Assessment of Expenditures of Personal Emoluments and Other Charges for Frontline Health Workers in Tanzania

At the national level, human resources for health has been identified as a priority for health system strengthening, resulting in increased budgetary allocation for personal emoluments. In addition to salaries, local government authorities can allocate resources to the development and retention of health workers through other charges, including personal allowances, working environment, training, and retention-related expenditures. The study collected data on the personal emoluments and other cost expenditures in 15 local government authorities over three consecutive years, in order to compare the amount of funding available through each stream. As expected, personal emolument expenditures contribute the largest percentage of the available funding for human resources for health, accounting for 73 percent of total human resource for health expenditures in 2012/13 and rising to 83 percent in 2013/14. While other cost expenditures were significantly less as compared to personal emoluments expenditures (27% in 2012/13 and 17% in 2013/14), these finances provided critical contributions to health workers' ability to provide quality services, through spending on equipment, job aids, training, allowances, and motivational resources. The study found that other cost expenditures reduced from 2012/13 to 2013/14, suggesting that further advocacy and education is required to encourage local government authorities to fund this government priority. The reduction in other cost expenditures is of concern to the overall operation of the health system, as these finances are critical to health workers' ability to provide quality services. The study highlights the need for increased funding for human resources for health, particularly for other cost expenditures. The findings of the study suggest that local government authorities need to be encouraged to allocate more resources to the development and retention of health workers through other charges. This can be achieved through advocacy and education, as well as through the development of policies and guidelines that support the allocation of resources for human resources for health. The study's findings have implications for the health sector in Tanzania, particularly in terms of the need for increased funding for human resources for health. The study's recommendations for increased funding for other cost expenditures are critical to addressing the health workforce crisis in Tanzania, which is characterized by a shortage of health workers, unequal distribution of health workers within the country, poor management, and poor performance of health workers.