Dar es Salaam. More than 50 per cent of all medical students enrolled in Tanzania between 2011 and 2020 will not be practising medicine by 2025, new study findings published in the Global Health Action predict.
The findings add that the they also won’t be captured anywhere as medical doctors in the public health facilities.
Researchers from US-based University of California, San Francisco, and Muhimbili University of Health and Allied Sciences (Muhas) have tracked medical students from 1990 using a system known as the Markov Process.
They traced the movement of 25,000 medical students from various medical universities in Tanzania and physicians from medical training and employment channels and established that most of them were gradually quitting the profession.
The findings predict an exodus of doctors who will leave to secure employment elsewhere or migrate to other countries in pursuit of greener pastures.
“Without linking these doctors to employment and ensuring their retention, the majority of this investment in medical education will be jeopardized,’’ warns the study titled Modeling Solutions to Tanzania’s Physician Workforce Challenge.
The cost of training one doctor is estimated at $25,000(Sh55 million) for an entire five-year course.
A researcher in Tanzania, who did not take part in the study, Dr Nathaniel Sirili, has estimated in another study that the government wastes billions of shillings in training doctors it cannot absorb. The loss was estimated at Sh68.3 billion until last year.
The Citizen is still seeking a response to some suggestions on the Global Health Action study from the lead author, Dr Alex Goodell, an analyst at the University of California, San Francisco. However, the unemployment situation for young doctors in Tanzania speaks volumes.
The study has largely confirmed the reality experienced by newly licensed doctors who completed their medical internship in the country, but have been finding it difficult to secure employment in public health facilities since 2014.
At least 1,774 young doctors who were trained locally and abroad have not been recruited in the last two years despite most public health facilities facing an acute shortage of doctors, according to the chairman of the Medical Association of Tanzania, Dr Obadia Nyongole.
The recent study says, “Increasing the absorption of recent graduates into the public sector and/or developing a rural training track would improve physician (the growing loss) in the most underserved areas.”
Tanzania’s doctor-to-patient ratio is pegged at 1:25,000, far short of the World Health Organisation’s standard of 1:10,000.
However, the study forecasts an improvement in the doctor-to-patient ratio in Tanzania in the next eight years, saying, “Even with these losses of doctors…(there is a forecast increase) in the physician-to-population ratio to 1.4 per 10,000 by 2025.”
Tanzania’s failure to absorb the doctors it trains took centre stage yesterday when public health stakeholders debated the country’s decision to offer 500 medics to Kenya to mitigate the effects of the just-ended strike in the neighbouring country that lasted for about 100 days.
The CEO of the Association of Private Health Facilities of Tanzania (Aphta), Dr Samuel Ogillo, told The Citizen that it was time to develop a robust private sector to create more jobs for young doctors. “It’s time to sit down as a nation and think. I take it as a challenge for the private health sector to create employment for the medical profession in Tanzania with innovative models.”
However, Dr Ogillo warned that “…it will only work if the government and the National Health Insurance Fund (NHIF) will be willing to work with the private sector on such initiatives”.
Last year, a study conducted in Tanzania by Dr Nathaniel Sirili of Muhas on the human resource crisis in the health sector revealed that 60 per cent of graduate medical doctors were not recruited to work in public health facilities. The study said 14 per cent went to the private sector and the rest were unaccounted for.
On the other hand, the findings unveiled recently by American and Tanzanian researchers say, “In light of these findings, Tanzanian policy makers would be well served to increase the health system’s capacity to absorb additional graduating students and improve physician working conditions, especially in rural areas.
“Without these efforts, the goals laid out in Tanzania’s Development Vision 2025 may be jeopardized.”
Dr Kagoro Frank, a Tanzanian doctor at Oxford University in the UK, says the government should look at its priorities afresh as part of efforts to address the situation.