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“Doctors ready to be posted are jobless on the street…” the deployment process and shortage of doctors in Tanzania
BACKGROUND: The World Health Organization advocates that health workforce development is a continuum of three stages of entry, available workforce and exit. However, many studies have focused on addressing the shortage of numbers and the retention of doctors in rural and remote areas. The latter has...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6359816/ https://www.ncbi.nlm.nih.gov/pubmed/30709401 http://dx.doi.org/10.1186/s12960-019-0346-8 |
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author | Sirili, Nathanael Frumence, Gasto Kiwara, Angwara Mwangu, Mughwira Goicolea, Isabel Hurtig, Anna-Karin |
author_facet | Sirili, Nathanael Frumence, Gasto Kiwara, Angwara Mwangu, Mughwira Goicolea, Isabel Hurtig, Anna-Karin |
author_sort | Sirili, Nathanael |
collection | PubMed |
description | BACKGROUND: The World Health Organization advocates that health workforce development is a continuum of three stages of entry, available workforce and exit. However, many studies have focused on addressing the shortage of numbers and the retention of doctors in rural and remote areas. The latter has left the contribution of the entry stage in particularly the deployment process on the shortage of health workforce less understood. This study therefore explored the experiences of medical doctors (MDs) on the deployment process after the internship period in Tanzania’s health sector. METHODS: A qualitative case study that adopted chain referral sampling was used to conduct 20 key informant interviews with MDs who graduated between 2003 and 2009 from two Medical Universities in Tanzania between February and April 2016. These MDs were working in hospitals at different levels and Medical Universities in eight regions and five geo-political zones in the country. Information gathered was analysed using a qualitative content analysis approach. RESULTS: Experiences on the deployment process fall into three categories. First, “uncertainties around the first appointment” attributed to lack of effective strategies for identification of the pool of available MDs, indecision and limited vacancies for employment in the public sector and private sector and non-transparent and lengthy bureaucratic procedures in offering government employment. Second, “failure to respect individuals’ preferences of work location” which were based on the influence of family ties, fear of the unknown rural environment among urbanized MDs and concern for career prospects. Third, “feelings of insecurity about being placed at a regional and district level” partly due to local government authorities being unprepared to receive and accommodate MDs and territorial protectionism among assistant medical officers. CONCLUSIONS: Experiences of MDs on the deployment process in Tanzania reveal many challenges that need to be addressed for the deployment to contribute better in availability of equitably distributed health workforce in the country. Short-term, mid-term and long-term strategies are needed to address these challenges. These strategies should focus on linking of the internship with the first appointment, work place preferences, defining and supporting career paths to health workers working under the local government authorities, improving the working relationships and team building at the work places and fostering rural attachment to medical students during medical training. |
format | Online Article Text |
id | pubmed-6359816 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-63598162019-02-07 “Doctors ready to be posted are jobless on the street…” the deployment process and shortage of doctors in Tanzania Sirili, Nathanael Frumence, Gasto Kiwara, Angwara Mwangu, Mughwira Goicolea, Isabel Hurtig, Anna-Karin Hum Resour Health Research BACKGROUND: The World Health Organization advocates that health workforce development is a continuum of three stages of entry, available workforce and exit. However, many studies have focused on addressing the shortage of numbers and the retention of doctors in rural and remote areas. The latter has left the contribution of the entry stage in particularly the deployment process on the shortage of health workforce less understood. This study therefore explored the experiences of medical doctors (MDs) on the deployment process after the internship period in Tanzania’s health sector. METHODS: A qualitative case study that adopted chain referral sampling was used to conduct 20 key informant interviews with MDs who graduated between 2003 and 2009 from two Medical Universities in Tanzania between February and April 2016. These MDs were working in hospitals at different levels and Medical Universities in eight regions and five geo-political zones in the country. Information gathered was analysed using a qualitative content analysis approach. RESULTS: Experiences on the deployment process fall into three categories. First, “uncertainties around the first appointment” attributed to lack of effective strategies for identification of the pool of available MDs, indecision and limited vacancies for employment in the public sector and private sector and non-transparent and lengthy bureaucratic procedures in offering government employment. Second, “failure to respect individuals’ preferences of work location” which were based on the influence of family ties, fear of the unknown rural environment among urbanized MDs and concern for career prospects. Third, “feelings of insecurity about being placed at a regional and district level” partly due to local government authorities being unprepared to receive and accommodate MDs and territorial protectionism among assistant medical officers. CONCLUSIONS: Experiences of MDs on the deployment process in Tanzania reveal many challenges that need to be addressed for the deployment to contribute better in availability of equitably distributed health workforce in the country. Short-term, mid-term and long-term strategies are needed to address these challenges. These strategies should focus on linking of the internship with the first appointment, work place preferences, defining and supporting career paths to health workers working under the local government authorities, improving the working relationships and team building at the work places and fostering rural attachment to medical students during medical training. BioMed Central 2019-02-01 /pmc/articles/PMC6359816/ /pubmed/30709401 http://dx.doi.org/10.1186/s12960-019-0346-8 Text en © The Author(s). 2019 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. |
spellingShingle | Research Sirili, Nathanael Frumence, Gasto Kiwara, Angwara Mwangu, Mughwira Goicolea, Isabel Hurtig, Anna-Karin “Doctors ready to be posted are jobless on the street…” the deployment process and shortage of doctors in Tanzania |
title | “Doctors ready to be posted are jobless on the street…” the deployment process and shortage of doctors in Tanzania |
title_full | “Doctors ready to be posted are jobless on the street…” the deployment process and shortage of doctors in Tanzania |
title_fullStr | “Doctors ready to be posted are jobless on the street…” the deployment process and shortage of doctors in Tanzania |
title_full_unstemmed | “Doctors ready to be posted are jobless on the street…” the deployment process and shortage of doctors in Tanzania |
title_short | “Doctors ready to be posted are jobless on the street…” the deployment process and shortage of doctors in Tanzania |
title_sort | “doctors ready to be posted are jobless on the street…” the deployment process and shortage of doctors in tanzania |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6359816/ https://www.ncbi.nlm.nih.gov/pubmed/30709401 http://dx.doi.org/10.1186/s12960-019-0346-8 |
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