National Assessment Tool

The Global Health and Care Worker Compact

The COVID-19 pandemic has showcased the extraordinary work performed by frontline health and care workers under extraordinary circumstances. Under such circumstances, however, more than 115,500 health and care workers are estimated to have died due to COVID-19 between January 2020 and May 2021. In addition, the workforce has and continues to face further pressures from COVID-19 infections and their long-term impacts, mental health issues (due to burnout, fatigue, stress, and violence, for example), labor protests, and critical shortages. Importantly, COVID-19 did not create such issues; it merely shone a light on such issues and exacerbated them.

Recognizing this, in 2021 the World Health Assembly requested the World Health Organization (WHO) to develop the Global Health and Care Workers Compact (the Compact). The Compact builds on existing standards in international law, including international conventions, instruments, treaties, and resolutions, and centralizes them into one comprehensive resource to guide WHO Member States on how to protect health and care workers and safeguard their rights. This is critical, not only in and of itself, but also to further health and development goals, such as universal health coverage and the goals of the 2030 Agenda for Sustainable Development including reducing poverty and advancing gender-equality.

The Compact covers 11 substantive topics, falling into one of five broad themes:

Purpose of the Self-Assessment Tool

The purpose of this self-assessment tool (“the tool”) is to measure country-specific status and progress in adopting the standards and recommendations of the Compact. The self-assessment is to be completed through a collaborative process between governments and other national stakeholders, especially civil society organizations, health and care workers, and their unions or other representatives. The tool addresses the law and policy environment across the 11 main areas of the Compact, as well as the implementation of existing laws and policies.

There are four key purposes of the tool:

1. Measuring progress on developing and implementing national laws and policies related to the substantive areas of the Compact, as well as in implementing policy and other recommendations.
2. Promoting consultation and dialogue between governments and other national stakeholders, including health and care workers themselves, to enable government officials to gain a deeper understanding of the situations health and care workers face, and to foster joint efforts to work towards implementing the recommendations contained in the Compact and securing the rights of health and care workers contained in international law – and the process, furthering the right to health of the public at large.
3. Supporting countries to gain a deeper understanding of their current state of laws and policies related to safeguarding the rights and well-being of health and care workers, and their implementation. This entails:
   • accurately assessing the current status of their legal and policy landscape as it relates to health and care workers,
   • better understanding of how national laws and policies are being implemented; and
   • identifying risks, gaps, and opportunities for a greater alignment between national laws, policies, strategies, processes, and practices and the aspirations – underpinned by treaties and other international instruments – of the Compact.
4. Collecting data at a global level on the legal and policy environment, and how laws and policies relevant to the Compact are being implemented internationally.

Process

The self-assessment is meant to be completed through a collaborative approach across sectors, including health and labor ministry officials, members of parliamentary committees with health and labor mandates, health and care workers, and civil society organizations. We urge those engaged in completing this self-assessment tool to include a wide range of health and care workers, including those serving marginalized, disadvantaged, and remote communities, and different categories of health and care workers, including home‐based personal care workers. If health and care worker committees have been established to advise on and monitor implementation have been developed, as recommended in the Compact itself, the committee should contribute to completing this self-assessment tool. Other participants should include employers, including private health and faith-based sectors.

While stakeholders in different countries might choose different approaches, we urge the maximum level of dialogue among stakeholders in completing this tool. If direct engagement – meetings of different stakeholders to discuss and collectively agree on responses to the self-assessment questions, for example – is not possible, different stakeholders could separately complete and submit their responses, or could provide separately completed responses to a small group of people to collate the answers into a single national response.

Space is provided at the end of each section for those filling out this self-assessment to describe any significant differences in perspectives among the different stakeholders (e.g., government officials and health and care workers) that may have arisen while filling out that section and are not resolved through dialogue.

In some cases, such a collaborative and inclusive process may not be possible. Yet we urge every effort be made to follow this process, even if it requires being selective in how much of the self-assessment tool can be completed. As noted above, a central purpose of this tool is to spark dialogue across stakeholders, including the health and care workers whose rights and well-being are most directly at stake in the Compact and who might have little other opportunity to engage with policymakers. The hope is that this process will itself lead to policies and other actions toward fulfilling the obligations and commitments underlying the Compact and implementing its recommendations.

The completed self-assessment will be shared with WHO/the O’Neill Institute for analysis and posting online. The first self-assessment will be a baseline measurement of the country’s progress and status with respect to the main principles of the Compact. Subsequent assessments will identify progress made and the sustainability of improvements. The self-assessment should be repeated ideally every two to three years, and not less frequently than every four to five years.

If this is the baseline assessment, please answer any such questions with respect to either the past 5 years or from May 2022. If your State has already conducted one or more assessments of the Compact, please answer any such questions with respect to implementation, and actions taken, since the previous assessment.

Format

The tool comprises a series of questions, which will enable respondents to measure country-specific status and progress against each main principle of the Compact. Questions include yes/no queries as well as questions requesting qualitative information. In most cases, “yes” responses indicate a positive step in implementing the Compact and its underlying commitments and obligations. An asterisk has been added to questions that are outliers to this norm.

Each section also mirrors one Compact area and comprises a series of contextual and technical questions to obtain qualitative information. Countries are asked to provide documentation, copies, or URLs of- all relevant laws, policies, or measures in response. Some questions ask about the implementation of commitments related to and recommendations in the Compact, as well as about reforms, actions, or other measures or progress towards fulfilling these commitments and carrying out the recommendations.