Newsroom
June 2010 Report
McKinsey on Africa is an anthology of provocative essays and interviews about Africa. Coverage includes the following perspectives: "Africa's growth story," "Doing business in Africa," and "Improving lives in Africa."
Developing the Workforce
Based on our early progress at Weill Bugando, the Tanzanian Government invited us to develop a plan for the expansion of health worker training nationally.
Producing more health workers, faster: The Twiga Initiative
In 2007, the Tanzanian Ministry of Health and Social Welfare made it a national priority to double student intake in health training programs. Working with McKinsey & Company, we analyzed the growth potential of different training schools and developed a plan by which Tanzania could achieve this goal.
We have compiled our findings and recommendations in the Twiga Initiative, which was adopted as policy by the Tanzanian health ministry. Swahili for “giraffe,” this initiative carefully links the pace of workforce growth to the pace of building new facilities, so that facilities are only built when there are enough health workers to staff them. Construction projects have often been easier to undertake than training programs, so this last component provides a blueprint for preventing waste of precious financial resources.
The Twiga Initiative is incorporated into the country’s internal budget and process for requesting international assistance.
Health worker retention: Staunching the brain drain
While emigration of doctors and nurses is not as serious a concern in Tanzania as in other sub-Saharan African countries, many health workers do leave the health workforce shortly after graduating from their training programs either to pursue other careers, or to take administrative jobs with international organizations in Tanzania. This amounts to a significant loss for the national workforce.
Many who leave their posts report a lack of job satisfaction – not simply low pay – motivating them to seek opportunities elsewhere. Job satisfaction is affected by a combination of factors, including support and supervision, success, professional development, and a desire to support the community.
We are working with Tanzanian partners to determine effective, long term strategies for increasing job satisfaction to help improve retention of health workers, with a particular focus on rural areas.
Looking ahead: Transforming medical education.
As the Touch Foundation grows, we plan to tackle four issues that currently hinder expansion and strengthening of Tanzania’s health workforce: limited teaching space; lack of on-site, continuing education programs; lack of student financing; and staffing targets out of step with public health needs.
Virtual learning
Virtual technology will link health workers in rural facilities to urban centers so they can improve skills on site, avoiding long or sometimes impossible journeys to urban centers. A single professor can then lecture hundreds of students rather than dozens, reaching those in Tanzania’s many rural facilities. This makes best use of inter-Tanzania partnerships and institutional twinning programs while maximizing the capacity of the training schools that already exist.
National loan program
National student loan programs are virtually unknown in sub-Saharan Africa. A well-conceived, sustainably financed loan program would make medical education available to more students, stabilize growth of the health training system, and potentially improve retention of health workers.
Workforce targets
The most efficient health workforce is one in which skills are tailored to the specific needs of the population served. We are working with the Government of Tanzania to design a diagnostic study to examine the relationship between the supply of health workers and patients’ demands, reflecting the disease burden in Tanzania.