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Abstract：
Similar to many other low- and middle-income countries, public private partnership (PPP) in the training of the health workforce has been emphasized since the launch of the 1990s\' health sector reforms in Tanzania. PPP in training aims to contribute to addressing the critical shortage of health workforce in these countries. This study aimed to analyse the policy process and experienced outcomes of PPP for the training of doctors in Tanzania two decades after the 1990s\' health sector reforms. We reviewed documents and interviewed key informants to collect data from training institutions and umbrella organizations that train and employ doctors in both the public and private sectors. We adopted a hybrid thematic approach to analyse the data while guided by the policy analysis framework by Gagnon and Labonté. PPP in training has contributed significantly to the increasing number of graduating doctors in Tanzania. In tandem, undermining of universities\' autonomy and the massive enrolment of medical students unfavourably affect the quality of graduating doctors. Although PPP has proven successful in increasing the number of doctors graduating, unemployment of the graduates and lack of database to inform the training needs and capacity to absorb the graduates have left the country with a health workforce shortage and maldistribution at service delivery points, just as before the introduction of the PPP. This study recommends that Tanzania revisit its PPP approach to ensure the health workforce crisis is addressed in its totality. A comprehensive plan is needed to address issues of training within the framework of PPP by engaging all stakeholders in training and deployment starting from the planning of the number of medical students, and when and how they will be trained while taking into account the quality of the training.
摘要：
与许多其他低收入和中等收入国家相似，自1990年代坦桑尼亚卫生部门改革启动以来，一直强调在培训卫生劳动力方面的公私伙伴关系（PPP）。培训中的PPP旨在帮助解决这些国家卫生人力严重短缺的问题。这项研究旨在分析1990年代“卫生部门改革”后二十年在坦桑尼亚培训医生的PPP政策过程和经验成果。我们审查了文件并采访了主要的线人，以从培训和雇用公共和私营部门医生的培训机构和伞式组织收集数据。在Gagnon和Labonté的政策分析框架的指导下，我们采用了混合主题方法来分析数据。培训中的PPP为坦桑尼亚越来越多的毕业医生做出了重大贡献。串联，大学自主权的破坏和医学生的大量入学不利地影响了毕业医生的质量。尽管PPP已证明成功地增加了毕业医生的数量，毕业生的失业和缺乏数据库来告知培训需求和吸收毕业生的能力，使该国的卫生劳动力短缺和服务交付点的分配不均，就像引入PPP之前一样。这项研究建议坦桑尼亚重新审视其PPP方法，以确保全面解决卫生劳动力危机。需要一个全面的计划来解决PPP框架内的培训问题，从规划医学生人数开始，让所有利益相关者参与培训和部署，以及何时以及如何培训他们，同时考虑到培训的质量。
