Open Source Software Helps Zanzibar Expand Its Health Workforce

CapacityPlus develops the core iHRIS software and releases routine updates.

Zanzibar, the semiautonomous archipelago off the coast of Tanzania, has increased its health workforce by more than 27% over the past three years by using data from open source tools.

Until 2011, Zanzibar’s Ministry of Health had funds for just 30 new health workers per year. But Zanzibar is home to over 1.3 million people, and its small health workforce of 3,270 was not able to keep up with the population’s health care needs. In fact, the workforce shrank year after year as health workers left the field, retired, or died and were never replaced.

Only about half of women who give birth in Zanzibar deliver their babies in health facilities or with the help of skilled birth attendants. Misconceptions about HIV abound, and adults in Zanzibar tend to be much less knowledgeable about the virus than those on the mainland. Without sufficient numbers of health workers and the right data about its health workforce, the health sector cannot tackle the most pressing problems or plan to meet the population’s evolving needs.

But through the Tanzania Human Resource Capacity Project, IntraHealth International has been working with Zanzibari officials since 2007 to roll out iHRIS, open source software that helps governments gather data about their health workforces. Officials have embraced the information system, amassing a trove of robust data about their health workforce—including how many workers exist, which areas they serve, what qualifications and licensing they hold, and more.

Zanzibar has also begun using WISN (or Workload Indicators of Staffing Need), a tool created by the World Health Organization to help governments determine the specific staffing needs within their countries’ health facilities. By analyzing data from the two tools in conjunction with one another, Zanzibar’s Ministry of Health officials saw that the population’s need for health workers was much greater than its current workforce and the 30 additional personnel the ministry was adding per year—in fact, it needed closer to 300 new workers every year. And the data also made clear where additional staff were needed most.

Thanks to these clear, data-based justifications for additional staff, the Ministry of Health was able to secure funds for an additional 315 employees of different cadres in 2011, 239 in 2012, and another 174 in 2013. The government is now recruiting an additional 169 health workers.

Zanzibar’s health workforce has grown to 4,170, an increase of more than 27% since 2011.

“The data empowered Zanzibar’s senior officials to create a workforce that could meet its poverty-reduction strategy goals,” says Jennifer Macias, IntraHealth’s country director of the Tanzania Human Resource Capacity Project. “Tanzania is made up of districts. And while the country is vast, each district could use the same strategy that Zanzibar is using.”

Even with the new influx of paid job openings, shortages of both new and existing health workers persist in Zanzibar. The ministry expects that when 385 students graduate from the College of Health Sciences this year, they will all have jobs waiting for them.

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