Where are the Doctors? Madaktari wapo wapi? Sikika, MAT joint press statement

A total of 890 out of 2, 246 (equivalent to 39.6%) medical doctors in Tanzania are not practising clinical medicine. Also, only 964 out of the same total figure (equivalent to 42.9%) of graduate doctors were working full time in hospitals. Others were pursuing further studies, work in NGOs, health or non- health related institutions or were suspended.

This was revealed in a study conducted by Sikika in collaboration with The Medical Association of Tanzania (MAT) between August and October 2012 of which a total of 2,246 graduate doctors were tracked.

The study highlights that among the tracked doctors, almost half of them were from Arusha, Dar es Salaam, Mbeya and Moshi. Dar es Salaam alone accounted for a total of 725 of the tracked graduate medical doctors.

The study also revealed that, nearly a half of the 2003 graduates (48 out of 107) were not practicing clinical medicine; while 68 out of 102 (equivalent to two out of three) of 2004, more than three quarters (176 out of 224) of 2008 graduates and 155 out of 206 of 2009 graduates were practicing clinical medicine.

However, about 246 out of 290 (equivalent to 85%) of tracked medical doctors who earned their degrees in 2011 were not practising clinical medicine while almost all the 2012 graduates (96 out of 101) were practising medicine.

According to WHO and MoHSW, Tanzania has about 1:30,000 doctor to population ratio. This ratio has not significantly improved in the past five years due to increased population.

Based on the findings of the study, Sikika and MAT recommend that the Tanzanian government needs to attract and retain an adequate and qualified health workforce in the country’s hospitals.

There is a need for new systems, rules and regulations to influence doctors in other jobs/careers to devote some time to clinical healthcare delivery in order to reduce the workload of those working full time in hospitals.

Since majority of doctors reside in major towns, there is a need for improved infrastructure for transportation in rural areas and create a better referral system that will make it easier for people to access quality services.

Furthermore, a research should be conducted to find out the factors that cause a high number of graduate medical doctors to abandon clinical medical practice in hospitals.

Due to limited availability of records, an information system should be established to inform the whereabouts of medical doctors and other healthcare workers and their clinical practice status right from the point of their graduation.