Urgent Call for Jobs: Tanzania’s Healthcare Crisis Demands Action in Vision 2050

By Adonis Byemelwa

Dar es Salaam. Health sector leaders are demanding the urgent inclusion of a formal employment strategy in the National Development Vision 2050 to tackle the growing crisis of jobless healthcare graduates, particularly doctors and nurses.

Professor Abel Makubi, Executive Director of Benjamin Mkapa Hospital (BMH) in Dodoma, emphasized the need for strategies to ensure that the financial resources invested in training these professionals do not go to waste.

Professor Makubi expressed his concerns at the National Health Sector Stakeholders Symposium on the preparations for the National Development Vision 2050, held on Saturday, July 6, 2024, at the Mwalimu Nyerere International Conference Center (JNICC).

"Employment is a significant challenge in the health sector; we have over 3,000 doctors and 25,000 nurses without jobs. This issue is very alarming. We must include strategies in the upcoming vision to ensure these professionals do not remain idle in our communities," he stated.

According to Dr. Mugisha Nkoronko, President-Elect of the Medical Association of Tanzania (MAT), it costs no less than TSh 60 million for a doctor to complete their studies.

"Public universities charge around TSh 5 million per year, amounting to Sh 25 million for five years. For private universities, the cost is TSh 8 million per year, totaling Sh 40 million for five years. When you factor in living expenses and other necessities, it’s not less than Sh 60 million," Dr. Nkoronko explained.

Professor Kitila Mkumbo, Minister of State in the President's Office for Planning and Investment, acknowledged the significant challenge of unemployed graduates, including doctors, teachers, and engineers.

"We face a challenge with graduates and business professionals. There are job opportunities worldwide; the West and Japan, for instance, have a shortage of workers. Our graduates should consider opportunities outside Tanzania. The government will also strive to increase employment opportunities as needed," Professor Kitila noted.

Alexander Bahulya, President of the Tanzania Nurses Association (Tanna), pointed out that investment in healthcare workers remains a challenge. He mentioned that despite many achievements in the health sector, investment in the workforce has been inadequate.

"We need to establish strategies for the next 25 years regarding human resources and how much we are enabling them to perform their duties of serving Tanzanians," Bahulya emphasized.

"The health policy should address the empowerment of health workers and professional boards should be involved in advising the government. There is significant overlap in the functions of leaders interfering with these bodies," he added.

Employment was one of the nine issues raised by health sector stakeholders, alongside funding for health services in the National Development Vision 2050. Other issues included investment in prevention, service quality, research, technology, community-level health service providers, accountability, and performance evaluation of employees.

Professor Makubi also highlighted the need for investment in the availability of medicines by investing in pharmaceutical factories and healthcare funding through health insurance.

"Health insurance alone cannot cover healthcare costs; we must have a health fund beyond insurance to support those in need. If we allocate funds for road construction, why not budget for health insurance? It’s a matter of decision-making," said Professor Makubi, who previously served as the Permanent Secretary in the Ministry of Health.

Speaking on the role of private sector involvement in healthcare, Professor Kaushik Ramaiya, representing Aphtha, stated that the private sector plays a crucial role in advancing healthcare technology.

"The private sector should be utilized to improve technology in the public sector, given the challenges of changing diseases. We must collaborate as we lead in technology," Ramaiya commented.

Dr. Ellen Senkoro, Director of the Mpaka Foundation, stressed the need for the country to invest in prevention, not just treatment, by 2050. She called for policies and guidelines focusing on primary healthcare.

The National Development Vision 2050 focuses on six areas: economic improvement, social welfare, good governance, justice and peace, advancements in digital technology, and environmental conservation and climate change.

Cuba boasts one doctor for every 150 people, and Canada has one for every 450. In stark contrast, Tanzania’s doctor-to-patient ratio is an alarming 1:20,000, far from the World Health Organization's recommended 1:8,000. Rwanda, with 1,350 physicians in 2018, had a ratio of 1 doctor per 8,919 people—still below its national target of 1 doctor per 7,000 by 2024 according to the Fourth Health Sector Strategic Plan (HSSP IV).

Both Rwanda and Ghana have shown that strategic planning and investment can significantly improve the employability of medical doctors. Tanzania must adopt similar strategies to address its healthcare crisis and ensure its medical graduates find meaningful employment.