Addressing the human resource for health crisis in Tanzania: the lost in transition syndrome

Sirili, Nathanael; Kiwara, Angawara; Nyongole, Obadia Venance; Frumence, Gasto; Semakafu, Avemaria; Hurtig, Anna-Karin

doi:10.4314/thrb.v16i2.6

Cited by 28 publications

(37 citation statements)

References 9 publications

(10 reference statements)

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“…This partly contributes to the difficulties in projecting the actual number of HRH to train and deploy. Failure to deploy and retain the trained MDs fuels the brain drain and brain waste [18]. …”

Section: Discussionmentioning

confidence: 99%

“…Although medical students have to pay tuition fees in private institutions, the majority are supported through grants from the government [4, 18]. The small number of MDs graduated challenges the support provided by the government to private institutions versus expansion of the public institution.…”

Section: Discussionmentioning

confidence: 99%

“…The shortage of HRH in Tanzania is believed to be a result of multiple factors including low output of highly trained cadres from the training institutions post-independence, failure to absorb all trained HRH in the country in the last two decades, brain drain and the increased disease burden [4, 15, 17]. Among the contributors of international brain drain is the failure to absorb the graduating HRH [18]. …”

Section: Introductionmentioning

confidence: 99%

“…Under this centralized system, the Ministry of Health directly posted all MDs who graduated for internship and then working stations [18]. …”

Section: Introductionmentioning

confidence: 99%

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Training and deployment of medical doctors in Tanzania post-1990s health sector reforms: assessing the achievements

et al. 2017

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BackgroundThe shortage of a skilled health workforce is a global crisis. International efforts to combat the crisis have shown few benefits; therefore, more country-specific efforts are required. Tanzania adopted health sector reforms in the 1990s to ensure, among other things, availability of an adequate skilled health workforce. Little is documented on how the post-reform training and deployment of medical doctors (MDs) have contributed to resolving Tanzania’s shortage of doctors. The study aims to assess achievements in training and deployment of MDs in Tanzania about 20 years since the 1990s health sector reforms.MethodsWe developed a human resource for health (HRH) conceptual model to study achievements in the training and deployment of MDs by using the concepts of supply and demand. We analysed secondary data to document the number of MDs trained in Tanzania and abroad, and the number of MDs recommended for the health sector from 1992 to 2011. A cross-sectional survey conducted in all regions of the country established the number of MDs available by 2011.ResultsBy 1992, Tanzania had 1265 MDs working in the country. From 1992 to 2010, 2622 MDs graduated both locally and abroad. This translates into 3887 MDs by 2011. Tanzania needs between 3326 and 5535 MDs. Our survey captured 1299 MDs working throughout the country. This number is less than 40% of all MDs trained in and needed for Tanzania by 2011. Maldistribution favouring big cities was evident; the eastern zone with less than 30% of the population hosts more than 50% of all MDs. No information was available on the more than 60% of MDs uncaptured by our survey.ConclusionsTwo decades after the reforms, the number of MDs trained in Tanzania has increased sevenfold per year. Yet, the number and geographical distribution of MDs practicing in the country has remained the same as before the reforms. HRH planning should consider the three stages of health workforce development conceptualized under the demand and supply model. Auditing and improvement of the HRH database is highly recommended in dealing with Tanzania’s MD crisis.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

“…Under this centralized system, the Ministry of Health directly posted all MDs who graduated for internship and then working stations [18]. …”

Section: Introductionmentioning

confidence: 99%

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Training and deployment of medical doctors in Tanzania post-1990s health sector reforms: assessing the achievements

et al. 2017

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“…In Tanzania, oral health screening services in primary health settings, particularly in reproductive and child health is inadequately addressed partly because the health care providers in these settings have little knowledge [14,15] and is partly due to the shortage of the oral health workforce. [16][17][18] In South Africa, like in Tanzania, there is minimal integration of oral health education at reproductive and child health sites. [19] According to this finding in South Africa; reproductive and child health sites remain important sites for integration of dental and oral health care with general health services.…”

Section: Early Childhood Caries (Ecc) In Tanzania and Other Eastmentioning

confidence: 99%

Primary oral health care and smiles for life curriculum adaptation for nurses training in low income countries: A case of Tanzanian context

Iseselo

Minja²,

Klar³

et al. 2016

JNEP

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Primary oral health care is essential for the overall wellness of all client populations, especially those living in rural communities. Nurses make up the majority of primary care providers in Tanzania. An opportunity for the lead author to participate as an Oral Health Global Scholar allowed for the exchange of interprofessional oral health knowledge and practice competencies and for the adaptation of a U.S. based oral health curriculum to meet the context of care in Tanzania. This paper identifies the gap in oral health care in Tanzania, describes the knowledge and practice exchanges, and next steps with the adaptation of the Smiles for Life curriculum in Tanzania. The aims is to share interprofessional experience designed to develop a user-friendly curriculum and train primary health care nurses in Tanzania, on applying modern concepts such as a collaborative approach in management of the oral health needs of the patient. Nursing is a profession that has multiple roles and functions which can be utilized according to the situation and need of the community served. Therefore, interprofessional collaborations among health care providers are important to the improvement of quality oral health services.

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International Perspectives on Moral Distress

Ulrich

Lievrouw

Bulcke

et al. 2018

Moral Distress in the Health Professions

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Addressing the human resource for health crisis in Tanzania: the lost in transition syndrome

Abstract: Tanzania is experiencing a serious Human Resource for Health (HRH) crisis. Shortages are 87.5% and 67% in private and public hospitals, respectively. Mal-distribution and brain drain compound the shortage. The objective of this study was to improve knowledge on the HRH status in Tanzania

Cited by 28 publications

References 9 publications

Training and deployment of medical doctors in Tanzania post-1990s health sector reforms: assessing the achievements

Training and deployment of medical doctors in Tanzania post-1990s health sector reforms: assessing the achievements

Primary oral health care and smiles for life curriculum adaptation for nurses training in low income countries: A case of Tanzanian context

International Perspectives on Moral Distress

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