Annual Report: October 2020 – September 2021

The activity is led by the Benjamin William Mkapa Foundation and is funded by the United States Agency for International Development (USAID) through Cooperative Agreement No. 72062120CA00003. The activity's goal is to support the Government of Tanzania (GoT) in addressing HRH gaps at the national, regional, and local government levels. During the second year of implementation (October 2020 to September 2021), the activity continued to address and respond to service delivery needs through optimized allocation, relocation, and enhanced productivity of health care workers (HCWs). The activity cumulatively allocated 1,063 HCWs, exceeding the annual target of 1,035 HCWs. The allocated HCWs contributed to improved performance of HIV, client-centered TB care, and reproductive, maternal, newborn, and child health (RMNCH) targets, particularly in facilities that were not performing well. The activity also focused on sustainability by transitioning 40 HCWs to the GoT employment systems and supporting the finalization, endorsement, and launch of the National Health Workforce Volunteering guideline. This guideline allows health facilities and programs to support healthcare workers in volunteerism schemes to address critical shortages of staff. Additionally, the activity facilitated the upgrading of the Human Resource for Health Information System (HRHIS) and incorporated supported HRH into the system to enhance visibility of PEPFAR HRH support in number and monetary value into the sectoral and national HR information system. The activity also documented success in improved maternal and child health services as a result of improved facility roster management, workload, and reduced unnecessary and risky referrals of pregnant women. Furthermore, the activity addressed long turnaround times for HIV viral load testing results through a joint work process review that informed relocation of staff to support data management in viral load centers. Despite challenges such as a shortage and access to personal protective equipment (PPEs) particularly masks and gloves in most supported health facilities, the activity learned that strategic engagement with the GoT during HRH gap identification and deployment creates coordination and higher chances of mainstreaming contracted HCWs into public service. The activity also learned that aligning allocated HCWs' qualifications with job and salaries contributes to cost-effective and increased HRH supply. The activity will continue to leverage on lessons to further improve implementation in the forthcoming year via cumulation of evidence-based HRH allocation and optimization of service delivery.