taking stock of health human resource capital - … stock of health human resource capital: gains,...

DOLE

Taking Stock of Health Taking Stock of Health Human Resource Capital:Human Resource Capital:

Gains, Challenges and ProspectsGains, Challenges and Prospects

The Philippine The Philippine ExperienceExperience

DOLE

BackgroundBackground

The Filipino Global WorkforceThe Filipino Global Workforce

Numbering more than 4 MillionNumbering more than 4 Million

In 188 CountriesIn 188 Countries

Varied skills: low, technical and professional Varied skills: low, technical and professional occupationsoccupations

DOLE

LabourLabour Migration FactorsMigration Factors

Supply sideSupply sideDemographic profile: increasing young Demographic profile: increasing young labourlabour forceforce

Slow economic capacity to generate local Slow economic capacity to generate local jobs, although improvingjobs, although improving

Unabated domestic unemployment and Unabated domestic unemployment and underemployment, contributing to povertyunderemployment, contributing to poverty

DOLE

LabourLabour Migration FactorsMigration Factors

Demand sideDemand side

Increasing demand for human Increasing demand for human resources among developed resources among developed countries with ageing populacecountries with ageing populace

DOLE

Institutionalization of overseas Institutionalization of overseas employment programemployment program

Started in 1974Started in 1974

Interim measure to address Interim measure to address unemployment and balance of unemployment and balance of payment problemspayment problems

DOLE

Supply and Demand Supply and Demand SituationerSituationerMedical and Allied Services, including NursesMedical and Allied Services, including Nurses

Supply of NursesSupply of NursesGraduates of medical and allied services ranked 5Graduates of medical and allied services ranked 5thth

among 5 top coursesamong 5 top courses

55--year data series posted decline in volume of year data series posted decline in volume of graduates of medical and related fieldsgraduates of medical and related fields

Downward trend attributed to decrease in nursing Downward trend attributed to decrease in nursing graduates; offset by increase in PT/occupational graduates; offset by increase in PT/occupational therapy and other related coursestherapy and other related courses

DOLETOP FIVE COLLEGE COURSES IN TERMS OF GRADUATESTOP FIVE COLLEGE COURSES IN TERMS OF GRADUATES

PHILIPPINES: 1995PHILIPPINES: 1995--20002000

76,32976,32930,95330,95334,01534,01544,55844,55860,41560,415104,537104,537350,801350,8012000200073,67773,67735,34835,34830,01830,01842,06442,06451,82651,8261,001,6311,001,631334,564334,5641999199968,63168,63134,32534,325325,999325,99940,50140,50143,95943,95993,61293,612307,027307,02719981998100,218100,21836,20636,20625,05525,05540,63940,63942,19742,19790,94290,942335,257335,2571997199780,01480,01447,48347,48319,49419,49438,91938,91945,54545,54596,66596,665328,120328,1201996199665,98265,98249,60249,60221,33821,33846,09046,09043,67443,67485,78185,781312,667312,66719951995

FieldField

FieldFieldScienceScienceRelatedRelated

OthersOthers& &

RelatedRelated& Computer& ComputerEngineeringEngineeringEducationEducation& & GRADUATESGRADUATES

MedicineMedicineMathematicsMathematicsBusinessBusinessTERTIARYTERTIARYYEARYEAR

Field of StudyField of StudyTOTALTOTAL

DOLEGRADUATES IN MEDICAL AND ALLIED SERVICES BY COURSEGRADUATES IN MEDICAL AND ALLIED SERVICES BY COURSE


292916169911113535100100% to Total% to Total

67,84067,84038,31038,31021,65321,65325,52425,52480,79080,790234,117234,117TOTALTOTAL

11,63711,6378,6388,6382,3452,3452,3532,3535,9805,98030,95330,95320002000

11,97511,9758,7228,7222,6642,6642,7682,7689,2199,21935,34835,34819991999

11,27111,2715,8275,8272,3122,3123,1953,19511,72011,72034,32534,32519981998

8,9398,9394,1024,1023,8873,8874,6674,66714,61114,61136,20636,20619971997

11,72311,7235,3795,3795,0985,0986,1216,12119,16219,16247,48347,48319961996

12,29512,2955,6425,6425,3475,3476,4206,42020,09820,09849,80249,80219951995

TherapistTherapistServicesServices

OthersOthersOccupationalOccupationalMedicineMedicineMidwiferyMidwiferyNursingNursingRelatedRelatedYearYear

