Educating Enough Competent Health Professionals: Advancing Educational Innovation at Muhimbili University of Health and Allied Sciences, Tanzania

As immediate and crushing as the health burden is for Tanzania and across Africa, health systems will not cope better without many more health professionals competent to play leading roles in meeting population needs. Thus, national and international strategies depend fundamentally on universities, and on their transformation into modern engines for change and as custodians of quality education. Tanzania suffers an extreme shortage of health workers [1]. A 2006 facility survey undertaken in Tanzania (Mainland and Zanzibar) suggests that about 39 nurses and midwives, between three and four medical doctors, and fewer than one pharmacist or dentist served a population of 100,000 [2]. The Ministry of Health and Social Welfare estimated that in 2006 about 29,000 government health staff served a Tanzanian population of approximately 38 million, 35% of the number needed [3]. Since independence, Tanzania has relied heavily on mid-level substitute health workers [4]. In 2006, 1,339 medical doctors, with five years training, comprised only 14% of Tanzania’s medical workforce [2]. Clinical officers (CO), with three years training, in clinical medicine and community health, provide basic services in dispensaries (for 6,000 people); assistant medical officers (AMO), with two years clinical training beyond COs, provide clinical services in health centers (for 50,000) and in district hospitals (for 300,000). District and regional referral hospitals are meant to have physician supervisors, but COs and AMOs commonly work without such supervision, and thus beyond their levels of training. To address the imperative for more health professionals, universities are expanding educational programs in Tanzania (Table 1), increasing intake of students [5], and introducing educational innovation [6,7,8]. To increase its teaching capacity, Muhimbili University of Health and Allied Sciences (MUHAS), for example, is expanding its teaching facilities by developing a new campus [9] and building its faculty. To ensure the quality of the services its graduates are able to provide, MUHAS is transforming its educational environment [10] in collaboration with educational institutions, ministries, professional bodies, and other stakeholders in Tanzania. MUHAS and the University of California San Francisco (UCSF) formed an academic partnership in 2005, and it has played a key role in curriculum innovation and faculty development [11,12].