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2017 ; 15
(1
): 27
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Training and deployment of medical doctors in Tanzania post-1990s health sector
reforms: assessing the achievements
#MMPMID28376823
Sirili N
; Kiwara A
; Gasto F
; Goicolea I
; Hurtig AK
Hum Resour Health
2017[Apr]; 15
(1
): 27
PMID28376823
show ga
BACKGROUND: The 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. METHODS: We 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. RESULTS: By 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. CONCLUSIONS: Two 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.