Dr. A. O. Mwakilasa Needs Assessment Report 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.

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