters referred to labor laws in receiving countries as legal 

mechanisms that promote <strong>the</strong> protection <strong>of</strong> Filipino migrants, such as in <strong>the</strong> United States <strong>of</strong> 

America. The POEA provides legal mechanisms and attempt to adopt prevailing wage rates 

in receiving countries to ensure protection <strong>of</strong> Filipino migrant workers. 

Trade unions represented in <strong>the</strong> workshop cited RA 8042 as amended by RA 10022(Section 

4), “whereby <strong>the</strong> State shall deploy OFWs (Overseas Filipino Workers) only in countries 

where <strong>the</strong> rights <strong>of</strong> Filipno migrant workers are protected.” Most Filipino health personnel 

migrate due to limited options for local employment. Their local education and training are 

not directly accredited in receiving countries in order to qualify for work abroad. Filipino 

migrant health workers are reportedly discriminated because <strong>the</strong>y do not receive <strong>the</strong> same 

remuneration (as nationals <strong>of</strong> o<strong>the</strong>r countries) and encounter difficulty in getting promoted 

in <strong>the</strong> receiving country. For instance, Filipino pharmacists need to have a post-‐graduate 

degree to be hired as pharmacists in <strong>the</strong> Middle East; o<strong>the</strong>rwise, <strong>the</strong>y are hired as pharmacy 

assistants. Trade unions raised <strong>the</strong> need to streng<strong>the</strong>n <strong>the</strong> <strong>monitoring</strong> <strong>of</strong> Pre-‐Departure 

Orientation Seminars (PDOS) by <strong>the</strong> OWWA, and Pre-‐Employment Orientation Seminars 

(PEOS) by <strong>the</strong> POEA, aimed at helping workers understand <strong>the</strong>ir rights and privileges in 

receiving countries. 

3. Evidence <strong>of</strong> legal mechanisms 

9

Identified by <strong>the</strong> government agencies in <strong>the</strong> HRH Network Philippines, <strong>the</strong> legal 

mechanisms on employment and conditions for local health workers that are relevant to 

foreign migrant health workers are <strong>the</strong> following: (1) PRC regulations; (2) Labor Code -‐ Book 

3 (Conditions <strong>of</strong> Employment in <strong>the</strong> Philippines);(3) DOLE Department Order No. 97-‐09 

(Revised Rules for <strong>the</strong> Issuance <strong>of</strong> Employment Permits to Foreign Nationals; <strong>the</strong> 

implementing guideline for Article 40 <strong>of</strong> <strong>the</strong> Labor Code on <strong>the</strong> issuance <strong>of</strong> employment 

permits;and, (4) DOLE Department Order No. 120-‐12 (Amending Certain Provisions <strong>of</strong> 

Department Order No. 97-‐09 Entitled Revised Rules for <strong>the</strong> Issuance <strong>of</strong> Employment Permits 

to Foreign Nationals). 

As legal mechanisms, <strong>the</strong> hospitals are guided by <strong>the</strong> Civil Services Commission 

(CSC), <strong>the</strong> <strong>practice</strong> laws specific to <strong>the</strong> health pr<strong>of</strong>essions, <strong>the</strong> PRC regulations, and <strong>the</strong> 

Bureau <strong>of</strong> Immigation (BI) requirements. 

Referring to Philippine legal mechanisms, <strong>the</strong> recruitment agencies cited <strong>the</strong> Migrant 

Workers Act (RA 8042 as amended by RA10022) implemented by POEA. And taking <strong>the</strong> view 

<strong>of</strong> <strong>the</strong> USA as <strong>the</strong> receiving country <strong>of</strong> Filipino migrant health workers, <strong>the</strong> recruitment 

agencies noted <strong>the</strong> following national laws: USA Immigration and Nationality Act <strong>of</strong> 1952 

(Sections 101(a)(15)(H)(i)(b) and (b1); 212(n) and (t), and 214(g), as amended (8 USC 

§1101(a)(15)(H)(i)(b) and (b1), 1182(n) and (t), 1184(g); 20 CFR Part 655 Subparts H and I); 

also, <strong>the</strong> William Wilberforces Trafficking Victims Protection. 

According to <strong>the</strong> trade unions, legal mechanisms are embodied in <strong>the</strong> Migrant Workers Act 

(RA 8042 as amended by RA 10022), in <strong>the</strong> PJEPA bilateral agreement and ASEAN MRArs and 

o<strong>the</strong>r similar government’s agreements. Despite legal mechanisms, procedures have not 

always been properly followed as shown in certain cases. The trade unions group 

emphasized <strong>the</strong> need for <strong>the</strong> WHO National ReportingInstrument to differentiate <strong>the</strong> 

question on legal mechanisms for sending and receiving countries. 

4. Bilateral, regional, multilateral agreements or arrangements regarding 

<strong>the</strong> international recruitment <strong>of</strong> health personnel 

Philippine bilateral, regional, and multilateral agreements and arrangements relevant to <strong>the</strong> 

international recruitment <strong>of</strong> health personnel, identified by <strong>the</strong> government agencies in <strong>the</strong> 

HRH Network Philippines, include <strong>the</strong> following: (1) ASEAN MRArs respectively for Dentistry, 

Medicine, and Nursing services;(2) Recruitment Agreement between <strong>the</strong> Government <strong>of</strong> <strong>the</strong> 

Philippines-‐United Kingdom <strong>of</strong> Great Britain and Nor<strong>the</strong>rn Ireland; (3) PJEPA; (4) 

AANZFTA;and, (4) Medical Association <strong>of</strong> Sou<strong>the</strong>ast Asian Nations (MASEAN). Compliance by 

countries cannot determined due to <strong>the</strong> lack <strong>of</strong> a <strong>monitoring</strong> system. 

In hospitals, <strong>the</strong>re are few twinning arrangements and exchange <strong>of</strong> trainees between <strong>the</strong> 

Philippines and a foreign institution, usually in <strong>the</strong> form <strong>of</strong> Memoranda <strong>of</strong> Agreement. 

Pr<strong>of</strong>essional associations mentioned <strong>the</strong> ASEAN MRArs and <strong>the</strong> PJEPA as evidence <strong>of</strong> existing 

legal mechanisms in <strong>the</strong> country 

For recruitment agencies, <strong>the</strong> POEA and <strong>the</strong> Department <strong>of</strong> Foreign Affairs (DFA)were seen 

as <strong>the</strong> appropriate agencies that can provide <strong>the</strong> detailed information on <strong>the</strong> bilateral 

10

agreements. On <strong>the</strong>ir part, <strong>the</strong>y stand to support <strong>the</strong> government and to ensure proper 

implementation <strong>of</strong> existing laws as <strong>the</strong>se apply to migrant workers. Recruitment agencies 

see <strong>the</strong> government’s role in initiating and properly implementing bilateral agreements. 

