The number of health workers in Tanzania has declined sharply over the last decade. The present number of health personnel in Tanzania is low both by international standards and relative to national staffing norms, and an even greater shortage of health workers is expected in the future. Due to geographical imbalance in the distribution of health workers, the shortage is most strongly felt in rural areas. The shortage is amplified by low productivity and sub-standard performance in some parts of the health workforce. Although the human resource situation of the Tanzanian health sector seems to be recognised as a crisis by the political leadership, the fundamental reasons for the crisis have yet to be addressed. Among the challenges ahead are the need to place the human resource issue higher on the agenda in national policy processes and documents, the need to address financial constraints, the need for further evidence on which policies are most effective in addressing the various aspects of the problem, and the need to strengthen the Human Resource Department of the Ministry of Health. An important challenge for health policy makers in Tanzania is to design a human resource strategy that appropriately reflects and responds to the current crisis. This report presents a framework that may form the basis for such a strategy process. It also presents existing evidence of relevance for the choice among available strategic options. The report also identifies knowledge gaps that need to be addressed in order to improve the evidence base for human resource strategies in the health sector. Knowledge gaps are large when it comes to the effect of alternative policy interventions, and intervention based studies are called for in order to fill these gaps.

Ottar Mæstad

Research Professor / Special Adviser, Director Development Learning Lab

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