In response to the looming shortage of health workers in the country affecting mainly rural areas, in July 2005 the Benjamin William Mkapa HIV/AIDS Foundation (BMAF) launched its first home-grown programme, Mkapa Fellows Programme, or in short MFP.
The programme was initiated to complement government efforts to scale up care and treatment of HIV/AIDS in the country following the launching of the five-year National Care and Treatment Plan (2003-2008) targeting to reach 400,000-500,000 people living with HIV/AIDS.
By then, only one percent (4,581 people) of the targeted Tanzanians eligible to receive ARV’s were reached in the middle of the implementation of the plan,” according to Dr Adeline Saguti Nyamwihura, BMAF Programme Manager responsible for Capacity Building.
She says the situation was worsened by the fact that the country had a capacity to deliver quality health services by 32 percent.
In response, Dr Nyamwihura says the Fellows programme recruited teams of three’s (clinicians, nurse and a third cadre which was to be determined by the districts whether a pharmacist or laboratory technician) to serve in 30 districts under the leadership of Council Health Management Teams (CHMTs).
A total of 99 skilled health workers were offered a three-year Mkapa Fellowship to work in 33 districts. The purpose of the programme was to recruit, train, deploy and retain skilled professionals to support the implementation of Tanzania’s response to HIV/AIDS, including, but not limited to the National Care and Treatment Programme.
This scheme was financially supported by the Norwegian government.
Dr Nyamwihura says the support includes paying the Fellows remunerations and benefits throughout their contract period, orientation and induction training on care and treatment of HIV/AIDS, computer training and general management.
Other activities were conducting outreach for HIV/AIDS services where the Fellows teamed up with district officials to visit remote villages to conduct care and treatment services, transportation of blood samples to the regional hospitals which were the only facilities that could perform analysis for HIV/AIDS such as CD4 count being crucial in case management of HIV/AIDS cases.
Of paramount importance, too, were internet installations to enable transfer of data to the National Aids Control Programme through the established database and refresher trainings on leadership and management.
One of the achievements attained during the June 2010 to July 2011 project implementation is that the programme attracted and retained more than 90 percent of the health workers recruited to work in rural Tanzania.
“This is 20 percent higher than the projected retention rate. Sixty percent of the retained workers were mainstreamed to government public service, providing sustainability to the efforts initiated during the project,” explains Dr Nyamwihura.
Another achievement is the MFP engagement in rural districts resulted in a five-fold increase in enrollment of clients receiving anti-retroviral treatments (ART) in districts that Fellows served, from 10,000 in 2005 to 60,000 by December 2009.
Similarly, more than 120 care and treatment centres in 33 districts were served by the Fellows.
“The government,” says Dr Nyamwihura, “recognised BMAF’s expertise in creating and managing human resource hiring innovation programmes and began several collaborative programmes, including Emergency Hiring Project that led to recruitment of 176 health workers to scale up HIV/AIDS, TB and malaria in 19 Tanzania Mainland districts.”
She adds: “Through this project workers were deployed to dispensaries, health centres and district hospitals and it contributed to three-fold increase in enrolment and clients on ARVs.”
According to Dr Nyamwihura, the Fellows have formed the Mkapa Fellows Alumni Association (MFAA), a registered entity with 83 members.
This association supports provision of quality health service in underserved rural communities through its members that are scattered countrywide.
The vast experience of the fellows in provision of HIV/AIDS services, particularly in the rural districts have lead to the Foundation using MFAA among the strategies to implement MFP Phase II, says Dr Nyamwihura.
“The project evaluation concluded that the programme achieved its goals. It recommended the expansion of services to use the current Mkapa Fellows Alumni. The future Fellows would continue with HIV/AIDS services to include Prevention from Mother to Child Transmission (PMTCT) as well as Maternal and Newborn Health services,” explains the Capacity Building Programme Manager.
Reaching graduates through job fairs
In order to establish a sustainable base for increased health workers, the the Benjamin William Mkapa HIV/AIDS Foundation in collaboration with some government ministries has come up with innovative ways of reaching health graduates through job fairs with support from the United States Agency for International Development (USAID) through the Tanzania Human Resource Capacity Project in Lake Zone and the Global Fund Round 9 through Health System Strengthening Project in Northern, Southern, Southern Highlands, Western, South West, Central, Eastern and Coastal Zones.
Pamela Maro, BMAF’s programme officer (capacity development, says by conducting job fairs, students and graduates from health institutions get a chance to hear presentations from the ministries on their roles and mandate, vacancies that exist in health sector from the central government and scheme of services.
“Information is also obtained from the local governments on available opportunities for health workers in their districts. This motivates the students and graduates to join the health sector,” she explains.
According to Maro, so far BMAF has conducted five job fairs in the Lake, Northern and Southern zones. Two other fairs are taking place in the Southern Highlands Zone (Njombe and Iringa regions).
A total of 1,552 graduates and final year students have applied for jobs; 113 were eligible as per 2011/2012 vacancies and 60 job applications have been sent to the Ministry of Health and Social Welfare for posting.
“The rest of the applicants will be graduating in 2012 and are therefore eligible for 2012/2013 vacancies. Nine more job fairs will be conducted in the remaining zones by February 2013.