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Table 1 Comparing the various current international Codes on health workforce recruitment

From: Empirically evaluating the WHO global code of practice on the international recruitment of health personnel’s impact on four high-income countries four years after adoption

Code Stated objectives Scope Implementation mechanism Considerations for developing countries Distinguishing features
WHO Global Code of Practice on the International Recruitment of Health Personnel (May 2010) Establish and promote voluntary principles;
Serve as a reference to improve legal framework;
Provide guidance in the formulation and implementation of bilateral agreements;
Facilitate and promote international discussion and cooperation
Global Bilateral agreements among states and other supplementary international legal instruments Destination countries should respect the overriding legal obligation of health personnel to fulfill their working obligations in home countries and seek not to recruit them
Destination countries should provide financial and technical support to developing source countries
Establishment of national health authority to provide updates on Code implementation and exchange information on health workforce migration to the WHO Secretariat
Global scope: considers rights and obligations of both source and destination countries and migrant health personnel
WFPHA Code of Ethics Pertaining to Health Worker Recruitment from Developing Countries (May 2005) Judiciously manage the employment of health professionals from abroad International—applies to all member states of the WFPHA Mandating WFPHA governments work only with employers that comply with the Code Low-income countries receive something in compensation for sending health professionals (e.g. health worker exchange programs, government remuneration, continuing education for workers) Builds upon UK DoH Code of Practice by restricting recruitment from developing countries that only have bilateral agreements with WFPHA
Proposes definition for “active recruitment”
UK Department of Health Code of Practice for the International Recruitment of Healthcare Professionals (Dec 2004) Offer principles and best practice benchmarks to be met in order to supply and manage international health professionals in an ethical manner.
Provide targeted recruitment guidelines, education and language proficiency requirements, and employment laws related to international recruitment in order to establish ethical practice (DOH, 2004).
Regional – applies to employers of the UK’s National Health System Mandating NHS to work only with recruitment agencies that comply with the Code Aims to prevent the active recruitment of healthcare workers from developing countries unless a government-to-government agreement to support recruitment exists
Manages migration with respect to active recruitment, but does not advocate for the retention or training of health workers in either the source or destination country
First national code of practice for international recruitment
Best practice benchmarks to gauge adherence to core principles
Online registry of commercial recruitment agencies complying with the code of practice
If non-compliance by an NHS-approved recruitment agency is suspected, a grievance application can be made to the NHS employers; an investigation of the offending agency will be performed and if found guilty, the offending agency will be removed from the approved list and can no longer supply workers to the NHS.
Commonwealth Code of Practice for the International Recruitment of Health Workers (May 2003) To provide Commonwealth governments with a framework for the ethical international recruitment of health workers to take place, taking into account the impact of such recruitment on source countries International – applies to all governments of the Commonwealth nations Promote dialogue among developed and developing countries to resolve this challenge
Follow-up with bilateral and other contractual agreements, e.g. bonding health workers
Acknowledges that recruitment diminishes the source country’s human resources and negatively impacts health systems.
Bilateral agreements should be drafted to regulate the recruitment process. All employment agencies must be bound by this Code and governments must set up regulatory systems for recruitment agencies and implement mechanisms to detect noncompliance [10].
Proposes its scope go beyond Commonwealth nations and be taken as a proposed global code of practice on this issue