HRH commitment pathways MALDIVES

HRH commitment pathways MALDIVES

1) What human resources for health (HRH) - related actions and pathways can your country/ institution commit to

The Ministry of Health is the main health care provider in Maldives and about 90 percent of health professionals were employed in the public sector in 2010. One of the priority issues related to health workforce faced by Maldives is variation in the quality of pre-service and postgraduate training, as 81 % of the doctors are expatriates. Doctors registered by Maldives Medical Council to date represent over 300 medical schools worldwide, leading to a wide variation in the quality of training. Currently Maldives Medical Council and Maldives Nursing Council do not have a list of accepted medical and nursing schools, therefore at the time of recruitment, it is difficult to be assure the quality of expatriates nurses and doctors.

Toward achieving the national vision on Human Resources for Health (HRH) to ensure `Access for all to competent and sustainable health workforce within the robust and enabling health system towards achieving the Universal Health Coverage, Millennium Development Goals 2015 and beyond'; Maldives, in addition to a number of other strategic and policy actions, is endeavoring to ensure adequate quality standards in training and services to deliver health care to the population with high professional standards. To this end, Maldives is proclaiming its commitment at the occasion of the 3rd global forum on HRH for `Improving HRH regulatory frameworks and institutionalize quality assurance towards enhanced health workface productivity.' This will be included as a priority objective in the HRH strategic plan being designed for 20132018. In order to realize this commitment, Maldives, with multistakehodler coordination and inclusive partnerships, under the overall leadership of Ministry of Health (MOH), aligned with the health system policies, and duly considering the WHO Global Code of Practice on international recruitment of health personnel, will implement the following strategies and interventions:

1- Institutionalize regulatory mechanisms for accreditation of health professionals' education for all cadres and medical qualifications from other countries. - Develop accreditation criteria for health professions education for doctors and nurses. - Develop a list of approved Medical and Nursing institutes for recruitment of health workforce - Develop a mechanism to enroll new institutes if not endorsed by any competent global or national process.

2- Establish a licensing system for health professional's recruitment - Develop professional standardization for doctors and nurses elucidating required competencies, knowledge and skills. - Develop and implement a Licensing Examination System to register the international medicos

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It is expected that through this process and pathway, country will be able to standardize and improve quality of the physicians and nurses, which will in turn lead to sustainable solutions towards ensuring access to competent medical personnel and delivery of adequate health services in accordance with the national health needs.

Following targets have been determined with realistic timeframe and potential roles for resources deployment, implementation and stewardship.

1- Targets related to accreditation of health professionals' education: - Operational plan for institutionalization of regulatory mechanisms to accredit health professionals' education for doctors and nurses (MOH with engagement of related stakeholders, facilitated by WHO)- January to March 2014 - Accreditation criteria for medical education for doctors and nurses (MOH with engagement of related stakeholders, facilitated by WHO)- April to June 2014 - List of approved Medical and Nursing institutes for recruitment of health workforce (MOH with engagement of related stakeholders, facilitated by WHO)- July to December 2014 - Mechanism for enrolment of new institutes if not already endorsed by any competent global or national process (MOH with engagement of related stakeholders, facilitated by WHO)- January to May 2015

2- Targets related to licensing system for health professionals recruitment: - Operational plan to initiate a licensing system for recruitment of doctors and nurses (MOH with engagement of related stakeholders, facilitated by WHO)- January to March 2014 - Set of country specific professional standards for doctors and nurses in line with the recommendations by WHO and global partners (MMC and MNC with engagement of related stakeholders, under leadership of MOH)- April to June 2014 - Government regulation for initiating a Licensing Examination System to register the international medicos (MOH and parliament)- March to July 2014 - Establishment of website and other related tools and materials including prospectus, programme, questionnaires bank and examination system (MMC and MNC, under leadership of MOH, and supported by WHO)- August to December 2014 - Launching of the licensing examination (Maldivian Medical Council with engagement of stakeholders, under leadership of MOH and facilitated by WHO)- January to March 2015 - System arrangements to ensure adequate mechanisms for using the licensing examination results in the health professionals recruitments (MOH with engagement of related stakeholders, facilitated by WHO)- March 2015 onwards

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2) How will you monitor progress towards achievement of your commitment pathways (What indicators will you track? What data sources will you use)?

In order to pursue and monitor the implementation of the commitment with its competent areas, following monitoring indicators have been determined : - Strategies and interventions related to the institutionalization of regulatory mechanisms and establishing Licensing Examination System have been included in the HRH strategic plans (Information source/s: HRH strategic plan) - Detailed operational plan with required cost is developed for institutionalization of regulatory mechanisms and establishing Licensing Examination System and is agreed by MOH and other key players (Information source/s: Operational plan report) - Adequate funding and system support has been provided to implement both initiatives (Information source/s: progress report) - Accreditation criteria for medical education for doctors and nurses is available and agreed by MOH and related stakeholders (Information source/s: progress reports and related documents) - List of approved Medical and Nursing institutes is available for recruitment of doctors and nurses (Information source/s: progress reports with list) - Country specific set of professional standards for doctors and nurses is available and validated by stakeholders (Information source/s: progress reports and related documents) - A regulation for initiating a Licensing Examination System has been issued by competent authorities of the government (Information source/s: regulation/notification copy) - The Licensing Examination System has been established with development of related tools and materials and is functional (Information source/s: progress reports and related documents)for pharmacists only - Adequate system arrangements have been made to use the licensing examination results in recruitments of doctors and nurses (Information source/s: progress reports and related documents).

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