To fulfill its Development Vision 2025, the Government of Tanzania is pressing for more health professionals practicing throughout the country. But training institutions are short of teaching faculty and their facilities are inadequate to train more graduates. Employers are unable to provide adequate facilities and supervision for the increasing numbers of graduates, through their internships and early employment. Without supportive supervision, continuing education and better employment conditions, graduates are unwilling to go to remote areas and are tempted to work in administrative jobs or to seek employment overseas. In the absence of other interventions, increasing the number of graduates will not translate into as many competent health professionals practicing where they are most needed.
Responsibility for planning interventions to increase the numbers of practicing health professionals cuts across ministries and organizations, including the Ministries of Health and Social Welfare, Education and Vocational Training, Planning, Finance, training institutions, public and private employers, and funding partners.
A group of researchers from MUHAS and UCSF decided to develop a tool to facilitate policy makers and others to make joint and realistic plans to increase the quantity and quality of health professionals in Tanzania – beginning with medical doctors. We consulted graduates and their employers and reviewed available literature about the health worker shortages in Tanzania in order to determine the most helpful ways to support the planning process. Using this data, we are developing a quantitative tool entitled Increasing Clinically Active Doctors in Tanzania, or ICAD.
We built ICAD as an Excel workbook using data gathered from various sources – the number of students entering medical schools, the 2006 Service Availability Mapping undertaken by the Ministry of Health and Social Welfare, a small survey of doctor movement conducted by MUHAS, and human resources for health surveys from other countries in sub-Saharan Africa – as well as expert opinion. While the numbers are plausible, users may alter some data if they have different assumptions or information. Use of ICAD highlights the paucity of data to evaluate the impact of policy interventions on the distribution of human resources in Tanzania and could drive further information gathering.
The software is still under development. More information can be found at the project website.