This activity relates to OPSS activities #7778 and #7743.

Tanzania continues to face a critical shortage of human resources for health (HRH). To address the multitude of complex issues relating to recruitment, productivity, and retention of HRH, the Capacity Project provides multi-faceted technical assistance to the Ministry of Health and Social Welfare (MOHSW) on both the mainland and Zanzibar.

In FY 2006, Capacity completed an assessment of the Human Resource Information System (HRIS) as well as a labor market analysis for the mainland. The labor market analysis has resulted in a better picture of the stock of active HRH as well as those who are not known to be working, are employed outside the health sector, or will become available as they are produced by training institutions. This analysis informed the HRH strategic planning process which was completed in September by the MOHSW with support and technical assistance from Capacity. The strategic plan charts out short and long-term directions for improving the efficiency of HRH management, enhancing training capacity, and reforming and implementing policies to improve retention.

In FY 2006, Capacity also leveraged field support funds with special GFATM TA funds to implement priority interventions recommended in the strategic plan. These included strengthening MOHSW competencies in human resource management; assistance in the design of an Emergency Hiring Plan to be supported through GFATM funds; support to the National Institute for Medical Research (NIMR) for HRH productivity and retention analyses; and an assessment and schematic of recruitment bottlenecks with which the Permanent Secretary of the MOHSW will advocate for streamlined recruitment processes at the inter-ministerial level.

In Zanzibar, in FY 2006 Capacity provided technical assistance to assess HRH productivity gaps and design strategies to improve worker productivity. Activities for strengthening the human resource information system (HRIS) reached an advanced stage. Zanzibar's Mnazi Mmoja Hospital benefited from Capacity Project technical assistance in the development of a strategic plan, resulting in the hospital nearing semi autonomous status which will allow more flexibility in addressing HRH challenges.

FY2007 funds will focus on continued support for policy and system strengthening interventions to address the worker shortage situation. Capacity will support the MOHSW to manage the parallel hiring process of the GFATM-supported Emergency Hiring Plan. The plan will support the fast-track hiring and deployment of approximately 300 HRH to the most underserved Care and Treatment Centres (CTCs) for a two year period. A HR functions Manager will lead the emergency hire management team with support by three MOHSW staff assigned to work full time on the emergency hire program. A critical function for the management team will be to establish and maintain stakeholder engagement at all levels. The management team will invest resources to improve national level stakeholder leadership by improving the capacity of the national human resource working group to oversee all HR activities, including the Emergency Hiring Plan. At other levels, the management team will periodically bring together stakeholders from all relevant sectors and institutions for consensus building, shared vision, role clarification, and for decision making to improve staffing fill rates and retention.

The same GFATM funds will also support a retention scheme and productivity interventions that will be designed by the MOHSW and Capacity in collaboration with NIMR. The mobilization of new workers must be accompanied by strategies to retain current workers, to attract departed workers, and to create a productive work environment for all health workers. Capacity will assist with the implementation of system strengthening activities in the public sector in both mainland and Zanzibar to increase capacity for long term planning and capacity to recruit, retain, and effectively utilize workers, especially in areas of greatest need.

A comprehensive human resource information system (HRIS) will be an important management tool for the Emergency Hiring Plan. Using findings of the FY 2006 HRIS assessment, in FY2007 Capacity will work with MOHSW to establish a data system to monitor the recruitment, deployment, and performance of all health sector employees, including those hired through the emergency hire program.

Other critical components of the management system for the emergency hire program will be processes and structures to confirm care and treatment centre staffing needs, manage recruitment and deployment and to support new hires for optimal performance. The management team will follow up with health professionals who have already demonstrated interest in joining the health work force to verify interest, especially to serve in CTCs located in disadvantaged areas. The management team will supervise selection, interviews, and the posting process. Prior to posting of new hires, the management team will work with appropriate partners to meet capacity building needs and provide on-site support for new hires through the existing training and supervision systems.

To address bottlenecks in the recruitment process, in FY2007 Capacity will build capacity of HR leaders in at least 80 of 121 mainland districts to address HRH hiring bottlenecks so that HRH employed through the Emergency Hiring Plan are absorbed into the system by the end of the two year parallel employment period.

Finally, in FY2007 Capacity will continue to support private sector engagement in HIV/AIDS by funding ABCT to expand advocacy and sensitization activities in the business community both in and outside of Dar es Salaam. ABCT will contribute to the mobilization of chief executives from private companies and to set up and support regional chapters to meet HIV/AIDS prevention, care, and treatment needs for private sector workers and their families.

Deliverables for FY07 include:1) a functional management team in place for an emergency hire program; 2) 300 additional health workers deployed at HIV/AIDS care and treatment centres; 3) 300 additional health workers competent to provide HIV/AIDS prevention, care and treatment centres; 4) 300 health workers hired through the emergency hire program enter the normal payroll system at the end of the 2nd year of employment; 5) existence of functional systems at central, and district levels to improve HR planning, recruitment and retention; 6) existence of a data system for tracking potential health workers; 7) at least 200 HR leaders with basic capacity to improve staffing filling rate, recruitment and retention; 8) at least 80 districts take action to remove hiring bottlenecks; 9) and at least 40 private sector companies with HIV/AIDS program at work.

With plus up funds, the Capacity Project will undertake a program to strengthen human resource management capacity for 25 EHP districts, including a grant mechanism to enable districts initiate practical interventions to improve recruitment and retention. They will also pilot additional workplace improvement programs in 5 districts to provide lessons learned for broader implementation.

Finally, due to limited capacity at the district level, a mechanism to monitor the application of the interventions and the appropriate use and management of funds will be initiated. The outputs expected from this will be the workers will have greater job satisfaction, a shared vision of the facility, improved leadership and management, improved client-provider interaction, improved facility environment and an overall improvement in worker productivity. Results will be monitored and evaluated for important lessons learned for broader implementation in Tanzania.