The demand for healthcare workers in Tanzania is at an all-time high,especially for Nurses, Clinicians,Pharmacy and laboratory Technicians,dental therapists and Health Assistants (at community level). The current vacancy rate is at 52 percent.Tanzania’s health facilities require approximately 209,603 health workers while the actual available health workers stand at about 99,684. This shortage is compromising the ability of the health systems to effectively deliver the National Essential Health Care Intervention Package-Tanzania (NEHCIP) and other health services. The human resource for health shortage is further exacerbated by an increased disease burden attributed to HIV,lifestyle-related diseases and expanded services in health facilities such as CEmoc e.tc
On the other hand, the Government is improving its support to the supply side,with additional funding for grants and student loans, expanding training facilities and provide good environment for private sector and faith-based organization to invest on Health training facilities country wide.This effort has led to a strategic mismatch on demand and supply side due to limited government capacity to absorb all trained HRH in the country in the last two decades(lbid).The private sector in health care is not well established and hence it can only absorb a small number of graduates.
2.0 HEALTH VOLUNTEER STRATEGY
Health Sector Strategic Plan IV Mid Term Review revealed a number of issues concerning HRH that need immediate attention. To address some of those challenges, On May 16th 2019 the MoHCDGEC and Health implementing partners,including CSOS,convened a meeting that spearheaded a new dialogue on HRH strategies and planning of a HRH Multi-sectoral High Level Meeting on November 15th 2019.Among the key resolution in that meeting was to establish a mechanism/framework for health graduate to volunteer in facilities that have critical shortage of HRH. The initiative aimed to partly address the HRH challenge at the same time provide opportunity for short-term on job training on lifelong skills for a career as a health professional.
3.0 NATIONAL HEALTH VOLUNTEERING GUIDELINES
The National health Sector Guidelines formalize and standardize health volunteer practices in Tanzania.The Specific Objectives of this Guidelines are:
i. To rationalize and harmonize pay and management of health volunteers across public health facilities.
ii. To set out the roles and responsibilities of all stakeholders in implementing health volunteering program
iii. To provide hands on practical skills development for health workers available in the market
iv. To enhance the capacity of the public health facilities to attract, retain through contract period and adequately motivate personnel with requisite skills.
v. To reduce service delivery burden caused by existing critical shortage of health workers at all levels of service delivery
vi. To put in place accountability mechanism on management of health volunteers
vii. To promote performance and productivity of health volunteers engaged in health facilities.
viii.To enhance access and quality of services in facilities that have critical shortage of health workers
ix) Ensure effective implementation through a rigorous monitoring and evaluation plan.
The National Health Sector Volunteering strategy is implemented at all levels of service delivery including Health Training Institutions. The levels includes:
i. Hamlet level(Community Level)
ii. Village level (Dispensary Level)
iii.Ward level (Health Center Level)
iv. District level (District Hospital Level)
v. Regional level (Regional Referral Hospital Level)
vi. Zonal Referral Hospital and National level
vii. Health Training Institutions
5.0 PRINCIPLES OF HEALTH VOLUNTEERING PRACTISE
The following principles govern Health Volunteering services in Tanzania
i. Demand driven: The Health volunteers services operates on demand driven basis. Health facilities/training institutions or programs should accommodate Health volunteers as per available vacancies or service demands. However, volunteers should be engaged as part of training where service gap is not available.
ii. Equity and non-discrimination: The program should be open to all Tanzanian health workers on the market irrespective of gender,age,ethnicity and disability
iii. Decent work environment: Health volunteers shall enjoy selected ‘Decent Work’ that are applicable as per national labor laws that include among others safe work environment to ensure occupational safety and health at work (PMO -LYEP, 2017)
iv.Mentorship: Facilities should prepare mentorship programs to ensure volunteers acquire relevant practical skills for their professional and career development
v. Adherence to organisation policy and rules: The health volunteers shall adhere to organizational rules and regulations including professional ethics set by Professional Councils and Boards
vi.Dispute settlement mechanism: The same procedures as established in the facility on management of human resources and administration shall apply to the Health Volunteers.In case the internal mechanism fails to settle the dispute, each party to the dispute, can refer the matter to the National Health Volunteering Committee,beyond which the national legislation and regulations shall apply
vii. Confidentiality: Volunteers must hold clients and hospital information confidential and ensuring that clients’ rights are upheld during health service delivery.
viii. Political neutrality: Duly comply with political restrictions in conducting political activities during official hours and or at work premises.