Health staff shortage a Sh500bn question Friday, 11 February 2011 22:59
By The Citizen Reporters
Dar es Salaam.
Tanzania urgently needs over Sh500 billion to fill the yawning personnel gap in the health sector, whose combined shortage comprises 90,000 doctors, nurses, managers and other workers, The Citizen on Saturday can authoritatively report.
Using the latest World Health Organisation (WHO) rates for calculating the cost of training, retaining and sustaining health workers, the country requires between Sh594.8 billion and Sh678 billion to clear the deficit by 2025.
The figures are based on an assumption of per capita health spending of $10 (Sh14, 870) for training, retaining and sustaining the workforce up to 2025, taking into account the country’s population of between 40 and 44 million.
On Tuesday, Health and Social Welfare minister Haji Mponda said the financial burden was too huge for the government to shoulder alone. Acknowledging the serious shortage, Dr Mponda said Tanzania currently produces only 800 health personnel annually.
At that rate, it would take over a century to fix the labour deficit, which was officially put at 104,915 about two years ago. According to official figures, the demand for qualified health workers then was 144,704, but only 39,789 were available.
“We currently have only 40 per cent of the required health workforce and our target is to increase that level to 70 per cent by 2025...The government alone cannot meet the international personnel standards; therefore the involvement and support of all stakeholders in tackling the challenge is both critical and urgently needed” he noted.
International organizations say Tanzania has 35,202 health personnel at present, whereas the existing health facilities require a total of 125,824.
The country is among those facing a severe shortage of the workers, according to WHO’s Global Health Workforce Alliance (GHWA) estimates, which show the affected nations face a combined health staff deficit of more than four million.
The WHO says 34 of the 57 countries facing the most severe health worker shortages are in Africa, including all the five members of the East African Community (EAC). The overall situation is so grim that the Second Global Forum on Human Resources for Health, which was held late last month, called for a quick intervention to help save lives lost due to the shortage.
“To meet the investment costs of training an adequate health workforce by 2025, the average country with a severe shortage would need to increase its annual level of health spending by about $1.60 per capita,” GHWA notes in a report presented at the forum in Bangkok, Thailand.
For a county like Tanzania with a population of 40 million, that translates to an increase of Sh83.2 billion annually.
GHWA says the shortage of health workers in many developing countries is a major obstacle in addressing HIV/AIDS, malaria and tuberculosis, as well as responding to emerging diseases and new pandemics.
The agency further cautions that low pay, poor working conditions and limited training programmes also contribute to the problem, in addition to the flight of health professionals from poor countries to seek greener pastures abroad.
The current Sh678 billion budget of the ministry of Health and Social Welfare in Tanzania, for instance, comprises a salary component of about Sh124 billion.
“To pay the salaries of the scaled-up workforce as they finish training, a minimum increase of $8.30 per capita would be required. That is a total increase in spending of $10 per capita on the health workforce by 2025,” GHWA further notes in the report. At that rate, the payroll for a boosted health personnel workforce in Tanzania would need to be adjusted to between Sh494 billion and Sh543 billion by 2025, in the context of prevailing exchange rates.
Various local and international studies have established that the shortage is more pronounced in rural and marginalised areas, and covers mid-level workers such as clinicians, nurses, midwives, laboratory staff, pharmaceutical technicians, health officers and administrators.
WHO categorises countries faced with a ‘critical’ health worker shortage as those with fewer than 23 health workers for every 10,000 people. Tanzania fairs dismally in this regard as one doctor attends an average of 20,000 people. Worst performers in the EAC region include Burundi, where there is an average of two nurses for every 10,000 people; while in Uganda, Kenya and Rwanda the number is 13, 12 and four, respectively.
Reported by Constantine Sebastian & Mkinga Mkinga
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