Aside from <strong>the</strong> PJEPA and <strong>the</strong> ASEAN MRAs, trade unions identified o<strong>the</strong>r Philippine bilateral 

(national or subnationals) arrangements with, for example,British Columbia (in Canada), 

United Arab Emirate, Bahrain; Iraq, Japan, Marianas Island, Indonesia, and Trinidad and 

Tobago. 

In destination countries where <strong>the</strong>re are no specific bilateral or multilateral mechanisms for 

protection <strong>of</strong> migrant health workers, <strong>the</strong> Philippines may look at <strong>the</strong> country’s labor laws 

and o<strong>the</strong>r relevant social and economic laws and policies. When at <strong>the</strong> destination country, 

<strong>the</strong> DFA and <strong>the</strong> DOLE’s Philippines Overseas Labor Office (POLO) are <strong>the</strong> relevant 

authorities for Filipino migrant workers. DOLE’s POLO are mandated to check if Filipino 

workers abroad are protected. The POEA and DOLE are mandated to take charge <strong>of</strong>migrant 

workers’ protection in collaboration with <strong>the</strong> DFA. 

5. Descriptions <strong>of</strong> bilateral, regional or multilateral agreements or 

arrangements 

The HRH Network Philippines identified <strong>the</strong> POEA and DFA as <strong>the</strong> appropriate agencies to 

provide supplementary answers to this <strong>monitoring</strong> item. In <strong>the</strong> case <strong>of</strong> PJEPA, <strong>the</strong> MOU sets 

<strong>the</strong> procedures for recruitment and deployment <strong>of</strong> Filipino nurses and careworkers to Japan. 

Under <strong>the</strong> agreement, Japan health facilities hire Filipino registered nurses with three (3) 

years work experience to undergo language training. For careworkers, entry requirement is 

a four-‐year course and Caregiving NC-‐II or <strong>the</strong> nursing course for certified caregivers. After 

passing <strong>the</strong> licensure exam, <strong>the</strong>y can work as nurses and careworkers in Japan. Candidates 

<strong>who</strong> do not pass <strong>the</strong> Japan licensure exams can be employed in Japanese retirement villages 

in <strong>the</strong> Philippines to be able to use <strong>the</strong>ir exposure to <strong>the</strong> Japanese language and culture. 

With respect to Australia and New Zealand, <strong>the</strong>se countries have committed to hire Filipino 

registered nurses that have undertaken <strong>the</strong> two-‐month bridging program. Given <strong>the</strong> 

experiences with <strong>the</strong>se bilateral agreements, <strong>the</strong> government agencies stakeholder group 

emphasized <strong>the</strong> need to set standards and include ethical recruitment in future 

agreements.Aside from <strong>the</strong> PJEPA and <strong>the</strong> ASEAN MRArs, <strong>the</strong> pr<strong>of</strong>essional associations 

identified <strong>the</strong> Philippine agreements with Canadaas regards to <strong>the</strong> hiring <strong>of</strong> nurses. 

Trade unions described PJEPA as national in scope pertinent to Filipino nurses and noted 

that this was signed in light <strong>of</strong> RA 8042, as amended by RA 10022, for protection <strong>of</strong> Filipino 

migrant workers. The trade unions raised <strong>the</strong>ir concern for <strong>the</strong> application <strong>of</strong> <strong>the</strong> General 

Agreement on Trade and Services Mode 4 provisions in bilateral and multilateral agreements 

and for laws in destination countries relevant to migrant workers, not merely an agreement. 

They suggested that <strong>the</strong> WHO <strong>monitoring</strong> instrument include, in <strong>the</strong> future, o<strong>the</strong>r elements 

to track implementation <strong>of</strong> <strong>the</strong> bilateral and multilateral agreements/arrangements such as 

<strong>the</strong> following: training, working conditions, grievance mechanism, skill recognition, and 

responsibilities <strong>of</strong> recruitment agencies. They raised <strong>the</strong> importance <strong>of</strong> <strong>the</strong> 

agreement/arrangement being written in <strong>the</strong> language that workers can understand and 

that can be monitored. 

11

Websites are available as sources <strong>of</strong> information on <strong>the</strong> Philippine bilateral and multilateral 

agreements and arrangements. 

6. Research in health personnel migration 

In general, research on <strong>the</strong> subject <strong>of</strong> health personnel migration has been conducted by 

various Philippine organizations. 

Government agencies referred to <strong>the</strong> conduct <strong>of</strong> research in <strong>the</strong> following organizations: 

HRH Network Philippines and member organizations, particularly <strong>the</strong> DOH, <strong>the</strong> National 

Institutes <strong>of</strong> Health (NIH), <strong>the</strong> DOLE-‐Institute Labor Studies (ILS), and <strong>the</strong> Public Services 

Labor Independent Confederation (PSLINK). 

The hospitals mentioned <strong>the</strong> DOH and DOLE, ILO and WHO as <strong>the</strong> institutions with research 

on health personnel related to migration. On <strong>the</strong>ir part, <strong>the</strong>y collect data, receive reports 

from alumni networks, and conduct interviews that may have some relevance to health 

pr<strong>of</strong>essionals’ migration. 

The pr<strong>of</strong>essional associations’ group cited <strong>the</strong> National Institutes <strong>of</strong> Health-‐Institute <strong>of</strong> 

Health Policy and Development Studies (NIH-‐IHPDS). The Philippine Association <strong>of</strong> Medical 

Technologists (PAMET) expressed its intention to prepare a research proposal on health 


Recruitment agencies referred to researches done in <strong>the</strong> Philippines by <strong>the</strong> DOH, DOLE, 

POEA and PSLINK and in receiving countries, by <strong>the</strong> US Department <strong>of</strong> Labor and US 

pr<strong>of</strong>essional organizations.They have observed that, research has been limited to <strong>the</strong> 

academe (for example Asian Institute <strong>of</strong> Management), while o<strong>the</strong>rs, such as recruiters, 

have not been invited to participate in research endeavors. 

