Mobilizing resources to develop human resources for health
At a higher level, the country was successful in its application for support to the Global Fund to Fight AIDS, Tuberculosis and Malaria Round 9 for Health Systems Strengthening ($149 million USD over five years). For a phase one implementation that ends in 2013, funds of $82.9 million USD have been allocated to the country. Out of this, 36% is set to increase production of health workers and 21% to enhance health workforce recruitment and retention. Some pharmacists have been recruited through these funds.
Emergency hiring and hiring retired health workers
Various strategies are in place to improve the recruitment and retention of health workers in Tanzania, including an emergency hiring initiative supported by the Benjamin William Mkapa HIV/AIDS Foundation. However, so far only five pharmacists and four technicians (out of 364 tutors and health workers) have been recruited through this initiative since 2010, to work mostly in rural areas (personal communication).
Two-year renewable contracts are also being offered to retired health workers, including pharmacists, if they are willing to continue providing services in the public sectors. At the same time, local governments are also being encouraged to employ pharmaceutical staff where there are shortages in their Councils.
Scaling up education and training
Scaling up and quality improvement of pharmacy education and training are essential for addressing workforce shortages and for meeting basic health needs in the country. The number of training institutions providing pre-service education for pharmacists and pharmaceutical technicians has doubled over the last five years. The number of schools of pharmacy offering a BPharm degree programme has increased from two to four since 2010, one of which also offers post-graduate programmes. However, these are still inadequate to cater for the needs of the country, and the private sector is being encouraged to open more schools; operating schools are encouraged to address the challenges hindering the increase in enrolees.
The number of schools offering diploma programmes for pharmaceutical technicians has also increased, from two to five (Table 5.9.3). To ensure more pharmacy assistants and technicians are produced, the Pharmacy Council is currently in the process of introducing a cascading curriculum to provide a path for career growth, particularly for pharmacy assistants. This will be a modular curriculum, in which students planning to earn a diploma will have the option to exit the programme early after completing several modules and receive a certifi- cate instead. This certificate gives them recognition by the PC as dispensers, and they can continue their education later with
higher modules until they complete the full diploma. This approach will allow Accredited Drug Dispensing Outlets (ADDO) dispensers with limited training to enrol and receive adequate training and recognition by the PC. With the cascading curriculum, they have a chance for career growth and increased opportunities to work not only in the private sector but also in the public sector. As per the Tanzania Food and Drug Agency, currently there are 10,445 ADDO dispensers in the country with 3,873 ADDO outlets distributed throughout the country and mainly in rural areas (personal communication).
Table 5.9.3. Pharmacy schools, location, year of establishment, and
1The diploma programmes started much earlier 2The enrolment capacity is 100 students per cadre but did not get enough students last year due to higher entrance requirements.
BPharm (50) MPharm, PhD, and Diploma1
BPharm Degree (65)
BPharm (35) and Diploma1 (55)
Diploma (20) and Certiﬁcate (20)
BPharm2, Diploma (3), and Certiﬁcate (7)
Dar es salaam
Dar es salaam
Dar es salaam
Type of Institution Town/City
Year it started
Academic qualiﬁcation offered (no. of students per enrolment)
Muhimbili University of Health and Allied Services (MUHAS)
St John s University of Tanzania (SJUT)
Bugando Catholic University of Health and Allied Services (CUHAS)
Kilimanjaro School of Pharmaceutical Sciences
Ruaha University College (RUCO)
Kampala International University (KIU)
Royal Pharmaceutical Collage
Needs-based education and training
Currently, there is a growing demand for clinically-oriented pharmacists who can work in a multidisciplinary health care team. At Muhimbili University of Health and Allied Services (MUHAS), this demand has been addressed through review of the BPharm curriculum, focusing more on patient care. However, capacity building of teaching staff to meet such transformations has remained a challenge. MUHAS, as a higher learning institution, is required to review its curricula regularly, usually every five years, previously undertaken in 2002. In addition, the government, through the Tanzania Commission for Universities (TCU), the regulatory authority for higher education, directed that all curricula in higher learning institutions be transformed from content-based to competencybased curricula to address the various needs of the country. Therefore, MUHAS embarked on a curriculum review in November 2008 through a partnership project, the Academic Learning Project, between MUHAS and the University of California San Francisco. The project, which was funded by the Bill and Melinda Gates Foundation, had several objectives. All MUHAS curricula, including the BPharm curriculum, were reviewed, and implementation of the new curricula began in October 2011.
The review process involved identification of competencies considered necessary for pharmacy graduates and analysis of the previous curriculum in order to identify any gaps and redundancies and make appropriate improvements. The process involved not only faculty and students, but also external stakeholders, such as professional regulatory authorities and associations, former pharmacy graduates, their employers, and their co-workers. Views from these stakeholders were obtained through surveys (tracer study) or their participation in curriculum review retreats, and eventually taken into account in the curriculum s revision. The BPharm curriculum was revised, made competency-based, and modularized to make it easy for one to transfer credits when moving from one institution to another. In addition, the content was also revised,focusing more on patient care; more student time was allocated to clinical exposure. The revised curriculum was subjected to approval at the university level and by TCU. It is anticipated that other pharmacy schools in the country will also revise their curricula towards a competency- based model and with greater focus on patient care.
Academic institutions are important centres for conducting needs assessments of pharmaceutical personnel in the country and in designing various continuing education programmes so as to build capacity of the pharmaceutical workforce and enable personnel to cope up with innovations in pharmacy. Currently, MUHAS is implementing a short course in good manufacturing practice and other aspects of industrial pharmacy to support regulatory functions and build capacity of local manufacturers.
5.9.4. Recommendations for pharmaceutical human resources development
The study on the pharmaceutical human resources was an eye opener to policy makers, donors, and other stakeholders, and it has galvanized some action. However more effort is needed if stakeholders want to see positive outcomes. Listed below are some of the recommendations made by stakeholders during the development of the strategic plan for pharmaceutical human resources in 2010, which are still relevant:
Improved pharmacy workforce planning, training, and education are needed in order to prepare an adequate and competent pharmaceutical workforce in the country. Al though the number of pharmacy schools in the country has increased, efforts are still needed to attract investors in the establishment of new pharmacy schools.
In collaboration with the PC and other stakeholders, pharmacy schools should be at the frontline in designing and instituting well-structured continuing education programmes so as to provide the support needed for pharmaceutical personnel to cope with medicines development.
Training institutions should find the means to address the challenges of inadequate infrastructure, tutors, and funds to enable them to increase the number of enrolees and output. The implementation of these recommendations will definitely bring change in the right direction in pharmaceutical workforce development.
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