Achievements in Health Workforce Development and Strengthening in the DPR Korea

Human Resources for Health Data in 2024, DPR Korea

Category	ISCO code	Total number
Generalist medical doctors	2211	23 788
Specialist medical doctors	2212	58 333
Traditional medicine professionals	2230	5 545
Paramedical practitioners	2240	5 343
Dentists	2261	7 954
Environmental and occupational health and hygiene professionals	2263	4 911
Pharmacists	2262	14 317
Nursing professionals	2221	113 553
Midwifery professionals	2222	4 277

Governance and leadership

Strong governmental leadership has been committed to human resources for health strengthening as one of priority public health development policies. HRH centralized governance has been institutionalized with a dedicated HRH unit in the Ministry of Public Health which provides leadership to production, deployment and management of HRH across the country in close collaboration with relevant stakeholders including the Ministry of Education. {Policy priority for PHC – as shared earlier would be powerful here]

Pre-service education and deployment

HRH development system has been effectively established and domestic production of health workers sufficiently meet the demand of population. [How – monitoring of evolving population needs; health service organization (incorporaton of digital); and associated changes in production]

Pre-service education involves the Pyongyang University of Medicine in central level and Medical Colleges in every province, and other education facilities. Those university and colleges have clinical faculty, Koryo medical faculty, dental faculty, public health faculty and pharmaceutical faculty, etc [are Koryo and allopathic integrated – some overlap]. All entrance and education of the university and colleges are free of cost. All curricula of the medical education are regularly reviewed and updated in line with evolving population needs + global advancement.

Graduates of medical schools plus clinical trainings are awarded Medical Practitioner’s Qualification Certificate by passing the National Medical Licensing Exam. The Government encourages the graduates of medical schools (very important – how) to be deployed in PHC facilities like clinics and Ri hospitals which contribute to workforce stability in PHC levels.

There are specialist medical doctors training system. Selected graduates are further trained in continuing professional development courses of medical specialization and awarded the Medical Specialized Practitioner’s Qualification. Then, they are deployed in their specialties of central level hospitals and specialized hospitals.

In addition, there is a National Health Professional’s Grading Assurance System. All health professionals are obligated to attend competency evaluation every 3 years and awarded certain grade certification according to result of the evaluation. It is also linked to career progress and choices. (very important – important learning; is better performance also linked to career progression/choice?] .

Capacity building of health workforces

All health workers are involved in in-service training system. They regularly attend the refresh training programme every 3 years for getting trained with up-to-date knowledge and skills on diagnosis and treatment of disease in their specialized as well as neighboring areas. This system includes Pyongyang College for refresh training of medical practitioners for doctors of central level hospitals and provincial institute for refresh training for doctors of provincial hospitals. (Important learning for us; how often is refresher training required)

All healthcare providers devote themselves for quality services delivery as well as competence improvement through technical study and consultations on a regular basis. The competencies are regularly evaluated every month in hospitals and every year by the Ministry of Public Health, which contribute to strengthening and improvement of technical capacities of all healthcare providers (is capacity building specifically linked to these assessment; would be very important to highlight).

Upholding the Regional Development Policy, modern hospitals are constructed in every city and county which are parallel to train and strengthen competencies of medical workers in those hospitals. It will contribute to equitable distribution of health facilities and health workforce.

New generation of the regions are educated and trained who will play a key role in newly built modern city and county hospitals.  Central level hospitals regularly organize technical trainings and transmissions for rural medical doctors, send mobile technical teams to rural hospitals and arrange remote trainings by telemedicine network established across the country which contributes to reduction of disparities between urban and rural healthcare services.

Quality healthcare services by quality healthcare providers

Domestic education and training of health workforce sufficiently meet demand of population in the country and all healthcare services are free of cost to all people.

Household doctor system established in PHC levels plays a key role in providing universal healthcare services to whole people. One household doctor is responsible for about 130 households. Clinic and Ri hospital exist in every Dong and Ri which are the lowest administrative division of the country. There are household doctors, health promotion and anti-epidemic doctors, surgical doctors, medical doctors, Koryo medical doctors, dentists, obstetric and gynecology doctors/midwives and pediatric doctors and nurses. All HH doctors in these clinics and Ri hospitals are graduated and qualified medical doctors. They provide regular visits to families in their charge for health promotion and counselling, screening and early detection of communicable and non-communicable diseases. Suspected cases are referred to clinics for registry, further diagnosis, treatment and follow up. If needed, these cases are referred to higher level hospitals for further examination and treatment.

In all healthcare facilities including hospitals and clinics, team based care are facilitated through doctors’ consultation and multidisciplinary cooperation for accurate diagnosis and treatment of patients. All doctors actively attend technical study and discussion for application of advanced medical science and technology.

It is one of prior health policy to develop Koryo medicine, the country’s traditional medicine, by education and training of Koryo medical professionals, and increase portion of Koryo medicine services in all healthcare services. Koryo specialized hospitals exist in central level and every province, Koryo specialized unit in all hospitals and Koryo medical doctors in all PHC facilities which contribute to facilitation of Koryo medical services to whole population.

Women and children’s health and oral health have also been committed as one of leading health policy. Specialized maternity and pediatric hospitals and dental hospitals are existing in central level and every province, obstetric and gynecology specialized unit and dental unit in all hospitals, obstetricians and gynecologists, and dentists in all PHC facilities.

Capacity building of nurses and midwives

Schools for education and training of nurses and midwives established in central level and every province where nurses and midwives are produced meeting demand of healthcare services. Qualification review system for nurses and midwives has been established and in-service refresh trainings are regularly provided to all in-service nurses and midwives. All nurses and midwives devote themselves to care and management of patients under supervision of doctors from central level hospitals to PHC levels.