1. RESPONDING TO INFORMAL TASKSHIFTING IN MEDICINES MANAGEMENT
A NEW PHARMACEUTICAL CADRE TO SERVE RURAL PRIMARY HEALTH CARE FACILITIES IN TANZANIA
Wiedenmayer K.1,2, Ndesendo V.3, Chilunda F.4, Meshack V.4, Mbwasi R.3, Shekalaghe E.5, Prytherch H.1,2
1 Swiss Centre for International Health, Swiss Tropical and Public Health Institute, Basel, Switzerland, 2 University of Basel, Basel, Switzerland, 3 St. John’s University of Tanzania, Dodoma, Tanzania, 4 Health Promotion and System Strengthening Project, Dodoma, Tanzania, 5 Pharmacy Council of Tanzania, Dar es Salaam, Tanzania
Introduction
Estimated 56% shortage of Human Resources for Health in Tanzania affecting primarily the rural population (70%) in 2014
Crisis of the health workforce reflected in low staffing levels of pharmacy staff in the public sector in rural regions
More pronounced among mid-and lower level health care workers including pharmaceutical staff (inverse pyramid)
Task of medicines management is shifted to non-pharmaceutically trained cadres whose main task is clinical care of patients
Dramatically impacts the quality of health service delivery, the attainment of UHC and desirable health outcomes
Objectives
Establish a one year curriculum for basic pharmaceutical cadre
Introduce a vocational training programme
Produce adequately trained Medicine Dispensers working in primary health care (PHC) facilities
Retain this new cadre in rural areas
Methods
Modular curriculum for a basic certificate course developed
Accreditation by Pharmacy Council and National Council for Technical Education (NACTE)
Financial and technical support by HPSS for renovation of required laboratories and recruitment of lecturers
Collaboration of St. John’s University of Tanzania (SJUT) with Health Promotion and System Strengthening Project (HPSS)
Memorandum of Understanding signed as a public-private partnership (PPP)
Sponsoring of some students by HPSS based on bonding contract for 3 years local employment in public sector
Table 1: New pharmacy workforce in Tanzania
Results
Course enrolment
Medicine Dispenser course launched in 2016
First batch of 107 students enrolled and 96 students graduated as Dispensers after 40 weeks of study in 2017 (majority female)
Course fee: affordable for rural students and sufficient for sustainable operations of course: Tsh 1.4 mio (620$)
Course contents
Theoretical training, field work for pharmacy practice, i.e. dispensing and stores management.
Career ladder
The modular programme offers an opportunity to progress to higher
Table 2: Enrolment numbers up to May 2017
Conclusion
This new certificate course is designed to suit professional needs of the health sector in Tanzania
Dispensers mitigate shortage and low retention of qualified supply staff at primary health facility level in rural areas
Dispenser profile responds to informal task shifting and fills a critical gap in the supply chain contributing to better medical care
Based on national policy: Tanzanian Health Sector Strategic Plan (HSSP IV) and HRH Strategic Plan , MoH
Acknowledgement
The work was done in the frame of the Swiss Agency for Development and Cooperation's (SDC) Health Promotion and System Strengthening (HPSS) Project
in Tanzania.