Health Workers Learn Task Sharing to Improve HIV Services in Tanzania

Tanzania needs more health care workers. Its workforce is only 44%¹ of the required staff, per its national human resources for health plan. This shortage is more dire in rural areas, where 80%² of the country’s population lives, as well as among mid-level health care workers. Hospitals are often filled beyond capacity, as they must also take referrals from less well-equipped facilities. Patients sometimes share beds or sleep on the floor, and health care workers struggle to provide patients with the care they need.

The Ministry of Health, Community Development, Gender, Elderly, and Children (MOHCDGEC) has begun a number of initiatives to help ease gaps and improve health services, particularly for the 1.5 million³ people estimated to be living with HIV in Tanzania. One initiative, called task sharing, aims to enable lower level health care providers to perform tasks that would typically be outside their scope of responsibilities. This frees up staff with higher-level skills to focus on more complicated cases and help a greater number of patients receive timely, quality care.

“The shortage of staff makes task sharing a necessity,” said Restituta Kushaba, assistant nursing officer at Bagamoyo District Hospital. “It plays a major role in helping the patients.”

The Tanzania Technical Support Services Project (TSSP), funded by The US President’s Emergency Plan for AIDS Relief (PEPFAR) through the Centers for Disease Control and Prevention, has helped the MOHCDGEC develop and implement task sharing strategic plans. Working with health care providers, professional associations, and implementing partners, TSSP helped the government create task-sharing policy guidelines and regulations and make sure these are reflected in formal job descriptions.

TSSP is also working to create a training plan to ensure that staff receive the appropriate certification for additional tasks that they will be providing. To make sure the plan meets these needs, the project interviewed staff at eight health facilities to better understand training needs and provider motivation.

The site visits revealed that many providers had been informally practicing task sharing out of necessity and were eager to receive formal training to ensure they were performing these tasks correctly. They most often requested training on HIV/AIDS care. Many patients have to travel a long distance to find a care and treatment clinic (CTC) for HIV, with transport often unaffordable; if local providers have sufficient training, their facilities can be certified as CTCs.

Based on this feedback, the training plan is on the right track with its prioritization of HIV and AIDs services training. The project is also collaborating in the creation of virtual learning programs so that many of these providers will soon have access to the training content they urgently need. Task sharing cannot work alone and needs to continue to occur simultaneously with programs to develop health care providers at the needed levels to fill priority vacant positions, but it can play an important role in ensuring patients have access to quality care in the meantime.

1. Ministry of Health, Community Development, Gender, Elderly and Children. (2018). Health Workforce Requirement And Recruitment Plan For The Public Health Sector In Tanzania Mainland 2018-2023 Implementation Plan. Dar es Salaam, Tanzania: MoHCDGEC

2. http://worldpopulationreview.com/countries/tanzania-population

3. http://aidsinfo.unaids.org/