The Status of the Master of Public Health Course, 2005 An Overview of the course from 1999-the present day.

n Increased importance of Human Resources in face of competition from the private sector and raised expectations of the general public due to cost-sharing. Key person: District Medical Officer (‘Public Health Specialist’) The need for MPH in Tanzania:

The role of DMOs n Decentralizing the health service provision beyond the district level n LGAs: management, coordination of the services in their locality (inc. district hospitals) n The DHMTs (CHMTs) led by the DMO are in the drivers seat of health management and service provision. n The DMO is secretary to the CHSB

The DMO is expected to: n Have leadership skills eg. To motivate staff, in problem-solving, marketing skills for the health sector (Positioning the sector at the district level and other levels in the face of competition ). n Be competent in the Management of change: - reforms, private sector, assignment of staff n Have skills in resource allocation and health financing n Competent to manage complex organisations

The School of Public Health & Social Sciences n Initiated the Master of Public Health Programme in order to prepare MPH graduates as Health Management Officers, who will be members of health planning and management committees within government as well as non-governmental organisations - in short professionals in public health matters

Process of Developing MPH n During Intergovt. Negotations Nov the Govts of Tanzania and Germany agreed to assist SPH&SS (then IPH) with technical assistance of GTZ to set up a MPH in context of HSR. n Planning and Preparation was done with backstopping from Dept. of Tropical Hygiene and PH at University of Heidelberg. n First course ran 1999/2000

Specific Objectives: n To translate national health policies into programme plans and conduct programme planning and management activities. n To identify and investigae disease outbreaks at the community level and recommend appropriate measures for control.

Specific Objectives: n To design, organise and initiate disease prevention programmes as well as public health interventions and surveillance systems. n To evaluate/ document such programmes To be able to make sound financial decisions relating to prioritisation of resource allocation, economic evaluation and cost effectiveness of programmes

Specific Objectives: n To provide strategic, operational and technical support as well as manage and implement primary health care programmes and health sector reforms. n To conceptualise, plan and prepare public health training programmes, particularly with regard to continuing education for different cadres of health workers in Tanzania

Specific Objectives: n To design and conduct relevant research studies in public health and critically interpret research/data collected for appropriate decision making. n To recongnise the role of cultural construction in health and illness and related local perception. To stimulate development of new strategies for improving health.

Specific Objectives: n Understand and influence decision-making processes related to health – with emphasis on the communication and community work. n Apply communication/ management skills effectively and participatory approaches to planning. n Analyse the effects of cultural conditions of health/ communication problems.

Course Structure: 5 Modules – lecture and Study: n Introduction to Public Health Assessing Community Health Needs n Implementing Change n Health Policy, Planning and Managemnt of Health Services n Special Public Health Issues eg. Family and Reproductive health, management of epidemics etc. n Field Work (x time) n Thesis (x time)

Performance of MPH n Since its inception, the MPH has run regularly as laid down in Prospectus of University of Dar-es- Salaam. n Secretariat, course coordinator and five module convenors in place. n Tuition fees attached to student’s stipend are sufficient to run the course financially independent from MUCHS and other outside sources. n Attrition and failure rate minimal to date

Performance of MPH Course n Constantly rising number of new applicants and successful candidates 47 in 1999, 66 in 2004, 90 for n Female/male ratio increased from 2 out of 14 in 1999 to 11 out of 24 in n 57% scholarships borne by MoH (and supporting donors). n Positive feedback from students n MoH and PORALG satisfied with quality of graduates

Where does the course lead? n 112 MPH graduates to date n In the Tracer Study % graduates found to occupy posts in government services – n Intention to establish Alumni Network to track more carefully where people end up to counter suspicion that MPH contributes to brain drain into neighbouring countries.

Challenges n Recent assessment and discussion with module convenors agree there is a need to “decongest” the course content. n Linkages with other relevant institutions – Tumaini University, East African PH Association, Ministry of Health n MoH report difficulty finding suitable MD candidates prepared to serve at district level – keeping balance between aim to train DMOs and increasing numbers of applicants from non- medical fields

Challenges n In constitution it stipulates that the responsibility for health at district level lies with MoH which delegates this to DMOs and under certain circumstances to AMO. Non-medical staff with MPH can be entitled to work as DMO. n AMOs do not fulfill academic requirements of University of Dar-es-Salaam

Recommendations Adaptation of MPH course to continue to meet objectives: n Provide more space for PPP, HRD, HIV/AIDS, financing and budgeting n Implement annual meeting of SPH&SS and MoH/Dept. of HR n Teaching Methodologies update for tutors