20.7 Percentage of Tanzanian doctors in North America20.7
Percentage of Tanzanian doctors in Uganda39.6 Percentage of Tanzanians
medical doctors not practicing clinical medicine
In Summary
- Apart from those working outside the country, the Sikika report reveals, less than half of Tanzania’s medical doctors who have remained are engaged full time in local hospitals
Dar es Salaam. With the cost
of training one doctor pegged at $60,000 (Sh99 million), Tanzania has
lost $11.22 million (Sh18.5 billion) as 184 of its graduate doctors left
for abroad to search for greener pastures by mid this year.
The majority of the country’s “missing” doctors work in Uganda, Kenya and North America, as health situation in Tanzania continues to worsen because of inadequate number of medical personnel.
This figure doesn’t include those who are still in Tanzania but not practicing medicine, a new report reveals.
Dubbed Practice Status of Medical Graduates-Tracking Study of Medical Doctors, a report launched yesterday shows that 8.2 per cent of Tanzanian doctors are residing outside the country.
The report is the product of a survey jointly conducted by Sikika, an NGO dealing with health matters and the Medical Association of Tanzania (MAT).
Almost half of all tracked doctors outside Tanzania are working within Africa with Uganda holding the largest share of about 20.7 per cent (38 doctors) while North America has at least 38.
Kenya is the third largest destination with 16 Tanzanian doctors followed by South Africa (12 doctors), Botswana (9 doctors) and Namibia (6 doctors). East Africa accounts for 30.5 per cent of all doctors that leave Tanzania for greener pastures.
Europe accounts for 14.7 per cent (27 doctors) while at least 8 doctors from Tanzania are working in the Far East (Japan, China, Korea and Singapore). And then, 35.4 per cent of the tracked Tanzanian doctors who work abroad are in Europe and North America.
While the government spends between $40,000 (Sh66 million) and $60,000 (Sh99 million) to train a single medical doctor, four out of every ten who graduate soon abandon their calling to pursue less exacting or better paying undertakings.
The cost of producing a medical doctor doubles if one goes for training abroad, especially in Europe and the US where medical education is still very expensive.
“The government needs to attract and retain an adequate and qualified health workforce in the country’s hospitals. There is a need for new systems, rules and regulations to influence doctors in other jobs/careers to devote some time to clinical healthcare delivery in order to reduce the workload of those working full time in hospitals,” Irenei Kiria, executive director of Sikika said at the launch.
According to WHO and MoHSW, Tanzania has a 1:30,000 doctor-to-population ratio. This ratio has not significantly improved in the past five years due to the fast growing population. The WHO recommended ratio is 1:1,000.
A separate research by Canadian scientists in 2011, in nine African countries reveals that taxpayers are losing the equivalent of $2 billion (Sh3.2 trillion) per year as their expensively trained healthcare professionals leave to work in wealthier countries.
Apart from those residing outside the country, a report also revealed that less than half of Tanzania’s medical doctors are working full time in local hospital.
But nearly half of them work for either health training or research institutes, NGOs or are pursuing further studies. Still, not all of those who work full time in hospitals practice clinical medicine.
On the other hand, of all doctors Sikika tracked, about 40 per cent reported not to be practicing clinical medicine with higher number being reported among female graduates. Yet when calculating physician-to-patients ratio, the number includes even those who aren’t practising.
The trend of doctors migrating to countries where the pay and working environment are better, or stopping practising medicine even when they are around, comprise the key factors that lead to shortage of medics, stifling efforts to improve health provision for the people.
There also the issue of poor motivation. Sikika reveals that only 8 per cent of medical students report being more motivated for a medical career than they were when they joined university.
An earlier study targeting final year medical students in 2005, reveals, in part: “Two-thirds report feeling less motivated and only 25 per cent retained the initial level of motivation”.
From the 2005 survey, the conclusion is that demotivation starts during medical training: “With training cost in mind, the implications of producing demotivated doctors in a country which has inadequate supply of doctors are enormous.”
Furthermore, a large majority of the country’s medical practitioners stay in major cities, such as Dar es Salaam which counts for 32.3 per cent, followed by Mwanza Region with 5.0 per cent. However, those residing upcountry are more likely to concentrate on clinical medicine compared to those in Dar es Salaam who are lured into other undertaking like teaching.
Part of the report reads “Almost three quarters (74.9 per cent) of doctors in upcountry regions practise clinical medicine only while two-thirds (66.7 per cent) of those in Dar es Salaam do.”
The survey further indicates that in addition to the abandonment of the profession by about 40 per cent of graduate doctors, a further 42 per cent of the graduates chose to stay in major urban areas such as Dar es Salaam, Arusha, Mwanza, Mbeya and Moshi.
Generally, about 60 per cent of all medical experts trained locally turn down job offers and leave the country to seek better paying hospitals and other health facilities outside the country, according to Kilimanjaro Medical University College Principal, Prof Egbert Kessy.