Physical &Physical &In Medical &In Medical &

GraduatesGraduates

CourseCourseTotalTotal

DOLE

1,8271,8276076071,0541,0542,3872,3874,3984,39811,15211,15221,42621,426AverageAverageAnnualAnnual

883355111121215252100100% to Total% to Total61,54561,54523,21723,21736,64036,64074,07874,078150,873150,873395,859395,859742,199742,199TotalTotal3,1813,1812,5832,5831,6221,6222,1742,1741,7381,7385,7845,78417,06217,062200020002,8942,8942,4452,4451,8971,8972,2762,2762,2782,2788,3138,31320,10320,103199919993,1043,1041,6001,6001,7021,7021,8121,8123,5033,5039,4419,44121,16221,162199819983,1423,1421,0931,0931,4471,4471,8761,8764,0174,01711,69711,69723,27223,272199719973,6763,6768138131,2961,2962,2072,2076,2926,29215,69715,69729,98329,983199619962,8062,8066996991,4981,4982,1762,1768,8338,83327,27227,27243,28443,284199519954,1374,1375595591,6211,6212,5532,5538,0228,02229,44529,44546,34246,342199419943453455785781,1071,1072,8092,8099,6779,67730,92130,92145,43745,437199319937677673693691,1551,1553,1193,1197,3997,39915,98615,98628,79528,795199219924654651311311,3591,3591,4151,4156,6816,6819,1659,16519,21619,216199119914874872032038488483,9113,9114,4714,4719,1009,10019,02019,02019901990

25,00625,00611,05311,05315,55215,55226,33326,33362,91162,911172,821172,821313,676313,67619901990--2000200011,53511,5351,0911,0915,5365,53621,41721,41725,05125,05150,21750,217114,847114,84719811981--19891989

tionaltional))OccupaOccupa--ProfessionalsProfessionals

OthersOthers(Physical/(Physical/PharmacyPharmacyMedicineMedicineMidwiferyMidwiferyNursingNursingMedicalMedicalTherapyTherapyRegisteredRegisteredYEARYEAR

Licensure ExaminationLicensure ExaminationTotalTotalQUALIFIERS IN MEDICAL LICENSURE EXAMINATION BY TYPEQUALIFIERS IN MEDICAL LICENSURE EXAMINATION BY TYPE

DOLE

Demand for NursesDemand for Nurses•• PNA 2002 survey points to PNA 2002 survey points to

27,000 nurses locally 27,000 nurses locally employedemployed

•• 170,000 overseas170,000 overseas

DOLE

94947676170170TOTALTOTAL2121222323Self EmployedSelf Employed

Operated BusinessOperated Business88--88Employer in Own FamilyEmployer in Own Family--

222237375959--Government/Govt. Corp.Government/Govt. Corp.424236367878--Private EstablishmentPrivate Establishment

FamilyFamily--Operated Bus.Operated Bus.11**22Household/OwnHousehold/Own

--PrivatePrivate65657474139139Wage and Salary WorkerWage and Salary Worker

ProfessionalsProfessionalsProfessionalsProfessionalsProfessionalsProfessionalsHealthHealthMidwiferyMidwiferyMedicalMedicalClass of WorkerClass of WorkerOtherOtherNursing andNursing andEmployedEmployed

OccupationOccupationTotalTotal

EMPLOYED NURSES, MIDWIVES AND OTHER HEALTH EMPLOYED NURSES, MIDWIVES AND OTHER HEALTH PROFESSIONALS, PHILIPPINES: OCTOBER 2001PROFESSIONALS, PHILIPPINES: OCTOBER 2001

DOLEForeign demand for medical Foreign demand for medical personnel, nursespersonnel, nurses

Permanent Migration: 24,029 medical Permanent Migration: 24,029 medical professionals (1998professionals (1998--2000)2000)

Nurses constituted single largest group of Nurses constituted single largest group of health professionals; midwives health professionals; midwives ranked 2ndranked 2nd

DOLE

10,8956151,03213,87526,417Total

71356441,5752,3882001

2,8931093102,8636,1751996-2000

4,4894114345,57710,9111991-1995

2,800392443,8606,9431988-1990

Professionals)

ProfessionsTherapistMidwifeNurse(MedicalYear

Other MedicalProfessionalProfessional

No. of Emigrants

EMIGRANT FILIPINO PROFESSIONAL MEDICAL EMIGRANT FILIPINO PROFESSIONAL MEDICAL WORKERS, BY FIELD OF SPECIALIZATION, WORKERS, BY FIELD OF SPECIALIZATION,


