Shortage of health professionals cripples service delivery

 As a result, the country has fewer health facilities with the required minimum standards to offer quality and equitable health care services.

According to Dr Zuweina Kondo Sushy, the Programme Officer for Health Services Delivery at Benjamin Mkapa HIV/AIDS Foundation (BMAF), Tanzania needs a viable health workforce in order to attain a strong health care system essential for  accomplishing the Millennium Development Goals (MDGs).

The health-related MDGs aim to reduce child mortality, improve maternal health, combat HIV/AIDS and other diseases such as tuberculosis and malaria, and ensure access to essential medicines. Health worker shortages are a major impediment to meeting these goals.

"We also recognise that the death or suffering of a pregnant mother goes hand in hand with the suffering and loss of newborn babies up to the age of one month. Therefore, it is important to improve maternal health services along with enhancing the health of new born babies at our health facilities," says Dr Zuweina.

The doctor added that Tanzania is one of the African countries with an acute shortage of skilled health workers with a doctor to patient ratio standing at one doctor for 25,000 patients. The urban ratio is one doctor for every 4,000 patients. She also said that on average, 47.6 per cent of births are attended by skilled health personnel.

A skilled health professional is an accredited health professional such as a doctor, midwife or nurse who has been trained to proficiency in the skills needed for delivering quality health services. In addressing this challenge, the government has increased the number of employment terms of health workers from 6,437 in 2007/8 to 7,471 in 2010/2011.

With reference to the Ministry of Health and Social Welfare staff tracking report, of September 2011, only 61 per cent of those recruited reported to the designated stations due to several bottlenecks within the recruitment system. There is a direct relationship between the ratio of health workers to population and survival of women during childbirth and children in early infancy. As the number of health workers declines, survival declines proportionately.

The small numbers of health workers suffer work overloads such that they neglect some components of maternal and child services.  Preventive measures such   as counselling and health education to pregnant women and their partners are often ignored. Last but not the least youth are not taught anything on reproductive health and rights. 

With the lack of skilled personnel, mothers with complications at the time of delivery are ignored and hence more likely to end up in more fatal complications. Even during routine treatment, overloaded health workers are not able to concentrate on patients as they rush to reduce the long queues of patients. As a result, prompt diagnoses are delayed risking more complications.

To complement government efforts to tackle this shortage, the Benjamin William Mkapa HIV/AIDS Foundation through the Mkapa Fellows Programme and many other initiatives is adding value to the health sector. Under different initiatives and in collaboration with the Ministry of Health and  Social Welfare, about  600 health professionals have been recruited and deployed by the Foundation to work in several public health facilities as well as health training institutions across the country.

Remarkably, its parent programme, the Mkapa Fellows recruited 99 Fellows who worked in 33 rural districts during its first phase which started in 2006 and ended in 2011. Jointly with the health professionals in the facilities and Fellows contributed towards improving the quality of HIV/AIDS services. Consequently, the number of patients attended by HIV/AIDS clinics increased five times in districts where the Fellows served.

Approximately 60,000 people living with HIV accessed services by December 2009 as compared to 10,000 in 2005. This major success was due to their commitment, hard work and support they got from the fellow health workers and district leadership.
Furthermore, the availability of medical supplies in HIV/AIDS clinics that were provided by the Government and development partners, made the clinical management by the profesionals feasible.

It is important to note that the shortage of skilled professionals coupled with the overburden of diseases such as malaria, and HIV/AIDS necessitated an urgent scaling up of concerted actions. Impact interventions such as the Mkapa Fellows Programme add value in speeding up government efforts towards achievement of the MDGs.

The five-year Mkapa Fellows Programme (2012 to 2016), will recruit at primary health care, at health centres, a few at district hospital level. The 150 professionals include 45 doctors; 30 clinical officers, 60 nurses and 15 laboratory assistants.

The government and development partners are encouraged to promote more innovative programmes geared at increasing the number of health professionals by enhancing recruitment and retention systems.



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