Tanzanian HRH progress and commitments towards UHC

1. Tanzanian HRH progress and commitments towards UHC Dr. Baltazar Ngoli | Tanzania

2. Tanzania National HRH Commitments - promote health workforce development towards UHC • Increase the availability of skilled health workers: at all levels of health services delivery from 46% to 64% by 2017 based on staffing level 2013. • Increase financial base (other charges and Private Sector Investment) to operationalise the pay and incentive policy by 2017 in order to promote retention, productivity and quality of health care. • Develop and implement a Task Sharing Policy on HRH by 2017.

3. Focus of the Commitments: • Increase the availability of skilled health workers: • Developed a Projection Plan to estimate needed HW – given new challenges • Making the case for new additional employment permits • Increase the density ration of HW to population ration of districts with below national average of 1.47 HW per 1000 population • Kigoma,Tabora, Rukwa, Shinyanga and Singida • Operationalise the Pay and Incentive policy: • Rural areas are not attractive for most HW • Councils proactively engage in different incentives to attract • Pay and Incentive Policy provide the financial flexibility and sources to cover these activities • Develop and implement a Task Sharing Policy on HRH • Reality - rural health facilities are managed by Medical Attendants • Mostly untrained in the task they have to perform in reality • Task Sharing Policy enhances training options and quality assurance

4. Strategic Response: HRH Strategic Plan 2008 - 2013 • Focusing at seven strategic areas: • Planning and Policy Development • Strengthening Leadership and Stewardship • Education, Training and Development • Workforce Management and Utilisation • Partnership in Human Resources • Human Resources Research and Development • Human Resources Financing • Outlining roles of different actors – national to local levels • Coordinated by a SWAP HRH TWG • Monthly coordination meetings • Chaired by MoHSW • Currently developing a new HRH Strategic Plan 2014 - 2019

5. Recommendations for Key Actors • Support strengthening Local Government capacity on proactive initiatives (recruitment, local students enrolment, sponsoring students) • Operationalising Pay and Incentives Policy • Building Capacity of the LGAs towards promoting partnership for Private Sector Investment especially in retaining health workers in rural areas • Support strategic implementation of the HRH Strategic plan (2014 – 2019) by strengthening national capacity on coordination

6. Best practices – national health workforce strategies • Bottom up: • Proactive rural staff recruitment and retention • Proactive rural/local students enrolment into training institutions • Sponsoring and bonding of health students • Top down: • Strategic Response (HRH Strategic Plan): coordinates partners’ efforts and divide priority areas to support

7. Lessons learnt – national health workforce strategies • Policy: recognise and address challenges in time • Task sharing – developing a solution to cope with (e.g. Medical Attendants reality) took too long • Policy and financial: mainstream and give guidance to LGAs local efforts (incentives) of mitigating the staff gap • Allow flexibility and innovation in implementing the HRH Strategic Plan • LGAs should feel guided but not limited by the plan

8. Conclusion • Tanzania has still persisting shortage of health care workers – current staff gap: 58% • Observe positive trend to ensure availability and quality health workforce: • Increased annual staff recruitment from 6,437 (2008) to 8,602 (2012) • Increased number of available Health Care Workers from 47,000 in 2006/7 to 64,449 in 2012/13 • Coordinated efforts to address priority areas with SWAP context • Providing flexibility and room for bottom up innovation (proactive initiatives)

9. THANK YOU! baltazar.ngoli@giz.de