Nevertheless, Sikika urges the government through the ministry of health and social welfare, president’s office, public service management (PO-PSM) and prime minister’s office regional administration and local government (PMO –
RALG) to attract and retain adequate and qualified health workforce through improving financial and non-financial incentives, work conditions and ensure availability of medical supplies and equipment.
The majority of the country’s “missing” doctors work in Uganda, Kenya and North America, as health situation in Tanzania continues to worsen because of inadequate number of medical personnel.
This figure doesn’t include those who are still in Tanzania but not practicing medicine, a new report reveals.
Dubbed Practice Status of Medical Graduates-Tracking Study of Medical Doctors, a report launched yesterday shows that 8.2 per cent of Tanzanian doctors are residing outside the country.
The report is the product of a survey jointly conducted by Sikika, an NGO dealing with health matters and the Medical Association of Tanzania (MAT).
Almost half of all tracked doctors outside Tanzania are working within Africa with Uganda holding the largest share of about 20.7 per cent (38 doctors) while North America has at least 38.
Kenya is the third largest destination with 16 Tanzanian doctors followed by South Africa (12 doctors), Botswana (9 doctors) and Namibia (6 doctors). East Africa accounts for 30.5 per cent of all doctors that leave Tanzania for greener pastures.
Europe accounts for 14.7 per cent (27 doctors) while at least 8 doctors from Tanzania are working in the Far East (Japan, China, Korea and Singapore). And then, 35.4 per cent of the tracked Tanzanian doctors who work abroad are in Europe and North America.
While the government spends between $40,000 (Sh66 million) and $60,000 (Sh99 million) to train a single medical doctor, four out of every ten who graduate soon abandon their calling to pursue less exacting or better paying undertakings.
The cost of producing a medical doctor doubles if one goes for training abroad, especially in Europe and the US where medical education is still very expensive.
“The government needs to attract and retain an adequate and qualified health workforce in the country’s hospitals. There is a need for new systems, rules and regulations to influence doctors in other jobs/careers to devote some time to clinical healthcare delivery in order to reduce the workload of those working full time in hospitals,” Irenei Kiria, executive director of Sikika said at the launch.
According to WHO and MoHSW, Tanzania has a 1:30,000 doctor-to-population ratio. This ratio has not significantly improved in the past five years due to the fast growing population. The WHO recommended ratio is 1:1,000.
A separate research by Canadian scientists in 2011, in nine African countries reveals that taxpayers are losing the equivalent of $2 billion (Sh3.2 trillion) per year as their expensively trained healthcare professionals leave to work in wealthier countries.
Apart from those residing outside the country, a report also revealed that less than half of Tanzania’s medical doctors are working full time in local hospital.
But nearly half of them work for either health training or research institutes, NGOs or are pursuing further studies. Still, not all of those who work full time in hospitals practice clinical medicine.
On the other hand, of all doctors Sikika tracked, about 40 per cent reported not to be practicing clinical medicine with higher number being reported among female graduates. Yet when calculating physician-to-patients ratio, the number includes even those who aren’t practising.
The trend of doctors migrating to countries where the pay and working environment are better, or stopping practising medicine even when they are around, comprise the key factors that lead to shortage of medics, stifling efforts to improve health provision for the people.
There also the issue of poor motivation. Sikika reveals that only 8 per cent of medical students report being more motivated for a medical career than they were when they joined university.
An earlier study targeting final year medical students in 2005, reveals, in part: “Two-thirds report feeling less motivated and only 25 per cent retained the initial level of motivation”.
From the 2005 survey, the conclusion is that demotivation starts during medical training: “With training cost in mind, the implications of producing demotivated doctors in a country which has inadequate supply of doctors are enormous.”
Furthermore, a large majority of the country’s medical practitioners stay in major cities, such as Dar es Salaam which counts for 32.3 per cent, followed by Mwanza Region with 5.0 per cent. However, those residing upcountry are more likely to concentrate on clinical medicine compared to those in Dar es Salaam who are lured into other undertaking like teaching.
Part of the report reads “Almost three quarters (74.9 per cent) of doctors in upcountry regions practise clinical medicine only while two-thirds (66.7 per cent) of those in Dar es Salaam do.”
The survey further indicates that in addition to the abandonment of the profession by about 40 per cent of graduate doctors, a further 42 per cent of the graduates chose to stay in major urban areas such as Dar es Salaam, Arusha, Mwanza, Mbeya and Moshi.
Generally, about 60 per cent of all medical experts trained locally turn down job offers and leave the country to seek better paying hospitals and other health facilities outside the country, according to Kilimanjaro Medical University College Principal, Prof Egbert Kessy.
Nevertheless, Sikika urges the government through the ministry of health and social welfare, president’s office, public service management (PO-PSM) and prime minister’s office regional administration and local government (PMO –
RALG) to attract and retain adequate and qualified health workforce through improving financial and non-financial incentives, work conditions and ensure availability of medical supplies and equipment.
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