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Joining forcesThe role of social dialogue in
addressing health worker migration an Action
Programme
International Labour Organization

• Christiane Wiskow
• ILO Sectoral Activities Branch
• A Call to Action Ensuring Global Human Resoruces
  for Health
• International Health Workforce Conference
• Geneva, 22-23 March 2007

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ILOPromoting decent work for all

• International Labour Organization
• Founded in 1919, UN specialized agency since
  1946
• ILO Mandate Promote social justice and
  internationally recognized human and labour
  rights
• Promote the development of independent employers'
  and workers' organizations
• Tripartite structure
• governments, employers, workers

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What is social dialogue?

• Social dialogue includes all types of
  negotiation and consultation, starting with the
  exchange of information between, or among,
  representatives of governments, employers and
  workers, on issues of common interest relating to
  economic and social policy.

• Elements of social Dialogue

Negotiation
Consultation
Information-sharing
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Social dialogue Who?Social partners in the
health sector
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Social dialogue a means of action

• ILO Action Programme
• International Migration
• of Health Care Workers the Supply Side
• 2006 - 2007

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Joining forcesInteragency cooperation

• Partnership with
• WHO and IOM
• Close collaboration in implementing the Action
  Programme
• Coordination of activities around health worker
  migration at country level

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Aim of the Action Programme

• Outcome
• Strategies and best practices for the management
  of health worker migration from the
  supplying nations perspective are
  developed and disseminated.

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Major areas of action

• Social dialogue and stakeholder involvement
• Data improvement
• Specific research

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Areas of actionSocial dialogue and stakeholder
involvement

• National Steering Committees multiple
  governmental agencies together with employers and
  workers, and other stakeholders
• Common and differing interests health systems
  needs, labour migration issues and value of
  remittances
• Dialogue that leads to policy development

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Areas of action Data improvement

• Objective
• Improve the quality of data on the movement of
  health workers
• Supporting countries to develop own data
  collection and analysis capacity and to use the
  findings for policy formulation
• Improve national health information systems
• Improve HRH information systems

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Areas of action Specific research

• Objective
• Conduct research of particular relevance to
  selected countries in order to assist in social
  dialogue and policy formulation

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Participating countries

• Africa Kenya, Senegal
• L. America Costa Rica
• Asia Sri Lanka
• Caribbean Trinidad Tobago
• Europe Romania

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Activities Achievements 2006- February 2007

• Launch at international level
• Interregional Tripartite Meeting,
• ILO, Geneva, March 2006
• Progress in implementation in 5 countries
• Costa Rica, Kenya, Romania, Senegal, Trinidad
  Tobago
• Social dialogue initiated national tripartite
  steering committees established
• National tripartite meetings agreed objectives
  and adopted plans of actions
• Data improvement research activities
• Preparation of policy development

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Launch of the Action Programme

• Interregional Tripartite Meeting
• ILO, Geneva, 22 March 2006
• Goals
• Bring together participating countries
• Share overview HW migration
• Provide a common AP framework
• Promote the role of social dialogue
• Support information sharing cooperation among
  participating countries

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Activities and achievements in the participating
countries

• Kenya
• Established Technical Working Group with key
  stakeholders Regular meetings, facilitated by IOM
  office Nairobi
• Results
• Lead of the programme Ministry of Labour
• Establishment of National Steering Committee,
  chaired by MoL key policy makers and
  stakeholders
• Commissioning 3 baseline reports
• Data collection policy and legislative
  framework impact on health system
• AIM
• Improving management of health worker migration
• Contributing to the development of labour
  migration legislation/regulation

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Social dialogue and Stakeholder involvement -
example KENYA

• Appointed members of the
• National Steering Committee Kenya
• Permanent Secretary, Ministry of Labour (MOLHRD)
• (Chairperson)
• Permanent Secretary, Ministry of Health
  (alternate Chairperson)
• Permanent Secretary, Ministry of Foreign Affairs
• Permanent Secretary, Ministry of Education
• Permanent Secretary/ Director DPM
• Principal Immigration Officer
• Department of Labour, 2 representatives
• Department of HRME, 1 representative
• Executive Director, Federation of Kenyan
  Employers
• Secretary General, Central Organization of Trade
  Unions
• Additional invitees professional associations,
  ILO, IOM, WHO

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Activities and achievements in the participating
countries

• Romania
• Coordinator Ministry of Labour,
• Secretary of State, Department of Labour
  Abroad,
• National tripartite meeting May 2006
• social dialogue including all stakeholders
• Results
• Agreed objective
• Consolidating the management of the
  international migration of health service
  workers
• Action Plan with clear measures, deadlines and
  expected results documentation gathered
• AIM Create a database to support monitoring of
  flows and developing efficient HRH policy
• Using various data sources
• data on emigrating HW and foreign HW in Romania
  information on requirements for working abroad
  and recognition of diplomas

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Activities and achievements in the participating
countries

• Costa Rica
• Tripartite meeting in October 2006
• Outcome
• reformulated objectives and focused plan of
  action
• Establishment of a NSC ?
• Research
• existing data on HW migration flows ? review of
  policies and legislative framework
• Develop policy guidelines on HW migration that
  help imprvoing working conditions
• Development of a proposal for a special chapter
  on migrant workers to be included in amendment of
  labour code 2007
• Interdisciplinary workshop and further advocacy
  planned

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Activities and achievements in the participating
countries

• Senegal
• Tripartite National Meeting in December 2006
• Results
• Established National Tripartite Steering
  Committee,
• Coordination
• Ministry of Labour co-chaired with Ministry of
  Health
• Reformulated objectives and plan of action
• Commissioning research on HW migration flows
• AIM Development of coherent strategy for
  managing HW migration
• Components
• Retention strategies
• Strategies facilitating return
• Encouraging Diaspora contribution to HS
  development

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Activities and achievements in the participating
countries

• Trinidad and Tobago
• Tripartite meeting February 2007
• Result
• Working group established
• Plan of action revised and adopted
• Objectives
• Improve data collection mechanisms and promote
  social dialogue on HW migration
• Integrate activities with existing initiatives

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Conclusions lessons learnt

• Role of social dialogue
• Bringing key actors together to develop
  consolidated strategies
• at national international levels
• Major challenge
• Coordinating the various initiatives around HW
  migration
• Various international initiatives confusing at
  country level
• Avoid duplication of work concurrent agendas
• Create synergies joining forces
• Critical
• Commitment of constituents at country level