Centre for Educational Development in Health, Arusha, the United Republic of Tanzania.
Hum Resour Health. 2010 Feb 26;8:3. doi: 10.1186/1478-4491-8-3.
The United Republic of Tanzania, like many other countries in sub-Saharan Africa, faces a human resources crisis in its health sector, with a small and inequitably distributed health workforce. Rural areas and other poor regions are characterised by a high burden of disease compared to other regions of the country. At the same time, these areas are poorly supplied with human resources compared to urban areas, a reflection of the situation in the whole of Sub-Saharan Africa, where 1.3% of the world's health workforce shoulders 25% of the world's burden of disease. Medical schools select candidates for training and form these candidates' professional morale. It is therefore likely that medical schools can play an important role in the problem of geographical imbalance of doctors in the United Republic of Tanzania.
This paper reviews available research evidence that links medical students' characteristics with human resource imbalances and the contribution of medical schools in perpetuating an inequitable distribution of the health workforce.Existing literature on the determinants of the geographical imbalance of clinicians, with a special focus on the role of medical schools, is reviewed. In addition, structured questionnaires collecting data on demographics, rural experience, working preferences and motivational aspects were administered to 130 fifth-year medical students at the medical faculties of MUCHS (University of Dar es Salaam), HKMU (Dar es Salaam) and KCMC (Tumaini University, Moshi campus) in the United Republic of Tanzania. The 130 students represented 95.6% of the Tanzanian finalists in 2005. Finally, we apply probit regressions in STATA to analyse the cross-sectional data coming from the aforementioned survey.
The lack of a primary interest in medicine among medical school entrants, biases in recruitment, the absence of rural related clinical curricula in medical schools, and a preference for specialisation not available in rural areas are among the main obstacles for building a motivated health workforce which can help correct the inequitable distribution of doctors in the United Republic of Tanzania.
This study suggests that there is a need to re-examine medical school admission policies and practices.
坦桑尼亚联合共和国与撒哈拉以南非洲的许多其他国家一样，面临着卫生部门人力资源危机，卫生人力数量少且分布不均。与该国其他地区相比，农村地区和其他贫困地区的疾病负担更高。与此同时，与城市地区相比，这些地区的人力资源供应不足，这反映了整个撒哈拉以南非洲的情况，在该地区，世界卫生劳动力的 1.3%承担了全球 25%的疾病负担。医学院选择培训候选人并塑造这些候选人的职业士气。因此，医学院可能在解决坦桑尼亚联合共和国医生地域分布不平衡问题方面发挥重要作用。
本文回顾了现有研究证据，这些证据将医学生的特征与人力资源失衡联系起来，并探讨了医学院在延续卫生人力分配不均方面的作用。本文还特别关注医学院的作用，回顾了有关临床医生地域分布不平衡决定因素的现有文献。此外，还向坦桑尼亚联合共和国 MUCHS（达累斯萨拉姆大学）、HKMU（达累斯萨拉姆）和 KCMC（坦桑尼亚基督复临大学莫西校区）的医学院的 130 名五年级医学生发放了包含人口统计学、农村经验、工作偏好和激励因素等数据的结构化问卷。这 130 名学生代表了坦桑尼亚 2005 年的最终入围者的 95.6%。最后，我们在 STATA 中应用概率回归分析来自上述调查的横截面数据。
医学院新生对医学缺乏兴趣、招聘中的偏见、医学院缺乏农村相关临床课程以及对农村无法提供的专业的偏好等因素，都是建立一支有积极性的卫生劳动力队伍的主要障碍，而这有助于纠正坦桑尼亚联合共和国医生分布不均的问题。
本研究表明，有必要重新审查医学院的招生政策和实践。
