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Optimising healthcare workforce training and deployment: qualitative experiences from stakeholders in Tanzania

Por: Nyongole · O. V. · Sirili · N. · Mwakilasa · M. T. · Temba · P. · Mkoka · D. A. · Akoko · L. · August · F. · Kiwango · G. · Kaale · E. · Kamori · D. · Mbawala · H. · Sangeda · R. Z. · Mbugi · E. V. · Balandya · E. · Kamuhabwa · A. A. R. · Kakoko · D.
Objective

To explore the experiences of different stakeholders on the balance of package training and deployment of highly skilled Human Resources for Health for specialised services in Tanzania.

Design

An exploratory qualitative case study was used as part of a larger tracer study conducted by Muhimbili University of Health and Allied Sciences (MUHAS) for its postgraduate programmes being a requirement for quality assurance. Semi-structured interview guides were used for in-depth interviews (IDIs) and focus group discussions (FGDs). Qualitative content analysis was adopted to analyse the data.

Setting

The trace study was carried out in all seven geopolitical zones of the Tanzania mainland and Unguja in Zanzibar.

Participants

We conducted 14 FGDs and 301 IDIs. Participants included alumni, immediate supervisors at employment sites, MUHAS faculty, continuing students at MUHAS and management of professional councils in Tanzania.

Results

Key findings revealed variations in demands and recognition within the scheme of services, even after registration by professional councils. Five main themes emerged from the qualitative interviews: Package training to improve service provision, Unprofessional collegial relationships or issues related to professionalism within interdisciplinary teams, Silence of scheme services on super specialisation in the medical cadre, Silence of scheme services on specialisation in the nursing cadre, Integrated scheme of services for specialties in pharmacy.

Conclusion

The findings highlight the demand for specialised training, challenges with professionalism and inconsistencies in the recognition and remuneration of specialists across medical, nursing and pharmacy cadres within existing service schemes. There is a need for harmonisation between specialisation/super specialisation and the scheme of services. This harmonisation is crucial to ensure the provision of quality healthcare services. Furthermore, harmonisation requires multistakeholder engagement to realise universal health coverage strategies.

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