Citing RA 8042, as amended by RA 10022(Sec. 10 and Section 17), trade unions 

acknowledged DOLE’s creation <strong>of</strong> a re-‐placement and <strong>monitoring</strong> center for returning 

Filipino migrant workers, named <strong>the</strong> National Reintegration Center for Overseas Filipino 

Workers (NRCO). This <strong>of</strong>fice implements mechanisms for re-‐integration <strong>of</strong> returning Filipino 

migrants into Philippine society, serving as promotion house for local employment. For 

research on health pr<strong>of</strong>essionals’ migration, <strong>the</strong>y identified <strong>the</strong> following organizations: 

PSLINK, UP Manila, DOH-‐ILS, POEA,and <strong>the</strong> HRH Network Philippines. 

7. Contact details <strong>of</strong> research programs or institutions 

The DOH is identified as <strong>the</strong> appropriate agency for information on research programs and 

institutions, specificially <strong>the</strong> DOH-‐HHRDB and <strong>the</strong> HRH Network Philippines <strong>of</strong> which <strong>the</strong> 

DOH-‐HHRDB is <strong>the</strong> Secretariat. Contact information are available for <strong>the</strong> NIH, Asian Institute 

<strong>of</strong> Management (AIM), o<strong>the</strong>r entities, even individuals that do research on health personnel 


12

8. Action to implement <strong>the</strong> Code 

The DOH is <strong>the</strong> identified national authority to respond to how <strong>the</strong> Codehas been 

implemented in <strong>the</strong> Philippines. Relevant to implementation are <strong>the</strong> Philippine international 

legal instruments, namely: <strong>the</strong> ASEAN MRAs, PJEPA and MASEAN.In <strong>the</strong> view <strong>of</strong> government 

agencies in <strong>the</strong> HRH Network Philippines, Philippine laws and policies tend to be 

conflictingwith <strong>the</strong> provisions <strong>of</strong> <strong>the</strong> WHO Code. 

Hospitals considered some <strong>of</strong> <strong>the</strong>ir <strong>practice</strong>s as aligned with <strong>the</strong> provisions <strong>of</strong> <strong>the</strong>Code. 

Private hospitals follow and harmonize <strong>the</strong> DOH and DOLE requirements in <strong>the</strong> operation <strong>of</strong> 

hospitals, while public hospitals follow those <strong>of</strong> <strong>the</strong> CSC. 

Pr<strong>of</strong>essional associations attributed <strong>the</strong>ir awareness <strong>of</strong> <strong>the</strong> Code to this current DOH-‐ and-‐ 

ILO initiativeto monitor <strong>the</strong>Code through multistakeholders consultations.Prior to this, <strong>the</strong>y 

had limited awareness <strong>of</strong> <strong>the</strong> Code. 

The implementation <strong>of</strong> POEA regulations and <strong>the</strong> Migrant Workers Act are relevant to <strong>the</strong> 

implementation <strong>of</strong> <strong>the</strong>Code, according to <strong>the</strong> recruitment agencies group. They considered 

<strong>the</strong>DOH-‐and-‐ILO initiated multistakeholder process as a step to monitor <strong>the</strong> Philippine 

implementation <strong>of</strong> <strong>the</strong>Code. 

Among <strong>the</strong> trade unions’s, <strong>the</strong>re is very limited awareness <strong>of</strong> <strong>the</strong> <strong>of</strong> <strong>the</strong> Code. They have not 

observed <strong>the</strong> Code being discussed in universities, in technical vocational schools, nei<strong>the</strong>r is 

<strong>the</strong> Code referred to in <strong>the</strong> PDOS and PEOS, undertaken respectively by <strong>the</strong> OWWA and 

POEA. 

9. Steps taken to implement <strong>the</strong> Code 

In general, <strong>the</strong> stakeholders observed <strong>the</strong> WHO Code’s implementation in <strong>the</strong> Philippines in 

terms <strong>of</strong> <strong>the</strong> steps below listed in <strong>the</strong> WHO <strong>monitoring</strong> instrument: 

• (9.a) Actions have been taken to communicate and share information across 

stakeholders on health worker recruitment and migration issues, as well as <strong>the</strong> 

Code, among relevant ministries, departments and agencies, nationally and sub-‐ 

nationally 

• (9.b) Measures have been taken to involve all stakeholders in any decision making 

processes involving health personnel migration and international recruitment. 

• (9.c) Actions are being considered to introduce changes to laws or policies on <strong>the</strong> 

international recruitment <strong>of</strong> health personnel. 

Not all bilateral agreements containprovisions on HRH. Among HRH Network Philippines 

members, <strong>the</strong> DOH is deemed <strong>the</strong> appropriate agency to respond to how <strong>the</strong> Code has been 

implemented, while o<strong>the</strong>r government agencies have authority with regard to<strong>the</strong> 

international recruitment <strong>of</strong> health personnel. 

Hospitals have <strong>practice</strong>s relevant to <strong>the</strong> implementation <strong>of</strong> <strong>the</strong> Code covering items 9a to 9c 

in <strong>the</strong> <strong>monitoring</strong> instrument, which are compliant with <strong>the</strong> PRC and CSC requirements. In 

<strong>the</strong> case <strong>of</strong> <strong>the</strong> Philippine Heart Center (PHC), a specialty government hospital, has 

interacted with recruitment agencies to develop exchange arrangements for <strong>the</strong>ir nurses’ 

13

training abroad.The PHC also has nursing alumni all over <strong>the</strong> world and informal networking 

through online communication, and visits <strong>of</strong> foreign health pr<strong>of</strong>essionals that can be 

harnessed for <strong>the</strong> purposes <strong>of</strong> <strong>the</strong> Code, such as information dissemination and data 

collection. 

Among pr<strong>of</strong>essional associations, <strong>the</strong> Philippine Nurses Association, Inc. (PNA) is engaged in 

collaboration with <strong>the</strong> POEA in <strong>the</strong> conduct <strong>of</strong> <strong>the</strong> PEOS, and has monitored <strong>the</strong> PJEPA’s 

implementation. Such actions are relevant to <strong>the</strong> implementation <strong>of</strong> <strong>the</strong>Code. 

For <strong>the</strong> recruitment agencies’ group, <strong>the</strong> implementation <strong>of</strong> <strong>the</strong> Codemay be considered in 

terms <strong>of</strong>: (1) <strong>the</strong> implementation <strong>of</strong> <strong>the</strong> Migrant Workers Act (RA 8042 as amended by RA 

10022); (2) <strong>the</strong> processing for pre-‐screening and job <strong>of</strong>fer; and, (3) <strong>the</strong> conduct <strong>of</strong> <strong>the</strong> PEOS 

and PDOS. Fur<strong>the</strong>r, one agency shared its “no-‐placement fee policy.” They also referred to 

POEA’s role as a step toward <strong>the</strong> implementation <strong>of</strong> <strong>the</strong> Code because it regulates 

recruitment agencies, ensures compliance with Philippine labor laws, and ensures protection 

<strong>of</strong> Filipino overseas workers through fair working conditions in employment contracts. 

