Desperate shortage of places at Zimbabwe medical schools reported

ONLY 1% of students seeking to be enrolled in Zimbabwe's medical schools get placed due to an acute shortage of training facilities, resulting in limited access to such training programmes.

Getting a place to train as a doctor, nurse, laboratory scientist or pharmacist is highly competitive in the country, forcing some students to study in foreign countries, but risking, upon their return, that their qualifications may be rejected due to quality concerns about foreign providers.

This emerged during a workshop organised by Zimbabwe's Ministry of Health and Child Care titled the ‘Health Labour Market Analysis to Inform Health Workforce Strategic Planning and a Sustainable Health Workforce' held on 7 February.

A presentation tabled at the workshop detailed the uphill task to train as a health practitioner in Zimbabwe, according to a government survey.

"With 397,185 applicants [queuing] for admission in the 2021 academic year, only 4,134 of the prospective health professions students were offered places – 1% of applicants got places to train.

"There were an average of 89 applicants competing for every available seat for admission in 2021 – highly competitive. There is a capacity to train 4,476 health workers per year (theoretical capacity). Of the capacity, the production has been 3,334 per year (75% of the theoretical capacity)," according to the survey report.

The shortage of places suggests that Zimbabwe may be struggling to pursue Sustainable Development Goal 3, good health and well-being, in particular the training and development of a health workforce to support the population's health.

Targeted scholarships needed

The report said there is an average course completion rate of 80.6% for health or medical-related courses and a dropout rate of 19.4%. A total of 90% of those who complete their training obtain their professional qualifications and licences to practise.

To underline the low access to health services training in the country, the report said 700 to 800 nurses are trained per year as well as 200 to 220 doctors, 90 to 110 pharmacists per year and between 27 and 31 laboratory scientists each year.

It said 34% of the registered trained health workers are not active and they have mostly emigrated, retired or changed jobs.

The report also said that, whereas there has been a growth in the number of doctors, nurses and midwives, the global estimate of the World Health Organisation estimates that at least 2.5 medical staff (physicians, nurses and midwives) per 1,000 people are needed to provide adequate coverage with primary care interventions.

A number of recommendations were made to arrest the situation and these include the need to increase the number and capacity of faculty as well as mobilising basic tools to retain high-quality human resources.

There was also a call to engage the private sector to optimise expanded contributions to training and employment as well as the need for collaboration between the ministry of higher and tertiary education to align training plans with the ministry of health in line with the projected needs based on disease burden.

"Establish and expand existing basic, post-basic, undergraduate and post-graduate training. Improve the skills mix for disciplines not locally trained and provide targeted scholarships for critical shortage areas," the report advised.

Training abroad

As a result of the low access to medical courses, the workshop heard, some Zimbabwean students are opting to study abroad.

In her presentation, the Zimbabwe Council of Higher Education (ZIMCHE) chief director of health and life sciences, Professor Felicity Gumbo, said some of the qualifications obtained outside Zimbabwe do not match local standards, hence students end up stranded or spend up to two years writing local examinations to be able to use their degrees.

The reasons why some foreign qualifications are not recognised in Zimbabwe include that they lack practical training through internships and other work-based learning.

She said organisations such as the Medical and Dental Practitioners Council of Zimbabwe have previously declined to register some students from foreign universities due to quality concerns.

She said students need to research whether foreign qualifications are accepted in Zimbabwe before enrolling at foreign institutions.

"When they [parents] are thinking of where and when to send their children outside the country, they need to check with ZIMCHE whether these universities and course programmes are accredited so that, when they come back, it would be easier for them to work locally.

"They will also need to check with the relevant professions in terms of [professional] associations for registration," said Gumbo.