DOLE

4394395755751,3501,35011,51111,51113,87513,875TotalTotal

141439391411411,3811,3811,5751,57520012001

1171171151153413412,2902,2902,8632,86319961996--20002000

2112111861866066064,5744,5745,5775,57719911991--19951995

97972352352622623,2663,2663,8603,86019881988--19901990

WorldWorldStatesStatesNurses EmigrantsNurses Emigrants

Rest of theRest of theAustraliaAustraliaCanadaCanadaUnitedUnitedprofessionalprofessionalYearYear

No. ofNo. of

EMIGRANT FILIPINO PROFESSIONAL EMIGRANT FILIPINO PROFESSIONAL NURSES BY COUNTRY OF DESTINATION, NURSES BY COUNTRY OF DESTINATION,


DOLE

6,5896,5892,8472,8471,8921,8922,6062,60614,33414,33411,32611,32643,80043,80083,39583,395TotalTotal8008003453451041043673673,6333,6332952955,0835,08310,62710,6272002*2002*844844991921922492496,9496,9493043045,2755,27513,82213,8222001200165465417171331333053052,7552,75591914,3864,3868,3418,341200020005055051818535337837893493453534,0314,0315,9725,9721999199972272289891431432792796363554,0984,0985,3995,39919981998

1,0311,03117517525252092090011113,7943,7945,2465,24619971997921921809809269269137137002702703,0713,0715,4775,4771996199648248238038059599494003,6903,6903,2493,2497,9547,954199519952462461515455455270270002,8532,8533,3323,3327,1717,171199419942122127217211391394747001,9871,9874,2024,2027,3087,30819931993172172269269320320271271001,7671,7673,2793,2796,0786,07819921992

Ireland

WorldEmiratesandStatesArabiaNurses

of theLibyaKuwaitUnited ArabKingdomUnitedSaudiDeployedRestUnitedNo. ofYEAR

Country of Destination

DEPLOYMENT OF FILIPINO NURSES BY DEPLOYMENT OF FILIPINO NURSES BY COUNTRY OF DESTINATION COUNTRY OF DESTINATION PHILIPPINES: 1982PHILIPPINES: 1982--20022002

DOLE

Policy Program Framework for Recruitment, Policy Program Framework for Recruitment, Training and Deployment of Filipino Nurses and Training and Deployment of Filipino Nurses and CaregiversCaregivers

Learning and training policies and Learning and training policies and institutionsinstitutions

Formal higher educational institutions: Higher Education Formal higher educational institutions: Higher Education Act of 1994Act of 1994

Commission on Higher EducationCommission on Higher Education

Policy formulation and regulation of institutions of Policy formulation and regulation of institutions of higher learninghigher learning

DOLE

Policy Program Framework for Recruitment, Policy Program Framework for Recruitment, Training and Deployment of Filipino Nurses and Training and Deployment of Filipino Nurses and CaregiversCaregivers

Technical and vocational training institutions: Technical and vocational training institutions:

Republic Act 7796, creating the Technical Education and Skills Republic Act 7796, creating the Technical Education and Skills Development AuthorityDevelopment Authority

Formulation of national skills standardsFormulation of national skills standardsCaregiversCaregivers

Occupational Qualification and Certification SystemOccupational Qualification and Certification System

Industry Working Group for HealthIndustry Working Group for Health

DOLE

The Overseas Employment ProgramThe Overseas Employment Program

Recruitment and deployment tracks:Recruitment and deployment tracks:

Through private recruitment orThrough private recruitment orplacement agencyplacement agency

“Name Hire” scheme“Name Hire” scheme

Government to GovernmentGovernment to GovernmentUnited KingdomUnited KingdomNorwayNorwayAustriaAustria

DOLE


United KingdomUnited KingdomJanuary 3, 2002January 3, 2002

UK employer pays for costs of recruitmentUK employer pays for costs of recruitment

POEA undertakes sourcing, advertising, prePOEA undertakes sourcing, advertising, pre--screening and documentation of selected nursesscreening and documentation of selected nurses

Deployed 101 nurses on 1Deployed 101 nurses on 1stst yearyear

Unique: Immersion Program for POEAUnique: Immersion Program for POEA

DOLE


NorwayNorwayJune 25, 2001June 25, 2001

AETAT conduit for recruitmentAETAT conduit for recruitment


Deployed 43 nurses on 1Deployed 43 nurses on 1stst yearyear

Equitable compensation packageEquitable compensation package

DOLE


AustriaAustriaBegan negotiations in 1993Began negotiations in 1993

Language requirement and 3Language requirement and 3--year work year work experienceexperience


Attractive compensation and benefit packageAttractive compensation and benefit packageFirst batch deployment now permanent residents First batch deployment now permanent residents of Austriaof Austria