Recruitment agencies also averred that <strong>the</strong>y do not have a forum to make recruiters 

understand <strong>the</strong> Code. On <strong>the</strong> o<strong>the</strong>r hand, <strong>the</strong> POEA called attention to <strong>the</strong>ir Continuing 

Agency Education Program to advocate ethical recruitment to licensed recruitment agencies, 

as well as, <strong>the</strong> PEOS conducted by POEA and PDOS conducted by OWWA, as potential 

platforms for knowledge dissemination on <strong>the</strong> Code. The recruitment agencies suggested 

that <strong>the</strong>y, <strong>the</strong> POEA, and DOLE, be engaged in collaboration and discussion on <strong>the</strong> Code’s 

implementation in <strong>the</strong> following years. Establishment <strong>of</strong> an on-‐line feedback mechanism to 

track how Filipino migrant health pr<strong>of</strong>essionals are treated in destination countries was 

strongly recommended. 

The trade unions confirmed <strong>the</strong> observations that items 9a to 9c in <strong>the</strong> WHO National 

ReportingInstrument are operational in <strong>the</strong> Philippines. 

In addition, recruitment agencies are engaged in records keeping and promotion <strong>of</strong> good 

<strong>practice</strong>s, which are items 9d and 9e in <strong>the</strong> <strong>monitoring</strong> instrument, respectively. The 

recruiters group suggested <strong>the</strong> following interventions: (1) awareness raising among migrant 

health workers, recruitment agencies, academe, pr<strong>of</strong>essional organizations, through multi 

media, <strong>the</strong> You Tube, comics, with <strong>the</strong> use <strong>of</strong> local language and in <strong>the</strong> perspective <strong>of</strong> <strong>the</strong> 

migrant workers; (2) a <strong>global</strong> meeting among <strong>the</strong> biggest sending countries (Philippines, 

India, China); (3) Commission on Higher Education (CHED)to include <strong>the</strong>Code into <strong>the</strong> 

curriculum <strong>of</strong> <strong>the</strong> health pr<strong>of</strong>essions, and <strong>the</strong> PRC to include <strong>the</strong> same into <strong>the</strong> licensure 

examinations; and, (4) CSC to incorporate <strong>the</strong> Code provisions into <strong>the</strong> system <strong>of</strong> 

performance appraisal <strong>of</strong> public sector health pr<strong>of</strong>essionals. Awareness <strong>of</strong> <strong>the</strong> Code has not 

cascaded from DOH and <strong>the</strong> HRH Network Philippines to o<strong>the</strong>r government agencies and 

stakeholders. 

14

10. Main constraints to <strong>the</strong> implementation <strong>of</strong> <strong>the</strong> Code in <strong>the</strong> country and 

proposed possible solutions 

Main constraints to <strong>the</strong> Code’s implementation, in <strong>the</strong> view <strong>of</strong> <strong>the</strong> HRH Network Philippines, 

derive from <strong>the</strong> limitations posed by provisions <strong>of</strong> <strong>the</strong> 1987 Philippine Constitution and 

o<strong>the</strong>r laws. 

For hospitals, constraints emanate from <strong>the</strong> devolution <strong>of</strong> authority in <strong>the</strong> delivery <strong>of</strong> health 

services from DOH to <strong>the</strong> local government units, <strong>the</strong> hospital budget and <strong>the</strong> lack <strong>of</strong> 

agreements among institutions regarding HRH. 

The pr<strong>of</strong>essional associations listed <strong>the</strong> lack <strong>of</strong> information on <strong>the</strong> Code as a constraint. The 

<strong>monitoring</strong> instrument itself poses a constraint in that many questions in <strong>the</strong> National 

Reporting Instrument do not apply to <strong>the</strong> situation in source countries, like <strong>the</strong> Philippines. 

Promotion <strong>of</strong> ethical recruitment was seen to be a challenge. To promote ethical 

recruitment among recruitment agencies, an incentive scheme such as an award system was 

recommended. Instead <strong>of</strong> sanctions, recruitment agencies suggested <strong>the</strong> institution <strong>of</strong> an 

award system for good <strong>practice</strong> on <strong>the</strong> Code , differentiating it from <strong>the</strong> current award 

system that recognizes <strong>the</strong> number ra<strong>the</strong>r than <strong>the</strong> quality <strong>of</strong> processed transactions for 

foreign recruitment.The proposed alternative award should focus on quality ra<strong>the</strong>r than 

quantity in <strong>the</strong> recruitment agencies’ performance. 

Main contraints cited by <strong>the</strong> trade unions are: (1) unemployment forcing local health 

personnel to migrate, indicating <strong>the</strong> need for industry policies and programs; (2) lack <strong>of</strong> 

awareness on <strong>the</strong> Code, among <strong>the</strong> migrant health workers, trade unions, and 

recruiters,which may be appropriately addressed by communication and information drives; 

(3) lack <strong>of</strong> dialogue on <strong>the</strong> WHO Code between receiving countries and migrant health 

personnel; (4) policy gaps on <strong>the</strong> part <strong>of</strong> government; and, (5) sanctions that can penalize 

<strong>the</strong> recruiter and employer. 

11. Database <strong>of</strong> laws and regulations related to international health 

personnel recruitment and migration and information related to <strong>the</strong>ir 

implementation 

According to HRH Network Philippines’ member-‐government agencies, <strong>the</strong> POEA and <strong>the</strong> 

DFA maintain a data base <strong>of</strong> laws and regulations related to international health personnel 

recruitment and migration (www.poea.gov.ph-‐Labor Agreements Section; www.dfa.gov.ph). 

O<strong>the</strong>r stakeholders are not informed <strong>of</strong> <strong>the</strong> existence <strong>of</strong> any such data bases on migration-‐ 

related laws. The recruiters’ and trade unions’ groups suggested that planning be done to 

include <strong>the</strong> setting up <strong>of</strong> databases. 

12. Technical cooperation agreement and financial assistance related to 

international health personnel recruitment or <strong>the</strong> management <strong>of</strong> and 

migration 

In <strong>the</strong> case <strong>of</strong> <strong>the</strong> PJEPA, <strong>the</strong>re are government agencies in charge <strong>of</strong> giving technical 

assistance, such as <strong>the</strong> DOH, DOLE, and PRC. 

