Roles of Various Institutions Related to Recruitment and Retention of Health Workers

Mkapa HIV/AIDS Foundation, established in 2007, plays a significant role in addressing the HIV/AIDS epidemic in Tanzania. The foundation focuses on various aspects of the epidemic, including prevention, care, and support services. In November 2012, the foundation published a document outlining the roles of various institutions related to the recruitment and retention of health workers in Tanzania. Local Government Authorities (LGAs) and District Councils are the ultimate employers of health workers in districts. Under the leadership of District Executive Directors, these authorities are responsible for planning, budgeting, recruitment, and retention processes. The key actors under the councils include the Council Health Management Teams (CHMTs), including the District Medical Officer (DMO), Health Secretaries (HSs), and District Human Resources Officers (DHROs). The President's Office Public Service Management (POPSM) is responsible for recruitment and retention in the public service, including health workers. In accordance with the Public Service Amendment Act (2007), Public Service Management & Employment Policy (2008), Public Service Regulations (2003), and Public Service Scheme (2003), POPSMS enacts employment policies and guidelines, sets PE budget guidelines, scrutinizes and approves PE budgets, issues approvals for hiring staff, registers new hires into the public service payroll, and monitors establishments, wage bills, and payrolls. The Public Service Employment Secretariat, established under POPSMS, has representatives in every region. The secretariat's specific functions include identifying graduates in various disciplines, maintaining a database of professionals, preparing and making advertisements of vacant positions, identifying interview and selection panels, and advising employers on recruitment and employment matters. The Ministry of Health and Social Welfare (MOHSW) plays a critical role as the parent ministry for health services in the country and is responsible for health policies, strategies, professional ethics, and guidelines that directly affect recruitment and retention. The Prime Minister's Office Regional Administration and Local Government (PMORALG) plays a facilitative role to the LGAs during the recruitment process. However, it has not been playing a significant role in the recruitment process for health workers, as most of the roles are performed by the office of DEDs. PMORALG is supposed to track the posted health workers by MOHSW. The Ministry of Finance and Economic Affairs (MOFEA) is mainly involved in two critical stages of planning and recruitment of health workers: setting PE ceilings for various votes with the government expenditure framework and activating new employed staff into the payroll through the treasury.