The leaking pocket: The implicit struggle for skilled health workers between private not-for-profit and public sector in Tanzania

Kahabi G. Isangula, Sharon Brownie

Abstract


Introduction: Human resource for health is the core building block of an effectively functioning health system, and, competent and motivated health workers are the key drivers at all levels in health service delivery. Public health services in sub-Sahara Africa countries face severe health workforce shortages exacerbated by both outward migration and internal public to private sector migration—Tanzania is no exception. This review was conducted to characterize the extent of health workforce shortages in Tanzania, and the factors impacting on the shortage.

Methods: The authors reviewed publicly available data to assess the extent of health workforce shortages within Tanzania and the range of ‘pull’ and ‘push’ factors contributing to the shortages.
Results: Findings highlight significant health workforce shortages in Tanzania. Specific ‘pull’ and ‘push’ factors were identified. Pull factors are considered to be factors such as the advantages offered by new jobs, such as higher pay and better working conditions that 'pull' workers towards the new jobs. Push factors have been identified as those negative factors that 'push' workers out of their jobs, such as poor pay, working conditions, and management and governance issues. These factors impact extensively acting upon the recruitment and retention of Tanzanian health workers. The issue of health workforce flow from the public to private not-for- profit sector was particularly notable and the impact this has on the ability to provide an effectively functioning public health system in Tanzania.

Conclusion: The authors conclude that opportunities exist for the private not-for- profit sector to take an active role in the production of skilled human resources for health in Tanzania.

 


Keywords


Key words: Health; Tanzania; public health services; private health services; capacity building; workforce development

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References


Munga MA, Mbilinyi DR. Non-financial incentives and retention of health

workers in Tanzania: Combined evidence from literature review and a focused cross-sectional study. EQUINET Discussion Paper Series 61, 2008. NIMRI, ECSA-HC, EQUINET: Harare.

Joint Learning Initiative. Human resources for health: Overcoming the crisis, Report from the Joint Learning Initiative. New York: Harvard University Press; 2004.

Essack SY. Issues in medicine: models for increasing the health workforce. South African Medical Journal 2012, 102(11), 830-832.

Matovu JK, Wanyenze RK, Mawemuko S, Okui O, Bazeyo W, Serwadda D. Strengthening health workforce capacity through work based training. BMC International Health and Human Rights 2013, 13(8). [http://www.biomedcentral.com/1472-698X/13/8].

Fitzen SA. Strategic management of the health workforce in developing countries: what have we learned? Human Resources for Health 2007, 5(4) Published online 2007 February 26. doi: 10.1186/1478-4491-5-4.

Bangdiwala SI, Fonn S, Okoye O, Tollman S. Workforce resources for health in developing countries. Public Health Review 2010, 32(1) 296-318.

Beaglehole R, Dal Poz MR. Public health workforce: challenges and policy issues. Human Resources for Health 2003, 1(4). [http://www.human- resources-health.com/content/1/1/4].

Chastonay P,Moreti R, Zeisger V, Cremaschini M, Bailey R, Pariya G, Kabengele EM. Health workforce development: a needs assessment study in French speaking African countries. Advances in Health Science Education 2013, 18(2), 265-277.

Ministry of Health and Social Welfare (MoHSW). Annual health statistical abstract. [http://www.moh.go.tz/documents/Abstract_2006- Version%203.pdf]

CIDA. Proposal for a Tanzania health workforce initiative. The Canadian International Development Agency, Tanzania Ministry of Health and Social

Welfare and private sector institutions, 2009. [http://www.tzdpg.or.tz/fileadmin/documents/dpg_internal/dpg_working_gr oups_clusters/cluster_2/health/Key_Sector_Documents/HRH_Documents/T HWI_-_HSSP3-Health_Workforce_Initiative_Jan__9th_2009.pdf]

Robinson R. The costs and benefits of health worker migration from East and Southern Africa (ESA): A literature review. EQUINET DISCUSSION PAPER 49 2007. [http://www.nsi-ins.ca/wp-content/uploads/2012/10/2007- The-Costs-and-Benefits-of-Health-Worker-Migration-from-East-and- Southern-Africa-ESA-A-Literature-Review.pdf]

Naicker S, Plange-Rhule J, Tutt RC, Eastwood JB. Shortage of health care workers in developing countries. Africa Ethnicity & Disease 2009, 19(1) 60-64.

Isangula KG. Viewpoint: Moral and ethical dilemmas during medical doctor’s strike in Tanzania (August 5, 2012). [http://ssrn.com/abstract=2129024 or http://dx.doi.org/10.2139/ssrn.2129024]

WHO. Health workers: A global profile. 2006. [http://www.who.int/whr/2006/06_chap1_en.pdf]

WHO. World Health Statistics, 2008. [http://www.who.int/gho/publications/world_health_statistics/EN_WHS08_ Full.pdf]

WHO. A universal truth: no health without workforce, 2013. [http://www.who.int/workforcealliance/knowledge/resources/hrhreport2013/ en/]




DOI: http://dx.doi.org/10.14738/assrj.15.416

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