Challenges in Managing Health Workers in Sub-Saharan Africa: The Case of United Republic of Tanzania
Creators: name: Bakari, Bakari A.
Publisher: name: The University of North Carolina at Chapel Hill University Libraries
Year: 2015

description: This study documents results of four years (2009-2013) of implementation activities under the Tanzania Human Resource Capacity Project (THRP), a USAID-funded initiative that addressed inefficiencies in the systems and structures of central government and local governments that deal with HRH in Tanzania. The initiative was a beneficial undertaking in Tanzania, a Sub-Saharan country facing the burden of a high maternal mortality rate, high incidence of malaria, HIV/AIDS and a host of other curable and preventable diseases; [1] partly due to fact that the current systems and structures that manage HRH are not responsive enough to the insufficient FTE's and low productivity of HRH. In 2009, the health system in Tanzania operated with 48 percent of the optimum workforce; in rural areas the vacancy rates reached up to 70 percent, threatening to negate national efforts to universal health care and health development goals [2, 3]. The THRP was, therefore, conceived to contribute to the realization of goals of the national HRH Strategic Plan for 2008 -2013 by influencing and contributing to multi-sectoral efforts to strengthen the planning, deployment, management and efficient utilization of human resources. The purpose of this paper is to describe overall strategic objectives of the project, the intermediate results, and to describe strategies that contributed to each of the project objectives. Key leadership challenges and lessons learned included: • A Knowledge gap within the RHMTs on CCHPs and PlanRep3 tools, a computer based planning tool used by PMO-RALG, has resulted in poor quality of initial plans submitted by LGAs many of which were mitigated by retraining and follow-up online support. • Increased workload for HR officers and other Local Government/Human Resource Information Systems (LGHRIS/HRIS) users due to the existence of multiple systems (HCMIS and HRHRIS) using the same staff for data entry and update of which the systems interoperability initiatives helped ease management burden and created resource sharing opportunities including data, computing infrastructure and capacity building. • LGAs/Councils willingness to seek and budget for HRM/HRIS/MVC resource despite their deficit; once they were sensitized, understood and owned the project activities/outcomes. • Lack of computing and connectivity infrastructure which was mitigated through partial provision of equipment and co-sharing to cover the missing items. Key workable sustainability strategies included: • Capacity building embodied as part of HRM/HRIS/MVC project activities, thus creating independent capabilities to manage and support the systems • Through USAID funding, THRP initially deployed the system to 91 LGAs and RSs. When this was successfully accomplished, PMO-RALG developed a cost sharing arrangement with IntraHealth to extend the deployment to the rest of LGAs and RSs in Tanzania, making a total of 154 LGAs and 21 RS offices with fully installed systems. This extension signaled a state of high demand and readiness and encouraged GOT ownership of the system. • Through THRP, the UDSM-CSD and the CapacityPlus Initiative, the project organized an international HRIS open source training for Sub-Saharan Africa countries in Dar es Salaam this year as part of regional HRIS capacity building. THRP has significantly contributed to bridging the HRH gap from over 50 per cent in the past four years to the current 40 per cent status [14]. Overall, the THRP initiative is a model that could be replicated in countries where such efforts are not yet on the ground in order to attain health related millennium development goals and other better health outcomes.