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Public private partnership in the training of doctors after the 1990s’ health sector reforms: the case of Tanzania

Similar to many other low- and middle-income countries, public private partnership (PPP) in the training of the health workforce has been emphasized since the launch of the 1990s’ health sector reforms in Tanzania. PPP in training aims to contribute to addressing the critical shortage of health work...

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Autores principales: Sirili, Nathanael, Frumence, Gasto, Kiwara, Angwara, Mwangu, Mughwira, Goicolea, Isabel, Hurtig, Anna-Karin
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6532226/
https://www.ncbi.nlm.nih.gov/pubmed/31118038
http://dx.doi.org/10.1186/s12960-019-0372-6
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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 Similar to many other low- and middle-income countries, public private partnership (PPP) in the training of the health workforce has been emphasized since the launch of the 1990s’ health sector reforms in Tanzania. PPP in training aims to contribute to addressing the critical shortage of health workforce in these countries. This study aimed to analyse the policy process and experienced outcomes of PPP for the training of doctors in Tanzania two decades after the 1990s’ health sector reforms. We reviewed documents and interviewed key informants to collect data from training institutions and umbrella organizations that train and employ doctors in both the public and private sectors. We adopted a hybrid thematic approach to analyse the data while guided by the policy analysis framework by Gagnon and Labonté. PPP in training has contributed significantly to the increasing number of graduating doctors in Tanzania. In tandem, undermining of universities’ autonomy and the massive enrolment of medical students unfavourably affect the quality of graduating doctors. Although PPP has proven successful in increasing the number of doctors graduating, unemployment of the graduates and lack of database to inform the training needs and capacity to absorb the graduates have left the country with a health workforce shortage and maldistribution at service delivery points, just as before the introduction of the PPP. This study recommends that Tanzania revisit its PPP approach to ensure the health workforce crisis is addressed in its totality. A comprehensive plan is needed to address issues of training within the framework of PPP by engaging all stakeholders in training and deployment starting from the planning of the number of medical students, and when and how they will be trained while taking into account the quality of the training.
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spelling pubmed-65322262019-05-29 Public private partnership in the training of doctors after the 1990s’ health sector reforms: the case of Tanzania Sirili, Nathanael Frumence, Gasto Kiwara, Angwara Mwangu, Mughwira Goicolea, Isabel Hurtig, Anna-Karin Hum Resour Health Research Similar to many other low- and middle-income countries, public private partnership (PPP) in the training of the health workforce has been emphasized since the launch of the 1990s’ health sector reforms in Tanzania. PPP in training aims to contribute to addressing the critical shortage of health workforce in these countries. This study aimed to analyse the policy process and experienced outcomes of PPP for the training of doctors in Tanzania two decades after the 1990s’ health sector reforms. We reviewed documents and interviewed key informants to collect data from training institutions and umbrella organizations that train and employ doctors in both the public and private sectors. We adopted a hybrid thematic approach to analyse the data while guided by the policy analysis framework by Gagnon and Labonté. PPP in training has contributed significantly to the increasing number of graduating doctors in Tanzania. In tandem, undermining of universities’ autonomy and the massive enrolment of medical students unfavourably affect the quality of graduating doctors. Although PPP has proven successful in increasing the number of doctors graduating, unemployment of the graduates and lack of database to inform the training needs and capacity to absorb the graduates have left the country with a health workforce shortage and maldistribution at service delivery points, just as before the introduction of the PPP. This study recommends that Tanzania revisit its PPP approach to ensure the health workforce crisis is addressed in its totality. A comprehensive plan is needed to address issues of training within the framework of PPP by engaging all stakeholders in training and deployment starting from the planning of the number of medical students, and when and how they will be trained while taking into account the quality of the training. BioMed Central 2019-05-22 /pmc/articles/PMC6532226/ /pubmed/31118038 http://dx.doi.org/10.1186/s12960-019-0372-6 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
Public private partnership in the training of doctors after the 1990s’ health sector reforms: the case of Tanzania
title Public private partnership in the training of doctors after the 1990s’ health sector reforms: the case of Tanzania
title_full Public private partnership in the training of doctors after the 1990s’ health sector reforms: the case of Tanzania
title_fullStr Public private partnership in the training of doctors after the 1990s’ health sector reforms: the case of Tanzania
title_full_unstemmed Public private partnership in the training of doctors after the 1990s’ health sector reforms: the case of Tanzania
title_short Public private partnership in the training of doctors after the 1990s’ health sector reforms: the case of Tanzania
title_sort public private partnership in the training of doctors after the 1990s’ health sector reforms: the case of tanzania
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6532226/
https://www.ncbi.nlm.nih.gov/pubmed/31118038
http://dx.doi.org/10.1186/s12960-019-0372-6
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