Needs Assessment Human Resources Development in the Health Sector in Tanzania:

1. Needs Assessment Human Resources Development in the Health Sector in Tanzania: Needs, Priorities and Potentials towards Strengthening District Health Services Management Siegrid Tautz & Dr.Amos Odea Mwakilasa, December, 2001 Dr. A. O. Mwakilasa Needs Assessment Report

2. Aims • Identify training needs and potentials regarding capacity strengthening of District (Council) Health Management in view of the Health Sector Reform • Formulate recommendations for future DSE support within the Agreed Strategy for Tanzanian-German Cooperation. Dr. A. O. Mwakilasa Needs Assessment Report

3. Methods • Key Informant interviews • Review of relevant documents • Field Observation (Resources, Equipment, facilities) • Round table discussions • Consensus agreement Dr. A. O. Mwakilasa Needs Assessment Report

4. Organizations/institutions interviewed • MOH Central – Directors,Heads,HRS Secreatriat, HSPS • MUCHS • GTZ • KFW • RHMTs, RMOs (Tanga, Iringa, Morogoro) • Muheza DDH, CEDHA, Arusha Municipal Team, • WHO • Eastern Zone Trainning Centre/DE Unit • PHCI Iringa Dr. A. O. Mwakilasa Needs Assessment Report

5. Field Observations results • Focus of human resources development is on sufficient capacities at district/ council level, hence tendency of focussing all initiatives on the district level (CHMTs) • Technical and managerial support and training to staff of lower health service levels? Dr. A. O. Mwakilasa Needs Assessment Report

6. Field Observations results Cont.... • Management training singled out as an important strategy for improving capacity of CHMTs in managing council health services. • But: Characteristic skill mixes of teams at the various levels predominantly technical rather than managerial Dr. A. O. Mwakilasa Needs Assessment Report

7. Field Observations results cont... • DHMT courses contributed to improve planning skills and team cohesion, but: they are not adequate to prepare e.g. team leaders for leadership & human resources management roles. • Capacities still inadequate to cope with workload and new challenges related to comprehensive district planning, & utilisation of the district health basket grants. Dr. A. O. Mwakilasa Needs Assessment Report

8. Field Observations results cont.... CHMTs need to be strengthened & initial training consolidated in: • Planning/resource allocation & utilisation; • Monitoring & evaluation • Teambuilding/communication & counseling • Data management & utilisation Dr. A. O. Mwakilasa Needs Assessment Report

9. Field Observation results cont… • Research skills, at least to the extent of developing simple operational research designs • Specific technical training needs Dr. A. O. Mwakilasa Needs Assessment Report

10. Field Observations results cont.... • Pivotal role attributed to the Zonal Training Centres → respective demands re. training, research, technical & managerial support to districts; and strengthening of community involvement → ZTC’s capacity of coping with these demands stretched to the limits Dr. A. O. Mwakilasa Needs Assessment Report

11. Guiding areas • Training activities are not offered as one-off events but sustained for a longer period to cater for untrained teams and individuals as well as for teams that due to high turnovers of individual staff members need refresher training Dr. A. O. Mwakilasa Needs Assessment Report

12. Apprehension towards the idea of introducing another short course that is not accredited and sustained within a more comprehensive, possibly modular arrangement and is guided by the attempt of linking new initiatives to existing experiences. Dr. A. O. Mwakilasa Needs Assessment Report

13. Staff of lower health service levels to receive appropriate attention, both in terms of technical and managerial support and training. • Zonal and regional levels to be included in capacity strengthening measures to be in a position to adequately support and supervise districts (e.g. as master trainers). Dr. A. O. Mwakilasa Needs Assessment Report

14. Programmatic approach (synergistic effects; networking) • German cooperation • MOH Tanzania (SWAPs) Dr. A. O. Mwakilasa Needs Assessment Report

15. Recommendations (Options matrix) • Development of individual modules (partly distance learning) on above subjects contributing to certified course (e.g. diploma) • Institutionalisation of comprehensive modular course ‘Strengthening of district management capacity’including distance (possibly internet-based) learning components (technical & managerial); accreditation at diploma (masters?) level Dr. A. O. Mwakilasa Needs Assessment Report

16. Options, cont. • Strengthening of zonal/district capacities in resource centres and HLMs production • Fellowships for Public Health courses for DMOs and advanced teaching skills courses for faculty members in training institutions. Dr. A. O. Mwakilasa Needs Assessment Report

17. Options, cont. • Capacity building/ strengthening beyond the district (in one or two model regions, e.g. Mtwara, Tanga) • Conceptualisation of a systematic programme of “learning from best practice” among districts & regions in Tanzania Dr. A. O. Mwakilasa Needs Assessment Report

18. Conclusion • Human resources is a fundamental and key to our Health Sector Reform Process BUT Human Resources Development is a challenging area needing the collaboration and support of every partner. MOH and InWent collaboration over the years in this area remains a living example. Dr. A. O. Mwakilasa Needs Assessment Report

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