Review of Recruitment Challenges of Health Workers in Tanzania and Ways of Closing the Gaps: Case of Local Government Recruitment Practices and Underlying Principles

The project aimed to identify the root causes of the challenges and provide recommendations for improvement. The review found that the adequacy of staff numbers and quality of health workers in Tanzania is a significant concern. The distribution of health workers in the country is uneven, with some regions having a higher concentration of health workers than others. The human resources production and supply are also inadequate, resulting in a shortage of health workers in many areas. The distribution of health workers by facility category and cadre (approved establishment vs. filled positions) further highlights the challenges in the health sector. Attrition of health workers in districts is another major concern, with many health workers leaving their posts due to various reasons such as lack of opportunities for career advancement, poor working conditions, and low salaries. Forecasting of human resources for health in Tanzania is also a challenge, as the country faces a shortage of health workers in many areas. Absenteeism due to attendance of long-term training is another issue that affects the health sector. The institutional analysis of human resources planning and budgeting, recruitment, and retention of health workers in the districts revealed that the current strategies and processes for planning, recruitment, and retention of health workers are inadequate. The institutional arrangement for human resources planning and budgeting is fragmented, and the legal and regulatory framework is not clear. The current payroll enrolment process is also a challenge, as it affects staff retention. Macro social-economic and political factors affecting recruitment and retention of health workers were also identified. Local government financing, public service pay, political influences, and sociological factors all contribute to the challenges in the health sector. Limitations in health facilities, such as lack of equipment and infrastructure, also affect the recruitment and retention of health workers. Lessons from successful stories of recruitment and retention were also identified, including the use of local incentive schemes and training of own people. The review concluded that the recruitment and retention of health workers in Tanzania is a complex issue that requires a multi-faceted approach. The report provides recommendations for improvement, including the need for a clear and comprehensive human resources plan, improved recruitment and retention strategies, and increased investment in the health sector. The review highlights the importance of addressing the root causes of the challenges in the health sector, including the shortage of health workers, poor working conditions, and low salaries. It also emphasizes the need for a coordinated effort from all stakeholders, including the government, local authorities, and development partners, to address the challenges in the health sector.