Since I have gotten this question repeatedly, it might help to backtrack a bit and offer an explanation of why I am here in Tanzania.
I am working on my graduate school fieldwork project in Global Health Sciences at the University of California, San Francisco (UCSF). The project is developing a clinical/educational relationship between the Muhimbili University of Health and Allied Sciences (MUHAS) in Dar es Salaam and the Bagamoyo Health District, about 70km north of Dar. The idea is to create an experiential education program for medical, nursing, pharmacy, public/environmental health, and dentistry students at MUHAS. UCSF has an existing relationship with MUHAS called the Academic Learning Project that is engaged in curriculum revision at MUHAS and an exchange of students between the two institutions. My project, fortunately, managed to fit in rather nicely with the existing UCSF project.
A significant aspect of my project is potentially creating an inter-professional program, in which students from each discipline will work as a team on identified community health projects in the district.
Why do this? Because Tanzania has a severe shortage of human resources for health. The country has nearly 40 million people and about 850 practicing physicians (a ratio of over 47,000 population to 1 doctor), and at recent count 58 dentists (a ratio of about 780,000 to 1 - clearly most people never see a dentist). Most of the staffing of the public health system is by mid-level cadres, particularly clinical officers, who have limited training, but perform an incredibly important function in the health system. However, clinical officers are also in short supply. Bagamoyo is unusual in that it actually has a complement of health professionals, albeit very short-staffed. Thus, goals of the program include having supervised students offering clinical assistance in the district, and hopefully engaging them in working in the district after graduation.
Another goal is a back and forth flow of education. For both existing staff in Bagamoyo and students who are there working, we are planning to hold grand rounds with staff from MUHAS who also are on staff at the nearby Muhimbili National Hospital. We are hoping to be able to do this through teleconferencing, which would enable a regular schedule of clinical and educational engagement between MUHAS and the districts. It's really very exciting, and people here are thrilled with the idea.
Right now, I'm mostly talking with people and finding out what it is that they want, to medical and nursing students who have been in the field elsewhere about what has worked for them, what has not, and how this new program could best meet their needs.
Inter-professional programs are pretty cutting edge, and people here are excited about the prospect of creating teams of professionals from different disciplines working together on specific needs identified in the outlying health districts. The longer term idea is to get this program up and running and then use it as a template for programs in other health districts in the country.
Makes the 3500 to 1 HPSA ratio seem pretty pale in comparison.
Posted by: Glen Davis | March 31, 2010 at 04:11 PM