1. Regional Conference of Sector Network Health & Social Protection Africa, MENA and LAC 6-9. May 2014 | La Palm Hotel, Accra/Ghana Tanzanian HRH progress and commitments towards UHC Dr. Baltazar Ngoli | Tanzania

2. Regional Conference of Sector Network Health & Social Protection | Africa, MENA and LAC  Increase the availability of skilled health workers: at all levels of health services delivery from 46% to 64% by 2017 based on staffing level 2013.  Increase financial base (other charges and Private Sector Investment) to operationalise the pay and incentive policy by 2017 in order to promote retention, productivity and quality of health care.  Develop and implement a Task Sharing Policy on HRH by 2017. Tanzania National HRH Commitments - promote health workforce development towards UHC

3. Regional Conference of Sector Network Health & Social Protection | Africa, MENA and LAC Focus of the Commitments:  Increase the availability of skilled health workers: →Developed a Projection Plan to estimate needed HW – given new challenges →Making the case for new additional employment permits →Increase the density ration of HW to population ration of districts with below national average of 1.47 HW per 1000 population →Kigoma, Tabora, Rukwa, Shinyanga and Singida  Operationalise the Pay and Incentive policy: →Rural areas are not attractive for most HW →Councils proactively engage in different incentives to attract →Pay and Incentive Policy provide the financial flexibility and sources to cover these activities  Develop and implement a Task Sharing Policy on HRH →Reality - rural health facilities are managed by Medical Attendants →Mostly untrained in the task they have to perform in reality →Task Sharing Policy enhances training options and quality assurance

4. Regional Conference of Sector Network Health & Social Protection | Africa, MENA and LAC  Focusing at seven strategic areas: →Planning and Policy Development →Strengthening Leadership and Stewardship →Education, Training and Development →Workforce Management and Utilisation →Partnership in Human Resources →Human Resources Research and Development →Human Resources Financing  Outlining roles of different actors – national to local levels  Coordinated by a SWAP HRH TWG →Monthly coordination meetings →Chaired by MoHSW  Currently developing a new HRH Strategic Plan 2014 - 2019 Strategic Response: HRH Strategic Plan 2008 - 2013

5. Regional Conference of Sector Network Health & Social Protection | Africa, MENA and LAC Recommendations for Key Actors  Support strengthening Local Government capacity on proactive initiatives (recruitment, local students enrolment, sponsoring students) →Operationalising Pay and Incentives Policy  Building Capacity of the LGAs towards promoting partnership for Private Sector Investment especially in retaining health workers in rural areas  Support strategic implementation of the HRH Strategic plan (2014 – 2019) by strengthening national capacity on coordination

6. Regional Conference of Sector Network Health & Social Protection | Africa, MENA and LAC Bottom up:  Proactive rural staff recruitment and retention  Proactive rural/local students enrolment into training institutions  Sponsoring and bonding of health students Top down:  Strategic Response (HRH Strategic Plan): coordinates partners’ efforts and divide priority areas to support Best practices – national health workforce strategies

7. Regional Conference of Sector Network Health & Social Protection | Africa, MENA and LAC  Policy: recognise and address challenges in time →Task sharing – developing a solution to cope with (e.g. Medical Attendants reality) took too long  Policy and financial: mainstream and give guidance to LGAs local efforts (incentives) of mitigating the staff gap  Allow flexibility and innovation in implementing the HRH Strategic Plan →LGAs should feel guided but not limited by the plan Lessons learnt – national health workforce strategies

8. Regional Conference of Sector Network Health & Social Protection | Africa, MENA and LAC  Tanzania has still persisting shortage of health care workers – current staff gap: 58%  Observe positive trend to ensure availability and quality health workforce: →Increased annual staff recruitment from 6,437 (2008) to 8,602 (2012) →Increased number of available Health Care Workers from 47,000 in 2006/7 to 64,449 in 2012/13  Coordinated efforts to address priority areas with SWAP context  Providing flexibility and room for bottom up innovation (proactive initiatives) Conclusion

9. Regional Conference of Sector Network Health & Social Protection Africa, MENA and LAC 6-9. May 2014 | La Palm Hotel, Accra/Ghana baltazar.ngoli@giz.de THANK YOU!