Tanzanian District Hospitals - The Gap Between Governmental Vision and Reality

In strategic plan 2014–2019 the Tanzanian Ministry of Health and Social Welfare identified “Human Resource for Health” to be the key component for “delivery of quality health and social welfare services, with the ultimate goal of having effective health services in a dispensary at every village, a health center at every ward and a district hospital at every district”. Another five year development plan from 2016 announced the construction of 67 new health facilities, in part improving existing district hospitals. In 2019 the government gave notice to end the public private partnership (PPP) with faith based (district) hospitals (at least 13% of Tanzanian hospitals). - District hospitals are supposed to have a minimal total staff 200 persons with a low number of (biomedical) technologists. The lack of human resources for health, particularly doctors, is nothing new. Therefore, district hospitals hardly can find the recommended number of doctors: 75% of the Tanzanian population lives in rural areas, 26% of doctors serve in rural areas. This situation mirrors in respect to clinical and hospital engineers: in 2017 the Tanzanian minister of education reported a shortage of 7000 biomedical engineers. A substantial relief is hardly to be expected in the near future: the gap between the governmental efforts and reality appears evident. In respect to biomedical engineering, extensive knowledge transfer, supervision and training to increase the provider’s skills will become more important than financially supporting the installment of technologically most advanced medical equipment in an inadequate infrastructure of district hospitals.