Participants at a knowledge-sharing forum

Kagera, Mara and Shinyanga regions have formulated strategies, dubbed ‘best practices’, aimed at solving the critical shortage of health workers in districts.

The country’s health sector currently faces a serious Human Resource crisis, which impacts negatively its ability to provide better services at village and district levels.

The crafted strategies by the Lake Zone regions health stakeholders address the inability of many districts in the country to attract and retain competent health workers, thus curtailing delivery of quality healthcare services in dispensaries, health centres and hospitals.

These ‘best practices’ are a product of knowledge-sharing forums held between May 7 and 15 in the three Lake Zone regions. The forums brought together key decision makers and human resources managers from respective local government authorities. Among them were District Executive Directors, District Human Resources Officers, District Medical Officers and District Health Secretaries.

Key objectives of the knowledge-sharing forums were to discuss best practices in handling recruitment and retention challenges in local governments as well as improving working conditions and performance.

At the end the forums participants came up with sets of commitments and recommendations, which are expected to guide implementation of various improvement initiatives, especially at local government authorities, towards improving their ability to attract, recruit and retain competent health workers and reduce vacancy rates.

The Government has had efforts to improve recruitment of health workers through respective ministries as it has been changing strategies from time to time. Currently, recruitment for health workers is centralised; initially managed by the Ministry of Health and Social Welfare and recently by the Public Service Employment Secretariat within the President’s Office - Public Service Management consistent with the 2007 Public Service Act.

Health experts say centralized recruitment practices and multi-sectoral involvement in the recruitment process of health workers have led to a number of contentious issues, arguably resulting into higher vacancy rates and reduced retention of staff at local government authorities.

Some of these contentious issues include receiving limited approvals of posts or permits compared to staffing needs and failure to receive required cadres due to shortage of skills in the market, among others.

Despite various ongoing and completed initiatives to address these problems and others, the limitation of most Local government authorities to attract and retain health workers still persists.

Furthermore, the health experts say the Human Resources Information System (HRIS) is being implemented in various local government authorities under the Tanzania Human Resources Capacity Project (THRP). Different districts are at different stages of implementation of the system for different reasons -- rendering knowledge and experience-sharing quite necessary.

It is against this background that the Benjamin William Mkapa HIV/AIDS Foundation (BMAF) and its partners came up with the idea of creating a multi-sectoral understanding and experience-sharing on the underlying Human Resource for Health policies and practices that contribute to the challenges experienced by local governments and soliciting appropriate ways of resolving them.

Among the resolutions discussed by participants at the forums include improvement of orientation at the district level for all newly employed staff as well as timely payment of subsistence allowance to the newly employed health staff.

.Other resolutions made during the forum includes the need for development of district profiles which can be circulated to potential sources of recruitment such as health training colleges and universities. Innovative ways of attracting graduates from colleges and universities which has been invented by Mkapa Foundation was also recognized as an important practise to be supported by donors, government and district generally in-order to obtain potential health staff to be hired. Furthermore, encouraging and attracting health students who are on field attachment at the districts facilities is important so as to familiarise to accept working in the local environment

Other recommendations coming from the forum is on encouraging construction of staff houses using available funding avenues at the LGAs as well as encouraging more funds disbursement from the ministry level to support the cause.

These outputs from the forums were sets of commitments by concerned local government authorities to improve methods, processes as well as instituting best practices on addressing the Health workforce challenges.

"Generally, we believe that these forums have been effective engines for generating knowledge and sharing practical strategies and techniques, especially local initiatives for improving recruitment and retention of health workers in the districts," the participants observed.

However, they say realisation of expected outcomes of various resolutions reached during the forums will highly depend on the commitment of both respective local government authorities and relevant central ministries to implement recommended actions.

“We at the Local Government depend on the common understanding and effective coordination of the four ministries, which deal and have stake on the human resource for health matters. These ministries are the President’s Office Public Service Management, Prime Minister’s Office Regional Administration and Local Government; Ministry of Health and Social Welfare and Ministry of Finance. Thus our plea is for the Mkapa Foundation who works closely with the districts to play a facilitative role across the Ministries so as to address our main challenges on Human resource for Health” , as stated by one of the participant in the forum.