Doctors’ joblessness in TZ: Reflections on how to harness the private sector

The private health sector in Tanzania can be boosted so that it creates job opportunities for medical doctors who cannot be recruited in government-run health facilities. In the context of the fact that the government trains more doctors than it can employ, yet there is a major outcry about new medical graduates staying jobless, something needs to be done.

Firstly, the doctors can be sensitized so that they form associations or clubs in groups of may be 5 to 10. Then the government through agencies such as the pension funds and the National Health Insurance Fund (NHIF) should support them.

In this case, the public agencies can extend soft loans to the doctors to help them build their own private health facilities. Then, in the process, the agencies can recover their money from the doctors through services offered by the private health facilities they put in place.

How can this work?

As an example, NHIF can extend soft loans to the doctors, and then the doctors enter a health-services-provision-contract with the NHIF.

Through this interplay, the doctors can provide health services to their clients through the private health facilities they run, as they pay back their loans to NHIF.

So as a country we reap two benefits; we increase health services access to the community and at the same time creating employment.

Usually, the main challenge to new for private health investors is that it requires huge capital to set up a private health facility. This makes it difficult for most young doctors who recently graduated to venture into such an investment.

Matters are also complicated by the fact that these same doctors have other outstanding loan obligations with the Higher Learning Students’ Loans Board (HLSLB); which they must pay.

Yet still, these doctors are not credit-worthy, so they cannot access loans from banks due to lack of job contracts.

So, the best way to help the young doctors is by the government supporting them through agencies such as those I mentioned earlier.

The government should also work on addressing the “barriers” that make it difficult for doctors to start-up private health facilities.

These include repressive regulations which impede growth of the private health sector.

Another way to improve the private health sector is through the government empowering existing private health facilities.

This can be done by providing them with soft loans—yet again—so that these health facilities gain the financial muscles to recruit more and more doctors.

One thing we need to note is that, currently, the private health facilities are more affected by the shortage of doctors compared to the public or government-owned facilities.

Another way the doctors’ employment paradox can be solved is through a strong collaboration between the existing public institutions with development projects.

Young doctors can be given job contracts and through these projects their contracts will survive pending securing of a new project, this will also stimulate the doctors to work hard to secure granted projects.

This article was published in 2017 but has been re-edited and updated in some areas. 

Dr Nathanael Sirili
Dr Nathanael Sirili
Dr Sirili is a Health Systems and Policy Research Specialist based at Muhimbili University of Health and Allied Sciences in Tanzania


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  1. Mhhhh…

    Soft loans from financial institutions…

    Medical doctors to form associations..

    Incorporate them into big development projects…

    Nionavyo Mimi, hii haitaweza kusaidia kusolve tatizo..

    Tulifikirie suala Hilo kwa mitazamo mipana zaidi..

    1. Kuna haja kubwa ya kurevise curriculum ya medical school ili ijumuishe elementary knowledge/skills ya Entrepreneurship..-( kupewa hizo soft loans kama huna foundation tutegemee mambo magumu zaidi)

    2. Suala la Umoja kati yetu madaktari kwa kifupi Ni complex.. ( sijui sababu lakini ukweli ndo huo).. Tunahitaji kubadilika sana..

    3. status ya private healthcare service business- Biashara kwa upande wa Afya has never been friendly in Tz in terms za Return on investment ( ROI), in terms za working environment(Bureaucracy nyingi n.k) etc.. Something has to be done here..

    4. Limit ya Madaktari kupractise outside Tz.. It is time Tzanian Doctors kuanza kufanya kazi nje ya Tz.. Uwepo mfumo Mzuri wa free market.. I mean utengenezwe mfumo Mzuri utakao toa fursa za wale unemployed doctors,( walokosa ajira kwenye gvt run facilities) kupata ajira nje ya nchi..

    5. Mentality change plus diversification amongst sisi madaktari..

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