Human Resources for health in Tanzania
The availability of qualified human resources plays a vital role in the provision of quality health
services. The prevailing human resources for health (HRH) crisis results from the growing demand
for health services along with an inadequate supply from our training institutions as well as inadequate
management of the available human resources.
Any policy that addresses the prevailing crisis has to rely on a sound HRH database. However, the
Health Sector Performance Profile Report 2009 indicates that available HRH data at the central level
differs from data at the district level. To resolve these inconsistencies, a deployment tracking study
has been conducted in 103 districts. Consequently, this report sheds light on the actual HRH situation
The findings indicate a dire shortage of staff in all public health facilities. The districts need more
staffing from all cadres especially clinical officers, nurses and medical attendants. Overall, the HRH
gap in the observed districts stood at 54%.
Moreover, the report enquires how effectively the HRH deployment process of 2008 has contributed
to the closing of the gap. The process of deploying graduates has been differentiated into: districts’
requests of HRH already made in 2007; deployed HRH by the MoHSW, the DMOs and the Benjamin
Mkapa HIV/AIDS Foundation in 2008; HRH reporting to their duty station; HRH that reported and
left or who were not sufficiently qualified; and HRH after deployment process in June 2009.
It has been observed that discrepancies exist throughout the whole deployment process. Districts
that lacked quite a lot of staff did not necessarily request relatively more personnel. The correlation
between the HRH requests and the gap is very weak (0.17). Regarding deployment, the same has
been observed since most of the cadres showed an actual deployment rate below 50%. The rate of
health staff reporting to their duty stations was also disappointing. This phenomenon seems to be
more severe in the rural districts than in the urban ones; the reporting rates stand at 74% and 93%,
respectively. We have also observed a gender bias since almost 70% of all graduates who reported to
their duty stations were female.
To close the HRH gap, the government needs to introduce a deployment policy. Moreover, because
the staff inadequacy will prevail in the short and medium term, the reallocation of available HRH
should be considered to mitigate the crisis. At the district level, responsible officials need to create
incentives to attract health workers to their underserved area. Also, the use of temporarily unemployed
and retired health workers can significantly help reducing the existing gap. Further, we hope that the
findings of this report will feed into the planning of HRH training and deployment and also inform
the government about how the available resources can be reallocate to mitigate the HRH crisis and
thereby improve the delivery of health services to the citizens.