Gender- and cadre-specific distributional inequality of the Tanzanian health workforce

Angelina Lutambi Mageni, Ifakara Health Institute (IHI)
Amon Exavery, Ifakara Health Institute (IHI)
Godfrey Mbaruku, Ifakara Health Institute (IHI)

While unavailability of health personnel in sufficient numbers, inadequate skills and geographical imbalance have been visibly documented as critical challenges the Tanzanian health sector faces, paucity lingers about gender- and cadre-specific distribution and what this implies to the country’s health sector. This study attempts to describe the distribution of the country’s health workforce primarily by gender and cadre but also taking a note of other demographic characteristics. Cross-sectional data collated in 2008 through self-administered questionnaire of the Health Systems Strengthening for Equity (HSSE) Project were used. A random selection of 88 health facilities in 8 regions yielded 815 health workers. Chi square and student’s t-tests for categorical and continuous variables respectively were used to test the associations at 5% significance level. 815 (75% women and 25% men) health workers responded to the questionnaire. Their mean age was 39.7 years (SD = 9) ranging from 15 to 63. Majority of the certificate (89%) and diploma (64%) holders were women but they were the minority (36% among holders of advanced diploma and higher professional qualifications. The proportion of women among Medical Attendants, Nurses, Midwives, Clinical Officers and Doctors was 86%, 86%, 91% 28% and 21% respectively. Distribution of the Tanzania’s health workforce is dramatically gender-skewed, a reflection of gender inequality in career choices. Women are concentrated in the lower-status health cadres but poorly represented in the highly trained ones. Nursing and midwifery cadres are large and female-dominant, whereas clinical officers, assistant medical doctors, medical doctors and higher cadres are fewer in absolute numbers and male-dominant. Since women-dominant cadres have more people, majority of which are less educated, furthering their education and improving career advancement opportunities with a special attention to women is worthwhile.