By Adonis Byemelwa
Dar es Salaam.
Health sector leaders are demanding the urgent inclusion of a formal employment
strategy in the National Development Vision 2050 to tackle the growing crisis
of jobless healthcare graduates, particularly doctors and nurses.
Professor
Abel Makubi, Executive Director of Benjamin Mkapa Hospital (BMH) in Dodoma,
emphasized the need for strategies to ensure that the financial resources
invested in training these professionals do not go to waste.
Professor
Makubi expressed his concerns at the National Health Sector Stakeholders
Symposium on the preparations for the National Development Vision 2050, held on
Saturday, July 6, 2024, at the Mwalimu Nyerere International Conference Center
(JNICC).
"Employment
is a significant challenge in the health sector; we have over 3,000 doctors and
25,000 nurses without jobs. This issue is very alarming. We must include
strategies in the upcoming vision to ensure these professionals do not remain
idle in our communities," he stated.
According
to Dr. Mugisha Nkoronko, President-Elect of the Medical Association of Tanzania
(MAT), it costs no less than TSh 60 million for a doctor to complete their
studies.
"Public
universities charge around TSh 5 million per year, amounting to Sh 25 million
for five years. For private universities, the cost is TSh 8 million per year,
totaling Sh 40 million for five years. When you factor in living expenses and
other necessities, it’s not less than Sh 60 million," Dr. Nkoronko
explained.
Professor
Kitila Mkumbo, Minister of State in the President's Office for Planning and
Investment, acknowledged the significant challenge of unemployed graduates,
including doctors, teachers, and engineers.
"We
face a challenge with graduates and business professionals. There are job
opportunities worldwide; the West and Japan, for instance, have a shortage of
workers. Our graduates should consider opportunities outside Tanzania. The
government will also strive to increase employment opportunities as
needed," Professor Kitila noted.
Alexander
Bahulya, President of the Tanzania Nurses Association (Tanna), pointed out that
investment in healthcare workers remains a challenge. He mentioned that despite
many achievements in the health sector, investment in the workforce has been inadequate.
"We
need to establish strategies for the next 25 years regarding human resources
and how much we are enabling them to perform their duties of serving
Tanzanians," Bahulya emphasized.
"The
health policy should address the empowerment of health workers and professional
boards should be involved in advising the government. There is significant
overlap in the functions of leaders interfering with these bodies," he
added.
Employment
was one of the nine issues raised by health sector stakeholders, alongside
funding for health services in the National Development Vision 2050. Other
issues included investment in prevention, service quality, research,
technology, community-level health service providers, accountability, and
performance evaluation of employees.
Professor
Makubi also highlighted the need for investment in the availability of
medicines by investing in pharmaceutical factories and healthcare funding through
health insurance.
"Health
insurance alone cannot cover healthcare costs; we must have a health fund
beyond insurance to support those in need. If we allocate funds for road
construction, why not budget for health insurance? It’s a matter of decision-making,"
said Professor Makubi, who previously served as the Permanent Secretary in the
Ministry of Health.
Speaking
on the role of private sector involvement in healthcare, Professor Kaushik
Ramaiya, representing Aphtha, stated that the private sector plays a crucial
role in advancing healthcare technology.
"The
private sector should be utilized to improve technology in the public sector,
given the challenges of changing diseases. We must collaborate as we lead in
technology," Ramaiya commented.
Dr.
Ellen Senkoro, Director of the Mpaka Foundation, stressed the need for the
country to invest in prevention, not just treatment, by 2050. She called for
policies and guidelines focusing on primary healthcare.
The
National Development Vision 2050 focuses on six areas: economic improvement,
social welfare, good governance, justice and peace, advancements in digital
technology, and environmental conservation and climate change.
Cuba
boasts one doctor for every 150 people, and Canada has one for every 450. In
stark contrast, Tanzania’s doctor-to-patient ratio is an alarming 1:20,000, far
from the World Health Organization's recommended 1:8,000. Rwanda, with 1,350
physicians in 2018, had a ratio of 1 doctor per 8,919 people—still below its
national target of 1 doctor per 7,000 by 2024 according to the Fourth Health
Sector Strategic Plan (HSSP IV).