“Is there a doctor in the house?” - Kenny Holt Published: 06 Mar 2017

An article by Kenny Holt, Vine Trust Medical Programme Manager.

There is no doubt that the availability and recruitment of suitably qualified personnel plays a fundamental role in the provision of quality health services. Despite significant improvements in the healthcare system in recent years, Tanzania still faces challenges in training, recruiting, retaining and distributing health professionals to meet the medical needs of its population of just over 49 million.

In the recently published National Five Year Development Plan (2017-2021), the Government highlights the need to address “the human resource crisis which constrains the provision of adequate health care”. This crisis includes an estimated 0.31 doctors per 10,000 of the population, giving Tanzania the seventh-lowest physician-to-population ratio of all nations.

Rural areas are particularly underserved by health workers. In 2006, studies revealed that only 20% of doctors practiced in the rural areas where 73% of Tanzania’s population lived. This unbalance was largely down to rural posts being unattractive for trained health professionals. A 2007 study of final year medical students in Tanzania highlighted that less than half (48.5%) were willing to apply for or accept rural posts, mainly due to “adverse working conditions”, despite most of them originating from these areas.  

Conversely, it is estimated that 52% of all doctors are employed in the Dar es Salaam region, resulting in the density of doctors there being six times higher than the national average.  Projections based on current training and recruitment strategies suggest that the physician-to-population ratio in rural areas will improve very little over the next decade, and will only reach 0.55 per 10,000 by 2025 (compared to 2.6 in urban areas).  

Since March 2015, the Jubilee Hope Programme has been working in the Kagera region, where it is estimated there are only 25 doctors serving a population of 2.5 million - the third lowest doctor-patient ratio in the country. With so few physicians for such a large population, it is unsurprising that there are no doctors stationed on Kagera’s remote islands of Lake Victoria.

Even if more doctors, dentists and nurses were available, the challenge of recruitment for rural areas would still need to be addressed. The islands are an even more extreme setting due their isolation and a lack of facilities, equipment, resources and support for anyone thinking of accepting an assignment there. Add to this the stigma and poor reputation of these island communities, and you have a very unattractive proposition for healthcare workers whose skills are in high demand on the mainland. 

This reality highlights three important features of Vine Trust’s Jubilee Hope Medical Programme as it works with local communities:

  1. The value of our current medical team - Despite the recruitment challenges, the Jubilee Hope Programme has been able to employ a core team of hard working and dedicated health professionals who are passionate about making a difference in the lives of the islanders. The ongoing success of the Programme depends greatly upon their continued commitment, development and training in the months and years ahead.
  2. The important role of volunteers – Overseas volunteers offer their knowledge and skills on expeditions, and support the small local team of health professionals to deliver the vital medical services which are in such high demand. As well as bringing their expertise to patient consultations and treatment, volunteers also help in the equipping, capacity building and training of local workers.   
  3. The suitability of the medical ship concept – A medical ship provides an equipped, safe and hygienic facility for patient consultations. It also facilitates the transportation and participation of a sizeable team of health professionals to visit these remote island locations.

To find out more about Vine Trust and the Jubilee Hope Medical Programme, including volunteering opportunities, please visit our Medical Volunteering page. 

Kenny Holt
Vine Trust Medical Programme Manager


Primary References:

  • Tanzania Service Availability Mapping Project - Ministry of Health and Social Welfare.
  • Worker Retention in Human Resources for Health: Catalyzing and Tracking Change - Yumkella, IntraHealth International.
  • National Five Year Development Plan: Tanzania 2017/17-2020/21 – Tanzania Ministry of Finance and Planning.
  • Addressing the human resource for health crisis in Tanzania: the lost in transition syndrome – Sirli, Kiwara, Frumence, Semafaku & Hurtig - Tanzania Journal of Health Research, Vol 16, Number 2, April 2014.