Equity and Efficiency in Service Delivery: Human Resources General Budget Support Annual Review, 2008 Wednesday 26 November

Contents What is the context? How large is the inequity in human resource distribution? What are the trends? How does it affect welfare? What are the factors that need addressing? Way forward and detailed proposed measures What can be done in the next year?

Gains in service delivery Primary education enrolment up from 59% (2001) to 84% (2007) Sharp reductions in infant and under 5 mortality - estimated 41% drop over 8 years But problems persist with… unequal distribution of gains across Tanzania

HBS shows increases in the equality of primary school enrolment… … but inequality remains. The enrolment rate is 78% in the poorest quintile and 91% for the best off quintile.

We will look at health and education because… MKUKUTA priority Nearly 30% of total budget Staffing budget for teachers and health workers is largest part of this Nearly 350,000 public servants –55.9% teachers –6.8% health workers We will use public expenditure on wages as proxy for number of workers in next slides

Workers are inequitably distributed in health sector… Health Staffing Budget 2008/9 per capita IFMS MoFEA

Education Staffing Budget 2008/09 per 7-13 aged child IFMS MoFEA Top 10 get 8 x more resources than bottom 10 And this is replicated in education

The pattern persists over past decade Login Tanzania If you received a high level of funding per child in 1999/00 likely to receive a high level in 2007/08

Poorest areas receive lower levels of funding It matters for poverty & welfare outcomes Login Tanzania, 2001 Household Budget Survey and 2002 population census

As can be seen looking at education The more that is spent per child, the greater the likelihood of success in examinations Login Tanzania, 2001 and EMIS

How does recruitment and posting happen? 1 LGAs/MDAs submit an establishment request that is approved by PO-PSM This is based on the number of facilities e.g. each clinic needs a certain number of workers to be fully staffed and other criteria 2 Recruitment drive takes place at LGA/MDA level Health workers and teachers are supplied by the centre 3 Establishment of new recruits that report to duty in civil service and payroll And many of those that are recruited (or posted) to under- served areas do not report to duty E.g. 07/08 Ministry of Health: 3,645 workers recruited, only 2,533 reported to duty In Rukwa: 122 health workers posted, only 31 reported to duty

What about the formula-based block grant allocation system? Introduced in 04 to address inequity in financial resource allocation of the recurrent block grant. Determines the staffing budget allocation based on population needs e.g. number of school going children but… Staffing budget can only be disbursed against the actual number of workers in duty Creating a gap between the number of posts allocated and the number actually filled, despite the available establishments and budgets. This is due to the difficulties in attracting workers to under-served areas.

Let’s show this visually… LGA = Rungwe (Rank 18) EDUCATION STAFFING BUDGET Per 7-13 Year Old BLUE LINE 2008/9 BUDGET RED LINE FORMULA Hold harmless would prevent large immediate staffing cuts & allow gradual smooth transition However, formula cannot be applied because it is hard to attract & retain staff in underserved LGAs Rungwe’s staffing budget would fall if formula applied

It cannot only be about allocating financial resources on an equitable basis Need to address the underlying factors that drive the inequity?... Attraction and retention of staff

Key factors to address Difficulties in attracting and retaining workers to under-served areas –Continued recruitment in better served areas –8000 transferred in just over a year to better served districts –Administrative procedures – speed, clarity –Roles and responsibilities, coordination – who does what? –Lack of comprehensive, accessible and regularly updated data on staffing

Way forward In the long term… –infrastructure –amenities –increased numbers of skilled workers …will make a huge contribution. But there are tangible things that can be done in the short-medium term...

Twin-track approach Pull factors - targeted incentives in under- served areas Push factors - limiting workforce in better served areas

Pull: Provide incentives at central & local levels Central: ‘ Attraction’ packages - monetary and non-monetary Local: Empower local government authorities to create local incentive schemes Assist in deploying to and within districts Explore flexible funding for LGAs - existing or new discretionary funding channels Learn from others

Push: limit workforce expansion Limit recruitment in and transfers to better served district councils –Centrally managed –Short-term –Using an agreed classification

In order to do this what do we need? Classification of under-served/better-served in relation to need Cross-government review of administrative procedures, roles and responsibilities Continued roll-out of the Human Capital Management Information System across government Development of Medium-Term Pay Policy

What can be done in the next year? Key stakeholders agree on a comprehensive roadmap –Clear time frames, –budgetary implications, –and technical and financial support required Classification of under-served/better-served Use established inter-ministerial (education) task force Medium-Term Pay Policy finalised

Summary Pull factors - targeted incentives in under- served areas Push factors - limiting workforce in better served areas Key stakeholders agree on a comprehensive roadmap Classification of under-served/better-served Use established inter-ministerial (education) task force Medium-Term Pay Policy finalised