15

In hospitals, <strong>the</strong>re are no technical and financial assistance on matters <strong>of</strong> international 

health personnel recruitment and migration mangement. 

Recruitment Agencies cannot respond to this <strong>monitoring</strong> item. 

Trade unions questionned <strong>the</strong> meaning <strong>of</strong> “financial assistance and technical cooperation”. It 

is not clear whe<strong>the</strong>r this <strong>monitoring</strong> item refers to government-‐to-‐government relations, or 

to government with international fund organizations like ILO’s DWAB and <strong>the</strong> Asian 

Development Bank. 

13. Statistical records <strong>of</strong> health personnel <strong>who</strong>se first qualification was 

obtained overseas 

Among government agencies, <strong>the</strong> POEA maintains a database <strong>of</strong> board passers for <strong>the</strong> 

purposes <strong>of</strong> <strong>the</strong> PJEPA, while <strong>the</strong> PRC maintains a list <strong>of</strong> foreign health pr<strong>of</strong>essionals that 

requested permission for limited local <strong>practice</strong>. Maintaining statistical records is tedious and 

difficult,though an important task for government agencies. 

Hospitals were not aware as to where such statistical records could be obtained and <strong>the</strong>y do 

not also operate such mechanisms. They do not track migrant health pr<strong>of</strong>essionals <strong>who</strong> 

obtained <strong>the</strong>ir license from o<strong>the</strong>r countries, though in certain cases <strong>of</strong> visiting foreign health 

pr<strong>of</strong>essionals, <strong>the</strong>y conduct exit interviews. 

Recruitment agencies cannot respond to this <strong>monitoring</strong> item and trade unions stated that 

<strong>the</strong>y do not have any such database. 

14. Mechanism(s) or entity(ies) that regulate or grant authorization for 

<strong>practice</strong> <strong>of</strong> internationally recruited health personnel and that maintain 

statistical records 

Among government agencies, <strong>the</strong> PRC’s International Affairs Division and POEAhave 

mechanisms that regulate and grant authority for internationally recruited health personnel 

to <strong>practice</strong> or work in <strong>the</strong> Philippines. However, <strong>the</strong> government agencies in <strong>the</strong> HRH 

Network Philippines are not aware <strong>of</strong> entities that maintain statistical data in <strong>the</strong> countryon 

health pr<strong>of</strong>essionals <strong>who</strong> first obtained <strong>the</strong>ir license to <strong>practice</strong> overseas. 

The hospitals in this stakeholder group are not aware <strong>of</strong> such mechanisms. Pr<strong>of</strong>essional 

organizations, recruitment agencies, and trade unions identified <strong>the</strong> PRC as possibly <strong>the</strong> 

government agency with data on <strong>the</strong> registration <strong>of</strong> foreign health pr<strong>of</strong>essionals. 

The stakeholders identified <strong>the</strong> POEA and <strong>the</strong> BI, but are unclear on <strong>the</strong>se agencies’ roles 

with respect to alien records data base. 

Over all, stakeholders agreed that this <strong>monitoring</strong> item no. 14 wasnot applicable to <strong>the</strong> 

Philippines, which is considered a source ra<strong>the</strong>r than a destination country for 

internationally recruited health personnel. 

16

15. Complementary comments or materials on <strong>the</strong> international 

recruitment and management <strong>of</strong> migration <strong>of</strong> <strong>the</strong> health workforce 

related to <strong>the</strong> implementation <strong>of</strong> <strong>the</strong> Code. 

The HRH Network Philippines emphasized <strong>the</strong>Code’sbias toward destination countries 

indicating <strong>the</strong> importance to develop <strong>the</strong> instrument pertinent to source countries. 

Stakeholders responses point to <strong>the</strong> need for streng<strong>the</strong>ing <strong>the</strong> <strong>monitoring</strong> <strong>of</strong> <strong>the</strong> Code, to 

link policy and <strong>practice</strong>, and to build <strong>the</strong> information database system. 

For hospitals, <strong>the</strong> references for international recruitment and migration management <strong>of</strong> 

<strong>the</strong> health workforce are <strong>the</strong> Migrant Workers Act (RA 8042 as amended by RA 10022), <strong>the</strong> 

Magna Carta <strong>of</strong> Public Health Workers (RA 7305), <strong>the</strong> Labor Code <strong>of</strong> <strong>the</strong> Philippines, and <strong>the</strong> 

Code <strong>of</strong> Ethics <strong>of</strong> each Health Pr<strong>of</strong>ession. 

Recruitment Agencies commented that <strong>the</strong>Codehas <strong>the</strong> right intentions and meaning, but is 

lacking in relevance and islimited by <strong>the</strong> “voluntary” adoption and implementation <strong>of</strong> 

member countries. As suggested, <strong>the</strong> Codeshould be disseminated not only to government 

institutions, but to all stakeholders, including recruitment companies and migrant health 

workers in all countries. The feedback mechanism should be made available (even 

throughweb) for all stakeholders to determine <strong>who</strong> are practicing <strong>the</strong> Code and<strong>who</strong> are in 

need <strong>of</strong> information. 

17

SUPPLEMENTAL INFORMATION 

At <strong>the</strong> on-‐set <strong>of</strong> this process, <strong>the</strong> technical and organizing comimitee mapped <strong>the</strong> questions 

in <strong>the</strong> National Reporting Instruments side by side with <strong>the</strong> provisions <strong>of</strong> <strong>the</strong>Code and 

concluded that some important provisions <strong>of</strong> <strong>the</strong>Code were not included in <strong>the</strong> National 

Reporting Instrument.As a result, additional questions were addedto <strong>the</strong> Philippine 

worksheet by <strong>the</strong> committee, which allowed<strong>the</strong> stakeholders to possibly assess <strong>the</strong> entirety 

<strong>of</strong> <strong>the</strong> Code’s implementation. So as to not confuse those additional questions with those in 

<strong>the</strong> National Reporting Instrument, letters were used by <strong>the</strong> organizing committee to 

address <strong>the</strong>se new items. 

a) Philippine participation in international discussions and advanced 

cooperation on matters related to ethical international recruitment 

Some HRH Network members reported <strong>the</strong> Philippine government’s participation in <strong>the</strong> 

recent international discussions on ethical international recruitment, among o<strong>the</strong>r such fora 

included: 

1. 6 th Asia-‐Pacific Action Alliance on HRH in 2011 

2. 10 th ASEAN Joint Coordinating Committee on Nursing (AJCCN) in 2011 

3. 6 th ASEAN Joint Coordinating Committee on Medical Practitioners (AJCCM) in 2011 

This DOH-‐and-‐ILO multistakeholder initiative, with <strong>the</strong>ir partners,constitutes<strong>the</strong> first time for 

<strong>the</strong> hospital to participate in such discussion on WHO Code and on ethical recruitment <strong>of</strong> 

health personnel. 

