Tanzania faces acute shortage of critical care nurses: experts

Dar es Salaam. Tanzania has an acute shortage of critical care nurses needed in its health facilities across the country, it was revealed yesterday.

According to experts in the health sector, such nurses specialise in attending to patients in serious condition.

Nurses with knowledge in the intensive care sector revealed that currently in a country of about 65 million people there were no more than 100 critical care nurses, while diseases and accidents increasingly wreak havoc on society.

They revealed this during the 6th conference of the African Federation of Critical Care Nurses and 1st conference of the Tanzania Critical Care Nurses Association held at the Muhimbili University of Health and Allied Sciences (Muhas).

Themed as ‘Critical care in Africa: Integrating Lessons from Covid-19’, the conference that brought together government officials, academics, nurses and students went hand in hand with the official launch of the Tanzania Critical Care Nurses Association (TCCNA) aimed at encouraging general nurses to specialise in the area.

According to Ms Ziada Sellah, who is the chief government nurse and who officiated the meeting, the total number of general nurses in Tanzania currently is about 60,000.

This she noted was far less of what the World Health Organization (WHO) recommends, saying that each nurse in Tanzania serves between 25 and 30 patients per day against the WHO’s reference that one nurse should serve 4 to 6 patients a day.

She said for nurses with a diploma to master’s level, one should serve eight to 10 patients (1:8-10) per day for normal patients but if the latter was in ICU then the nurse should be able to serve 1-2 patients.

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“In the current situation, we still have a great need for nurses in general, including midwives, putting aside those of critically ill patients,” she revealed, adding that the demand was more than 49 percent for skilled nurses.

Ms Sellah conveyed that investing in critical care nurses was necessary especially to make Tanzania be able to deal with epidemic diseases like Covid-19 and Ebola due to the sudden surge of cases in need of critical care.

“Of all the medical employees in the health ministry, 60 percent are nurses, yet they provide 80 percent of their services in 24 hours. You can see that only 20 percent of the service will be provided by a doctor, pharmacist and laboratory technician,” she reminded.

Despite the challenges, Ms Sellah noted her optimism following government decision to employ more staff.

In the Ministry of Health, she said, nearly 1,700 workers have been hired while the President’s Office-Regional Administration and Local Government was offered with not less than 9,000 slots, however, Ms Sellah insisted, “the need is still too big, to be honest.”

She also said that the government has been able to create guidelines for volunteer nurses and reward them with a certain amount of money, noting that there were challenges but not as scary as in previous years.

According to her, the government has made an effort to install modern equipment in hospitals and healthcare centres and there was a plan to open critical care units in all referral hospitals in all regions.

“The Ministry of Health has been allocating funds as well to support nurses and midwives to study at Masters Level to specialize in providing various services including critical care,” she said.

But, Tanzania’s higher learning institutions produce about 400 general nurses in total per year. However, it is only Muhas that produces graduate nurses who qualify for critical care in Tanzania. It produces only 10 critical care nurses per year.

Dr Dickson Mkoka, Dean School of Nursing (Muhas) and founder of TCCNA said that the annual production of critical care nurses in his institution was less than 10 percent compared to the current demand.

“For example, this year students who are expected to graduate from this programme do not exceed 10, yet this service is currently needed in all referral hospitals and even health centres,” he noted.

He explained further that Tanzania had 28 regions and by including the islands of Zanzibar, it became about 30 regions, with regional and district hospitals that receive patients who needed critical care such as those resulting from accidents, more expertise was important.

“Diseases that need critical care can happen to a person anywhere in the village or in the city and would need a critical care giver. So the demand is high even though the government has started to make several efforts…,” he explained.

For his part, Mr Sixtus Safari, the current TCCNA president said that the goal of their institution was to be able to bring down the expertise they have in the healthcare centres to the grassroots level (district level) because that was where there are more people in great need.

“For now, critical care services are only available in tertiary hospitals; regional, referrals, national and private facilities like The Aga Khan Hospital.There are very few experts who provide these services at the lower levels and if we reach them and give them this knowledge by working with them it will help,” he said.