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

Dr Nathanael Sirili, MD, MSc.

drnsirili@gmail.com

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.

Read: Tanzania trains more doctors than it can employ-study

Firstly, the doctors can be sensitised 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.

The author is a Tanzanian researcher and a PhD candidate in Public Health (Health Policy and Systems Research)-Umea University (Sweden).He is also assistant lecturer at Muhimbili University of Health and Allied Sciences (Muhas).