BackgroundThe establishment of a functional information system for human resource for health (HRH) was one of the major challenges for the Tanzanian health sector. In 2008, the Ministry of Health and Social Welfare developed the HRH Strategic Plan, in which establishment of computerized information systems were one of the strategic objectives. In response to this objective, the Ministry developed two information systems, namely the Human Resource for Health Information System (HRHIS) and the Training Institution Information System (TIIS), to capture information from both the public and private sectors.Case descriptionThe national rollout of HRHIS and TIIS was carried out in four phases during a 6 year period between 2009 and 2014. Together with other activities, the rollout process included conducting system operation training and data utilization training for evidence-based planning, development and management of HRH and social welfare workers and health training institutions.DiscussionHRHIS was rolled out in all 25 regions of the Tanzanian mainland, including 171 districts, and TIIS was rolled out in all 154 health training institutions and universities. Information is captured from both the private and public health sectors with high-data coverage. The authors identified several key factors for the achievements such as using local experts for developing the systems, involvement of system users, positive attitudes among users, focusing on routine work of the system users and provision of operations and data utilization trainings. However, several challenges were also identified such as getting a consensus on sustainable HR information systems among stakeholders, difficulty in obtaining baseline HRH information, inadequate computer skills and unsatisfactory infrastructure for information and communication technology. We learned that detailed situation analysis and understanding of the reality on the ground helped to reduce the “design–reality gap” and contributed to establishing user-friendly systems and to improve sustainability of the systems.ConclusionsThis paper illustrates the successful development and national rollout of two information systems for HRH in Tanzania. The approaches used and activities conducted here and lessons learned could be useful for countries which are planning to establish HR information systems.

This study sought to assess actions which Indonesia, Sudan, and Tanzania took to implement the health workforce commitments they made at the Third Global Forum on Human Resources for Health (HRH) in November 2013. The study was conducted through a survey of published and gray literature in English and field research consisting of direct contacts with relevant ministries and agencies. Results show that the three countries implemented interventions to translate their commitments into actions. The three countries focused their commitments on improving the availability, geographical accessibility, quality of education, and performance of health workers. The implementation of the Recife commitments primarily entailed initiatives at the central level, such as the adoption of new legislation or the development of accreditation mechanisms. This study shows that action is more likely to take place when policy documents explicitly recognize and document HRH problems, when stakeholders are involved in the formulation and the implementation of policy changes, and when external support is available. The Recife Forum appears to have created an opportunity to advance the HRH policy agenda, and advocates of health workforce development in these three countries took advantage of it.

Objective: Tanzania has a high maternal mortality ratio of 556 per 100,000 live births. Timely caesarean sections avert mortality due to life threatening conditions like obstructed labour. This study assessed capacity of selected health facilities to provide caesarean sections in terms of infrastructure, equipment, essential supplies and skill mix. Methods: A cross-sectional mixed methods design was used to include systematic observations using highly structured checklists to determine the adequacy of infrastructure, functional status of equipment, availability of supplies and skill mix. An interview guide and a key-informant interview guide were used to collect data from assistant medical officers and key informants respectively. Descriptive data analysis was conducted using IBM SPSS software package. Results: Deficit for doctors ranged between 3 (37.5%) and 5 (62.5%) per each district hospital. Two out of 3 health centres did not have doctors. Deficit for assistant medical doctors ranged between 10 (62.5%) and 11 (68.8%) per each district hospital. In terms of absolute numbers, assistant medical doctors were more than doctors. Not all facilities had all the equipment, infrastructure or supplies. Challenges cited by most assistant medical officers were; shortage of theatre-trained nurses (91%; n=21), theatres not functioning (61%; n=14), inadequate blood supply (87%; n=20) and inadequate equipment (96%; n=22). Conclusion: Capacity of health facilities to provide caesarean sections was found to be sub-optimal due to health workforce shortages, inadequate infrastructure, equipment and supplies, thus increasing the risk of maternal deaths. These findings are useful in informing strategies to reduce maternal mortality.