TITLE:Human Capacity Building at Bugando and the Lake Zone Catchment Area

NEED and COMPARATIVE ADVANTAGE:

In Tanzania, the severity of the HIV/AIDS problem is compounded by an acute shortage of skilled health

workers. The program at Weill/Bugando strives to increase the numbers of skilled health workers across

the spectrum of medical professionals. They have expanded training capacity at Bugando University

College of Health Sciences from 10 medical students to 60 per class. In addition, they have established a

twinning program with Weill Cornell Medical School to enhance training. Bugando is the second-largest

zonal training and health facility in Tanzania. It trained over 600 HCWs across eight cadres in 2007. Touch

has been working closely with the Ministry of Health and Social Welfare (MOHSW) and Bugando for nearly

three years, and provides on-the-ground management capacity, technical assistance, and funding. Touch

has significant expertise in the Lake Zone and strong relationships with the key players. The combined

experience of McKinsey & Company, the Weill Cornell Medical School, and Touch form a formidable

partner to address human resource issues.

ACCOMPLISHMENTS:

The Touch Foundation has just been awarded a three-year agreement to focus on human resources and

systems strengthening in Tanzania. Therefore, there have been no accomplishments to date with USG

funding.

ACTIVITIES:

The program is a Global Development Alliance, partnering the Touch Foundation (and their key private

partners, McKinsey & Company, Citigroup, Stroock & Stroock & Lavan) and the USG to address health

worker and health systems issues in Tanzania.

Key components of the work with Touch will focus on pre-service training of health workers across eight

cadres. Touch expects to train approximately 130 nurses, 100 lab techs, 100 pharmacists, 100 Assistant

Medical Officers, 210 Medical Doctors, 40 post-graduate specialists, 50 radiographers, and 20 anaesthetists

(a total of 750) in Government of Tanzanina (GoT)-accredited programs. The funds requested for pre-

service training complements the funds requested by Bugando for in-service training in HIV/AIDS care and

treatment and early infant diagnosis.

In addition, the program will identify ways to help link graduates to health facilities; e.g. through an incentive

packages for deployment to remote, hard to fill posts after receiving full tuition in their training. This is

similar to the arrangement made for clinical staff under the Global Fund sponsored Emergency Hiring Plan.

There has been strong support from the GoT for this approach. In addition, special slots will be allotted to

the training programs for children who have been orphaned.

Trainees from the Bugando University training program will be used to staff various tiers of the health

system to help enrich the staff already assigned there, and to provide experiences to students at all levels of

the health system.

The program will also have a systems strengthening component that will cover primarily the Lake Zone.

Because of the potential for replication in other parts of the country, the program will link with the MOHSW

for scaling up the lessons learned. It will identify ways to provide the appropriate skill mix, staffing, and

support at all levels of the health system from dispensary level up through tertiary care facilities, and

strengthening the referral mechanisms. The program will also leverage the work of the USG partners who

provide clinical services in the Lake Zone.

Lastly, at the national policy level, Touch will assist the USG and USG-funded programs to address the

bottlenecks and barriers to the recruitment process. The issues have been identified through an

assessment done by the Capacity Project, and Touch would leverage their relationships at the national level

to convene a high-level task force to address the issues that preclude the streamlining of many aspects of

the recruitment process.

LINKAGES:

Touch has a formal agreement with the GOT through an MoU with the MOHSW. Touch would also link with

other partners in the area of Human Capacity Development, especially the Capacity Project, and treatment

partners who are involved with Bugando, including AIDSRelief and Columbia University. Touch also works

closely with the six regional governments in the Lake Zone and the RMOs of each region.

CHECK BOXES:

Areas of emphasis selected are based on anticipated human capacity development work.

M&E:

Touch monitors all training activities through an international staff based in Mwanza and our local partners.

Training programs are evaluated in partnership with the Bugando University College of Health Sciences. In

terms of fiscal accountability, Touch reviews each expense on a monthly basis before transferring further

funds.

Touch also works to systematically analyze all programs that fail to or succeed in meeting expected

outcomes.

SUSTAINABILITY:

Touch's focus on sustainability relies on strengthening the health system by enabling increased production

of skilled health workers and building management capacity within Tanzania to problem-solve and

implement solutions.

Systemic improvements at Bugando will stimulate best practices in patient care, which can then be

replicated by posting students to other facilities. Touch ensures that, where possible, all elements of the

program are led by Tanzanian university and hospital staff. In addition, Touch operates under the premise

that visiting experts maximize transfer of knowledge.