DOLECaring for our Global Caring for our Global CarersCarers

34 Overseas Labor Offices34 Overseas Labor Offices

Bilateral agreements with host countriesBilateral agreements with host countries–– 12 existing bilateral agreements12 existing bilateral agreements–– 22 pending negotiations22 pending negotiations

Migrant Workers Act: institutional structures Migrant Workers Act: institutional structures and programs for welfare servicesand programs for welfare services

DOLECaring for our Global Caring for our Global CarersCarers

Over Over PhPPhP 8 Billion in migrant workers 8 Billion in migrant workers welfare and training fundwelfare and training fund

Overseas Workers and Welfare Overseas Workers and Welfare Administration: fund managerAdministration: fund manager

–– Medical and health insuranceMedical and health insurance–– Disability and death benefits, repatriationDisability and death benefits, repatriation–– Livelihood and entrepreneurial activitiesLivelihood and entrepreneurial activities

DOLEDomestic law for protecting nurses and Domestic law for protecting nurses and health workershealth workers

Magna Magna CartaCarta for Health Workersfor Health Workers

Philippine Nursing ActPhilippine Nursing Act

DOLE

Gains, Challenges & ProspectsGains, Challenges & Prospects

Gains and BenefitsGains and BenefitsShortShort--term: foreign currency term: foreign currency remittance boost economic and fiscal remittance boost economic and fiscal situationsituation

Strategic benefits:Strategic benefits:Transfer of acquired advanced training, Transfer of acquired advanced training, upgraded skillsupgraded skills

DOLE


ChallengesChallengesSocioSocio--cultural costs of cultural costs of labourlabourmigrationmigration

Added financial burden to meet Added financial burden to meet certain standardscertain standards

Increased health risks to workersIncreased health risks to workers

DOLE


ChallengesChallengesStrain on national and local health Strain on national and local health care delivery systemscare delivery systems

“Nursing medics” as a phenomenon“Nursing medics” as a phenomenon

Potential supply shortage of nursesPotential supply shortage of nurses

DOLE

1212Total =222Total =222Total = 234Total = 234SubSub--Total = 145Total = 145

19921992--2001 (POEA data)= 732001 (POEA data)= 7319811981--1991 (estimate) = 721991 (estimate) = 72

Deployment:Deployment:SubSub--Total = 23Total = 23

19881988--2001 (CFO data) = 142001 (CFO data) = 1419811981--1987 (estimate) = 91987 (estimate) = 9

Emigrant:Emigrant:Overseas Employment =168Overseas Employment =168

Oct. 2001 (LFS data) =54Oct. 2001 (LFS data) =541001 (estimate) = 111001 (estimate) = 11Domestic EmploymentDomestic Employment19811981--2000 (PRC data) = 2232000 (PRC data) = 223

(Employed Nurses)(Employed Nurses)(Registered Professional (Registered Professional Nurses)Nurses)

Surplus/(Gap)Surplus/(Gap)DEMANDDEMANDSUPPLYSUPPLY

SUPPLYSUPPLY--DEMAND SITUATION OF THE NURSING DEMAND SITUATION OF THE NURSING PROFESSION, PHILIPPINES: 1981PROFESSION, PHILIPPINES: 1981--2001 2001 (in thousands)(in thousands)

DOLE


ChallengesChallengesStrategic issues on GATSStrategic issues on GATS

National barriers on international mobilityNational barriers on international mobility

DOLE


ProspectsProspectsNational action to increase productivity, National action to increase productivity, promote multipromote multi--skillingskilling and skills upgradingand skills upgrading

Reforms in health financing, management of Reforms in health financing, management of medical and nursing education and servicesmedical and nursing education and services

Development of new learning and career Development of new learning and career opportunitiesopportunities

DOLE


ProspectsProspectsPursuit of strategic global action to Pursuit of strategic global action to address labor migration challengesaddress labor migration challenges

Sharing of health human resource policies and Sharing of health human resource policies and data basedata base

Forging a joint or multiForging a joint or multi--country policy research country policy research and action agenda on health human resources and action agenda on health human resources developmentdevelopment

DOLE


ProspectsProspectsReversing outReversing out--migrationmigration

Bringing the demand inBringing the demand in--countrycountry

Philippine Retirement AuthorityPhilippine Retirement Authority

Policy shift: dual citizenshipPolicy shift: dual citizenshipIncentives: affordability, weatherIncentives: affordability, weather

taking stock of health human resource capital - … stock of health human resource capital: gains,...

Documents