Review of the Health Services in the United Nations system (JIU/REP/2025/6 and JIU/REP/2025/6 (Expanded report))

The Joint Inspection Unit (JIU) is pleased to announce the release of its report “Review of the Health Services in the United Nations system”, prepared by Inspector Victor Moraru.

The main objective of the review was to provide an assessment of Health Services in the United Nations system and the related policy guidance and practices, with a view to identifying areas for further improvement, good practices, and opportunities for enhancing system-wide coherence.

The mandate and function of a Health Service is to promote and protect the health, safety and well-being of the organization’s personnel both at headquarters and field offices, thus enabling the organization to achieve its objectives while controlling health care costs and ensuring adherence to the duty of care.

In the move away from a limited medical-administrative function to a more holistic, preventative and modern healthcare approach, organizations progressed with the integration of key sub-functions, such as psychosocial well-being, occupational health, and occupational safety under the organization’s Health Service. However, the JIU found that full integration has not yet been achieved in about half of the organizations with own Health Services, which is recommended in view of facilitating coordinated, holistic and strategic healthcare support to personnel. The organizational arrangements for the Health Services should be reviewed, so as to assign a degree of autonomy that is required for the proper management and supervision of the function. Policy guidance consists of a multitude of documents, yet standalone documents clearly defining the mandates of the organizations’ Health Services are largely absent. Decision-making on the resourcing of Health Services is mostly driven by the availability of funds and not tightly aligned to the organizations’ healthcare needs and priorities.

Outdated practices undermine the implementation of risk-based healthcare management in the field. In particular, the practice of closing or opening of field clinics by field managers without reference to a system-wide Health Support Plan should be avoided. Insufficient use of Health Risk Assessment methodologies and their weak implementation in managing health facilities in the field are affecting the access of United Nations personnel to healthcare.

The JIU also found that the implementation of the United Nations OHS Framework’s components is uneven and at various stages of maturity in participating organizations. OHS capacity remains sub-optimal and insufficient to support full OHS implementation in the field.

The Inspector stresses that inter-agency cooperation could be improved through the establishment of a dedicated health technical network within the United Nations Chief Executives Board (CEB) mechanism, to provide strategic advice on system-wide health management issues.

The JIU makes nine formal recommendations: six to the executive heads of the JIU participating organizations, two to the United Nations Secretary-General and one to the executive heads of the JIU participating organizations, in their capacity as members of the CEB. The formal recommendations are complemented by 24 informal recommendations aimed at further improving the policies, practices and functioning of Health Services, including: improving health data collection to support a data-driven, risk-based and strategic approach to healthcare and workforce health management; consolidating sick leave management through the adoption of effective methodologies for the determination of the costs associated with certified sick leave to inform decision-making; and applying the model of cost-recovery through insurance in order to enhance the financial sustainability of the cost-shared/common Medical Services.

Read more:

Access the report here

Access the expanded report here

Access the review highlights here