Touch Symposium 2005
On September 19th, 2005, the Touch Foundation convened its first-ever symposium on Human Resources for Health (HRH). This all-day workshop focused on laying the strategic groundwork necessary to help the Bugando University College of Health Sciences (BUCHS) address Tanzania’s dire healthcare needs.
Some 75 participants from around the world – including key leaders of the public health community, university deans, foundation executives, heads of NGOs, and representatives of the Tanzanian and U.S. governments – attended the event, which was co-hosted by McKinsey & Company and Citigroup, and kicked off by Touch Foundation Chairman Robert Jeffe.
Featured speakers Lincoln Chen, of Harvard’s School of Public Health, and Tim Evans, of the World Health Organization, outlined the issues at stake in the global HRH crisis, with particular emphasis on sub-Saharan Africa and Tanzania. Dr. Chen, who congratulated McKinsey and Citigroup on their “innovative philanthropy,” called the gravity of today’s HRH condition “truly unprecedented, even beyond the famines and wars of the 20th century.”
Dr. Evans put the situation, quite poignantly, into context: “[Africa has] about tenfold the burden of disease per capita as the U.S., with one-tenth the density, or less in some cases, of the workforce. So there is about a hundredfold differential in terms of what each health worker in Africa needs to consider…to address health problems in their context successfully.”
Dr. Judith Hazlewood and Vidya Prakash, of McKinsey’s Global Health Practice, reviewed their findings from a visit to Tanzania – most notably, the dearth of healthcare workers there. Reverend Dr. Peter Le Jacq offered a moving account of the origins of the BUCHS dream, centering on the themes of providence and friendship. Touch Board President Lowell Bryan then shared Touch’s strategy for the next decade, including expanding the medical college at Bugando into paramedical fields, such as nursing and pharmaceutical studies.
The assembly then divided into five groups to discuss the following issues:
- Major HRH Priorities: What are the major HRH issues, and how do they rank in importance?
- Teaching and Training: How can Touch ensure the appropriate development and delivery of training programs and teaching resources at BUCHS?
- Student Population Issues: What are the key issues BUCHS students encounter (e.g., housing, classroom facilities, and extra curricular services)?
- Postgraduate Issues: What factors would ensure a healthy environment for BUCHS graduates (e.g., alumni loyalty and giving, quality and availability of jobs, and potential impact of HRH jobs)?
- Building Partnerships: How can Touch create lasting partnerships between public and private organizations to ensure a sustainable supply of resources and expertise?
Afterward, a panel discussion outlined the key findings of each breakout. The “HRH Priorities” group emphasized training additional cadres of healthcare workers and equipping doctors with the managerial skills they need to function in the hospital environment.
This group also encouraged Touch to embrace end-to-end systems thinking – i.e., to plan with Tanzania’s entire healthcare system in mind. Touch might incorporate a distributed training program, for example, identifying the communities that most require HRH and then training healthcare workers on-site.
The “Teaching and Training” group focused on the challenges of increasing the pool of talented HRH students and faculty – for example, the strenuous requirements Tanzania’s medical school. faculty must fulfill in order to teach. The group also discussed how best to provide students with the particular skills Tanzania’s unique health environment requires. One potential solution: A problembased learning curriculum adapted to Tanzania’s medical challenges, with an emphasis on communitybased learning. Business schools might develop parallel programs to address doctors’ lack of basic business and administrative skills.
Three issues emerged from the “Student Population” breakout. The first was how best to find funding for crucial bricks-and-mortar projects like the dormitory. The second issue involved attracting and motivating medical students via salary and other incentives, such as quality schooling for doctors’ children.
The third issue entailed expanding Touch’s reach to multiple sites in a distributed training network, thus enhancing students’ learning environment and providing medical services to needy communities beyond Bugando.
The “Post-Graduate” group raised issues such as alumni loyalty, the retention of doctors within Tanzania’s healthcare system, and HRH placement, including rural deployment. Interesting approaches included establishing an internship program to rotate students through other hospitals and clinics, thus providing exposure to diverse health environments and challenges; establishing a voucher system and “doc-in-a-box” transportable clinics to encourage practice in rural areas; and institutionalizing BUCHS’s doctor-placement process to employ graduates in private practice, at corporations, in hospitals and clinics, or with the government.
The “Building Partnerships” breakout praised Touch on its headway in creating effective, broad-reaching partnerships and identified three areas of focus: first, building greater management capacity in Tanzania by partnering with usiness schools and corporations, which can provide management support in addition to capital; second, securing funding for physical infrastructure projects by partnering with the local Tanzanian government, institutions concerned with development investments, and government agencies such as the Export/Import Bank and the Trade and Development Agency; and third, escalating the HRH issue on the agendas of a broader range of institutions.
The symposium closed with a dinner including additional guests and a recap of the day’s event. Ambassador Augustine Mahiga, Tanzania’s Permanent Representative to the UN, addressed the group, thanking Touch, McKinsey, and Citigroup and praising the Bugando project for its unparalleled diversity of partnerships, particularly in the context of the UN’s Millennium Development Goals. Another highlight was the appearance of Citigroup Chairman Sandy Weill, a major supporter who recently made another sizable donation to Touch. “This is something that can really make a difference in the world,” Mr. Weill told attendees.
The September 19th symposium was immensely productive, both in facilitating greater outreach to the HRH community and in sharpening our strategic focus. The questions posed at the event, as well as the many creative ideas presented, will be instrumental for the development of Touch’s vision. Thanks to all who attended for your time and insights.