Let us make improving public health a priority

By Editor

Editorial Cartoon

Tanzania’s health sector is experiencing a human resource crisis that has disrupted the country’s ability to offer quality public health services, most especially in underserved areas. Undeniable.

The World Health Organisation says Tanzania is among African countries with a severe shortage of skilled health personnel, with the doctor-to-patient ratio standing at 1:25,000. Very bad – but true.

This shortage is threatening healthcare delivery wholesale, what with the country having few facilities and not meeting globally accepted minimum standards in the delivery of services.

There is no denying that the government made some efforts towards rectifying the situation, in part by recruiting more and more health workers and coming up with improved and therefore more effective strategies from time to time.

Recruitment for health workers is centralised. Once it was the Health and Social Welfare ministry and later the Public Service Employment Secretariat in the President’s Office (Public Service Management) that was in charge – by law.

But the centralised recruitment has had its share of constraints that have eaten into efficiency chiefly resulting from failure to fill a substantial number of staff vacancies as well as failure by local government authorities (LGAs) to retain as many health workers as circumstances demanded.

One explanation for this was the understandable hunt by doctors, nurses and various other health personnel for “greener pastures” in the private sector and outside Tanzania, with the local public sector unable to stand the competition.

Central and local government initiatives to address these and related problems have yet to stem the tide and attract new personnel, and it would be foolhardy to expect things to improve appreciably soon.

Yes, there is the Human Resources Information System, which is being implemented by a number of LGAs under the Tanzania Human Resources Capacity Project – and districts differ in the level of implementation at which they are.

It is precisely because of these harsh realities that private institutions both local and foreign or international have been called upon to chip in with more substantial amounts of support in the form of financial and other resources, including medical facilities and supplies.

Giving its fast-swelling population, Tanzania badly needs a viable health workforce if it is to attain a healthcare system essential solid and vibrant enough to ensure the country attains the Millennium Development Goals (MDGs) even if it is beyond the 2015 global deadline.

Shortage of qualified health workers still remains a major obstacle to the attainment of these all-important goals: reducing child mortality, improving maternal health, controlling HIV/Aids and other debilitating or killer diseases such as TB and malaria, etc.

There is therefore urgent need for much more to be done towards ensuring that the country has most of the essential health workers it ought to have for the health sector to tick as expected – including retaining those already in place.

In this regard, we commend the Health and Social Welfare ministry for planning to implement a five-year Human Resource Strategic Plan, beginning next year, meant to address the most daunting challenges facing the health sector, among them those relating to staff planning, utilisation and development. For, indeed, what is a health sector without enough really qualified and committed personnel? 

SOURCE: THE GUARDIAN