Some <strong>of</strong> <strong>the</strong> pr<strong>of</strong>essional associations have participated in international discussions 

concerning <strong>the</strong>ASEAN MRArs and <strong>the</strong> PJEPA. 

Some trade unions are aware <strong>of</strong> Philippines’ participation in international fora, while some 

have <strong>the</strong>mselves participated in international discussions on ethical international 

recruitment, migration and development. 

b) Mechanisms for internationally recruited health workers to report non-‐ 

conformity to policies on ethical recruitment and labour standards? 

The Philippines is not a destination country for internationally recruited health workers. For 

Filipino migrants abroad, <strong>the</strong> Philippines has embassies and labor <strong>of</strong>fices in destination 

countries to receive reports on non-‐conformity to policies, ethical recruitment, and labour 

standards. 

c) Perception <strong>of</strong> circular migration 

Pr<strong>of</strong>essional associations mentioned <strong>the</strong> Balik Turo (“return teaching”)project for Filipino 

Nurses 4 , for those <strong>who</strong> have been abroad to share <strong>the</strong>ir knowledge to local nurses. Circular 

migration is done by way <strong>of</strong> scholarships for training and education from <strong>the</strong> receiving 

country to <strong>the</strong> sending country. There are migrant health pr<strong>of</strong>essionals <strong>who</strong> opt to stay in 

4 http://balik-‐turo.cfo.gov.ph/index.php/about-‐us 

18

<strong>the</strong>ir adoptive country, while o<strong>the</strong>rs move from one country to ano<strong>the</strong>r using one foreign 

employment as “jump-‐<strong>of</strong>f” to ano<strong>the</strong>r target country. The pr<strong>of</strong>essional associations 

acknowledged <strong>the</strong>ir limited knowledge about circular migration. 

From <strong>the</strong> hospital group’s perspective, circular migration is <strong>the</strong> transfer <strong>of</strong> technology <strong>of</strong> a 

migrant health worker from <strong>the</strong> destination country to <strong>the</strong> source country. The PHC 

experience provides an example <strong>of</strong> Filipino nurses sharing <strong>the</strong>ir learning from abroad upon 

return to <strong>the</strong> Philippine hospital. 

Recruitment agencies suggested that circular migration be facilitated and encouraged for 

<strong>the</strong> benefit <strong>of</strong> stakeholders, in both source and destination countries, and to highlight <strong>the</strong> 

importance <strong>of</strong> reintegration to sending countries. Circular migration addresses brain drain 

and promotes transfer <strong>of</strong> technology from receiving to sending countries. For society to 

benefit from circular migration, remittances need to be plowed back to investments in 

health in <strong>the</strong> Philippines to provide re-‐integration options and to facilitate technology and 

knowledge transfers. In this context, circular migration becomes an economic and a political 

issue. Currently, <strong>the</strong>y are not aware <strong>of</strong> re-‐integration policies for health personnel. This is 

also a personal concern because individuals can opt to become citizens <strong>of</strong> destination 

countries ra<strong>the</strong>r than be a worker with a contract or working visa. 

For trade unions, <strong>the</strong>re existno single and agreed upon definition <strong>of</strong> circular migration. In 

general, circular migration is similar to temporary migration, which undermines workers’ 

rights in so many ways and negatively impact on <strong>the</strong> delivery <strong>of</strong> health services. 

d) Philippines’ promotion <strong>of</strong> ethical recruitment 

To promote ethical recruitment, <strong>the</strong> HRH Network Philippines and recruitment agencies 

suggested <strong>the</strong> inclusion <strong>of</strong> provision on ethical recruitment in bilateral and multilateral 

agreements. Hospitals use <strong>the</strong> Contract <strong>of</strong> Service as a stop-‐gap measure pending available 

permanent positions;government hospitals follow CSC guidelines and private hospitals 

follow <strong>the</strong> Labor Code provisions. The PNA conducts information dissemination through 

websites and chapters throughout <strong>the</strong> country. Recruitment agencies and trade unions cited 

<strong>the</strong> amended Migrant Workers Act as a means for promotingethical recruitment. 

Compliance with ethical recruitment should be national in scope, with a national policy to 

regulate recruiters and foreign employers. 

e) Strategy to retain, sustain and distribute health workers in <strong>the</strong> country 

The HRH Network Philippines reported several programs such as <strong>the</strong> DOH’s Doctors to <strong>the</strong> 

Barrios and Registered Nurses for Health Enhancement and Local Services, and DOLE’s 

former program, Project: Nurse Assigned in Rural Service. There are DOH Community Health 

Teams in <strong>the</strong> country. The Philippines has a six-‐year plan up to 2016 to carry out <strong>the</strong> Migrant 

Workers Act (RA 8042 as amended by RA10022). 

Some hospitals have residency programs in remote areas, after which <strong>the</strong> health 

pr<strong>of</strong>essionals return to <strong>the</strong>ir hometowns. There are retention schemes in hospitals for <strong>the</strong> 

health pr<strong>of</strong>essionals. 

19

Trade unions emphasized <strong>the</strong> need for more jobs for Filipinos in <strong>the</strong> Philippine,with fair 

compensation, better working conditions, and implemenetation <strong>of</strong> <strong>the</strong> Migrant Workers Act 

(RA 8042 as amended by RA10022). 

f) Measures undertaken to streng<strong>the</strong>n educational institutions to scale up 

training <strong>of</strong> health personnel and developing innovative curricula to address 

current needs 

Stakeholders generally observed <strong>the</strong> WHO Codeto be biased in favour <strong>of</strong>receiving countries, 

while <strong>the</strong> Philippines is currently a source country<strong>of</strong> health pr<strong>of</strong>essionals. The stakeholders 

have taken <strong>the</strong> perspective <strong>of</strong> <strong>the</strong> Philippines as a source country in responding to <strong>the</strong> 

<strong>monitoring</strong> <strong>of</strong> measures for streng<strong>the</strong>ning educational institutions for <strong>the</strong> health 

pr<strong>of</strong>essions. 

• CHED has policies on moratorium for nursing programs, for schools to become 

Centers <strong>of</strong> Excellence, and financial assistance programs. 

• Technical Education and Skills Development Authority (TESDA) <strong>of</strong>fers caregiver 

courses. 

• The University <strong>of</strong> <strong>the</strong> Philippines Manila, a state funded university, has initiated <strong>the</strong> 

return service <strong>of</strong> graduates in <strong>the</strong> health pr<strong>of</strong>essions, for <strong>the</strong>m to initially serve <strong>the</strong> 

country. 

• The Commission on Filipinos Overseas (CFO), in cooperation with <strong>the</strong> DOH Bureau <strong>of</strong> 

International Health Development (DOH-‐BIHC), runs an exchange visitors program 

for foreign health pr<strong>of</strong>essionals to come to <strong>the</strong> Philippines and for Filipino medical 

doctors (under J1 Visa) to enhance <strong>the</strong>ir skills overseas. 

Hospitals have <strong>the</strong>ir own specialization programs and certification <strong>of</strong> competencies. 

However, <strong>the</strong>re is no mechanism for national certification to recognize competencies. 

The pr<strong>of</strong>essional associations suggested <strong>the</strong> review <strong>of</strong> <strong>the</strong> curriculum for K-‐12.K-‐12 is <strong>the</strong> 

newly implmented program <strong>of</strong> <strong>the</strong> Department <strong>of</strong> Education where basic education is 

extended by two years to enhance <strong>the</strong> basic education curriculum. Such program was 

designed to ascertain that Filipino graduates <strong>of</strong> teriatry educationwill be more capable <strong>of</strong> 

competing with <strong>the</strong>ir <strong>global</strong> counterparts as <strong>the</strong>y will now have received <strong>the</strong> same 

internationally-‐accepted number <strong>of</strong> years <strong>of</strong> basic education. 

Recruitment agencies cited <strong>the</strong> limitations <strong>of</strong> <strong>the</strong> Code, <strong>the</strong> need for dissemination and 

feedback. Since <strong>the</strong> US is a prefered destination <strong>of</strong> health pr<strong>of</strong>essional graduates, <strong>the</strong> CHED, 

PRC, TESDA, and universitites should take appropriate measures. 

Trade unions observed <strong>the</strong> requirement forpassing average in board examinations. If <strong>the</strong> 

schoolsare unable toproduce successful examinees for five consecutive years, <strong>the</strong>y will no 

longer be allowed to <strong>of</strong>fer such course. The trade unions also pointed out <strong>the</strong> need to 

streng<strong>the</strong>n research, and to link <strong>the</strong> labor market with <strong>the</strong> academe 

DOLE’s labor market study shows doctors are needed in <strong>the</strong> Philippines, which has 

implications on <strong>the</strong> Philippines accepting doctors from o<strong>the</strong>r countries. 

20

CONCLUSION 

The present report constitutes <strong>the</strong> Philippines’ additional contribution to <strong>the</strong> <strong>monitoring</strong> <strong>of</strong> 

<strong>the</strong> WHO Global Code <strong>of</strong> Practice on <strong>the</strong> International Recruitment <strong>of</strong> Health Personnel. The 

Department <strong>of</strong> Health (DOH) <strong>of</strong> <strong>the</strong> Philippines, being <strong>the</strong> designated national authority to 

oversee <strong>the</strong> implementation <strong>of</strong> <strong>the</strong> Code, accepted in March 2012 <strong>the</strong> proposal <strong>of</strong> <strong>the</strong> 

International Labour Organization to set up a participatory assessment process to collect 

data, instead <strong>of</strong> having DOH single-‐handedly collecting data, to include in <strong>the</strong> WHO National 

Reporting Instrument. Under <strong>the</strong> organizing leadership <strong>of</strong> <strong>the</strong> DOH, DOLE, <strong>the</strong> ILO and WHO 

fed a process which through various preliminary meetings and two multistakeholder 

assessment meetings yielded <strong>the</strong> information that became <strong>the</strong> basis for <strong>the</strong> on-‐line 

Philippines National Reporting Instrument (submitted on 31 May 2012) and this 

supplementary, more thorough report. 

Five stakeholders group were identified as relevant to <strong>the</strong> exercise: government, trade union 

and employers’ organizations, recruitment agencies and pr<strong>of</strong>essional organizations. 

As a way to conclude this report, below are some <strong>of</strong> <strong>the</strong> main points that were extracted 

from <strong>the</strong> meetings with stakeholders and that <strong>the</strong> organizing committee would like to 

submit to <strong>the</strong> WHO’s attention. 

1. The <strong>monitoring</strong> instrument should be differentiated for sending and receiving 

countries, respectively. The questions need to be applicable to respondents from 

sending and receiving countries. 

2. The WHO <strong>monitoring</strong> instrument can include o<strong>the</strong>r elements to track 

implementation <strong>of</strong> <strong>the</strong> bilateral and multilateral agreements/arrangements such as 

<strong>the</strong> following: training, working conditions, grievance mechanism, skill recognition, 

and responsibilities <strong>of</strong> recruitment agencies. They raised <strong>the</strong> importance <strong>of</strong> <strong>the</strong> 

agreement/arrangement beingwritten in <strong>the</strong> language that workers can understand 

and that can be monitored.There is still a need to set up a database <strong>of</strong> Philippine 

laws and policies relevant to <strong>the</strong> WHO Code 

3. Ensuring <strong>the</strong> circulation <strong>of</strong> information about <strong>the</strong> Code should be a priority. The 

Code should be disseminated not only to government institutions but to by all 

stakeholders, including recruitment agencies and migrant health workers in all 

countries through multi media, <strong>the</strong> You Tube, comics, with <strong>the</strong> use <strong>of</strong> local language 

and in <strong>the</strong> perspective <strong>of</strong> <strong>the</strong> migrant workers. 

4. A feedback mechanism should be made available (even by web) for all stakeholders 

to determine <strong>who</strong> are practicing <strong>the</strong> Code and<strong>who</strong> are in need <strong>of</strong> information. A 

formal feedback mechanism is also suggested to obtain information from <strong>the</strong> health 

pr<strong>of</strong>essionals <strong>who</strong> undergo <strong>the</strong> recruitment process. For CHED to include <strong>the</strong> Code 

into <strong>the</strong> curriculum <strong>of</strong> <strong>the</strong> health pr<strong>of</strong>essions and <strong>the</strong> PRC to include this into <strong>the</strong> 

licensure examinations 

5. In terms <strong>of</strong> collaboration for effective <strong>monitoring</strong>, <strong>the</strong>re should be a stronger 

tandem between countries’ departments <strong>of</strong> health and labor to ensure <strong>the</strong> 

implementation <strong>of</strong> The Code. An example <strong>of</strong> collaboration may be done through 

information dissemination using DOH, DOLE and o<strong>the</strong>r relevant government 

21

websites and <strong>the</strong> inclusion <strong>of</strong> information about <strong>the</strong> Code in <strong>the</strong> seminars for Filipino 

migrant workers and recruitment agencies. 

6. Stakeholder/sector planning relevant to <strong>the</strong> WHO Code can help in taking action and 

ensuring progress <strong>of</strong> stakeholders or sectors in <strong>the</strong> next round <strong>of</strong> <strong>monitoring</strong>. An 

advisory or oversight group may be created and a sector-‐specific plan <strong>of</strong> action be 

prepared relevant to <strong>the</strong> implementation <strong>of</strong> <strong>the</strong> Code. 

7. Translation <strong>of</strong> <strong>the</strong> Code as an international framework to policies and programs at 

<strong>the</strong> national levelis necessary to ensure that ethical recruitment is adhered to by 

recruiters and to institutionalize effective mechanisms for negotiations with foreign 

employers. 

8. For <strong>the</strong> Philippines as a source country, <strong>the</strong> involvement <strong>of</strong> foreign health workers in 

hospitals is mainly as trainees (e.g., residency/fellowship) and not as workers. There 

are experiences on twinning arrangements between Philippine hospitals and foreign 

hospitals for training/exchange <strong>of</strong> trainees. 

9. Hospitals have no data to track migration <strong>of</strong> health personnel. Data primarily comes 

from alumni reports, exit interviews, and data on <strong>the</strong> percentages <strong>of</strong> those <strong>who</strong> 

resigned or went on-‐leave. Hospitals are still bound by national laws and by 

regulations <strong>of</strong> <strong>the</strong> PRC, CSC, POEA, and BI, which are found to be consistent with <strong>the</strong> 

provisions <strong>of</strong> <strong>the</strong> Codeon <strong>the</strong> International Recruitment <strong>of</strong> Health Personnel. 

10. Given that health pr<strong>of</strong>essionals have common concerns including migration, an 

omnibus law is recommended to cover <strong>the</strong> principles underlying <strong>the</strong> <strong>practice</strong> <strong>of</strong> <strong>the</strong> 

different pr<strong>of</strong>essions, without encroaching on <strong>the</strong> respective <strong>practice</strong> <strong>of</strong> <strong>the</strong> 

pr<strong>of</strong>essions. 

The participatory assessment process set in motion by <strong>the</strong> organizers (DOH, DOLE, ILO and 

WHO) proved not only to be an efficient way to collect data for <strong>the</strong> National Reporting 

Instrument and additional report, but it is also a tool to raise awareness <strong>of</strong> <strong>the</strong> Code and <strong>the</strong> 

importance <strong>of</strong> ethical recruitment <strong>of</strong> health personnel. Through <strong>the</strong> various meetings 

organized between March and May 2012, a momentum was generated among stakeholders, 

which Philippine government agencies and <strong>the</strong> ILO Decent Work Across Borders project, 

tapping into <strong>the</strong> dynamism <strong>of</strong> <strong>the</strong> DOH and DOLE will now strive to sustain in <strong>the</strong> view <strong>of</strong> 

continuously improving <strong>the</strong> systems ensuring that <strong>the</strong> rights to movement <strong>of</strong> migrants, <strong>the</strong> 

rights to health and <strong>the</strong> right to decent work for all. 

The success <strong>of</strong> <strong>the</strong> process undertaken by <strong>the</strong> Philippines will be documented and turned in 

an easy to use guide (good <strong>practice</strong> sheet) that <strong>the</strong> authorities would be glad to present and 

share to <strong>the</strong> WHO and ILO and <strong>the</strong>ir member countries. 

22

ANNEX A: PROPOSED QUESTIONS FOR SOURCE COUNTRIES 

The Philippine worksheet developed by <strong>the</strong> DOH, DOLE, ILO and WHO, which was completed 

by <strong>the</strong> many stakeholders allowed <strong>the</strong>m to contribute amendment and improvement to <strong>the</strong> 

WHO National Reporting Instruments. The following are some <strong>of</strong> <strong>the</strong> questions formulated 

by DOH that WHO may take into consideration when developing an updated reporting 

instrument that would better reflect <strong>the</strong> perspective <strong>of</strong> source countries: 

1. Do health personnel that migrate from your country to work in destination countries 

enjoy <strong>the</strong> same legal rights and responsibilities as domestically trained health 

workforce in terms <strong>of</strong> employment and conditions <strong>of</strong> work? 

2. What legal mechanisms are in place to ensure that health personnel that migrate to 

destination countries enjoy <strong>the</strong> same legal rights and responsibilities as <strong>the</strong> 

domestically trained health workforce? 

3. As a source country, are <strong>the</strong>re mechanisms, processes and structures in place to 

engage in bilateral, regional or multilateral agreements addressing <strong>the</strong> international 

recruitment <strong>of</strong> health personnel? 

4. To describe those steps to implement <strong>the</strong> Code (add to <strong>the</strong> list) 

a. Development <strong>of</strong> a long-‐ or medium-‐term plan that includes health personnel 

migration and international recruitment 

5. Has your country participated in international discussions and advanced cooperation 

on matters related to ethical recruitment? 

6. How does your country promote ethical recruitment? 

7. Does your country have a strategy to retain, sustain and distribute health workers in 

<strong>the</strong> country? 

8. Has your country implemented measures or strategies to scale up training <strong>of</strong> health 

personnel and develop innovative curricula to address current needs? 

9. Measures undertaken to streng<strong>the</strong>n educational institutions to scale up training <strong>of</strong> 

health personnel 

10. Are <strong>the</strong>re mechanisms by which migrant health personnel/agencies are able to 

report non-‐conformity to labor contracts/policy? 

11. Are <strong>the</strong>re provisions <strong>of</strong> <strong>the</strong> Code that have not been recognized/implemented 

through international legal instruments? 

12. In your country, have health systems been streng<strong>the</strong>ned or health workforce been 

sustained as a result <strong>of</strong> <strong>the</strong> implementation <strong>of</strong> <strong>the</strong> Code? 

23

monitoring of the who global code of practice on the international ...

You also want an ePaper? Increase the reach of your titles

Delete template?

Save as template?