More on working at the College - the mystery of staff salaries

As part of the background information for the draft Strategic Plan that I am here to produce, staff salaries have been a big issue. Illustrated again by snaps from our safari, as you may find the text a bit tedious.

bemused giraffe..

Zanzibar health worker salaries

The College of Health Sciences is a Government college, currently run by the Ministry of Health though an Act of the Zanzibar Parliament passed in 1998. This gives the College a lot of powers, for example, to employ, to own and dispose of land, to borrow. These have not been exercised much, and the College currently lacks management capacity to run very independently of the Ministry.

The Ministry of Health employs College staff, along with all staff at Government health facilities and in central departments – about 4,000 in all. Perhaps not surprisingly, since the Ministry controls the payroll, it takes an age for the College, and possibly other health services, to get permission to hire.  The draft Strategic Plan proposes an expansion in student numbers. This will clearly require more staff and the College is proposing to employ the additional staff itself from tuition fees rather than expect the Ministry to pay. This does not seem very satisfactory and it is more likely that a change in the organisation that pays salaries will be made.

Paying salaries is the largest single contribution that the Government makes to the health system (the Government paid 43% of health costs in 2010, Development Partners over 54% and the remainder came from fees and charges). Some Ministry employees’ posts are funded by donors, possibly as many as 20%. There are also volunteers doing clinical work.

Salaries of Ministry employees have not risen for a long time, possibly years, but inflation is quite high here – 10% in some years recently. So the Ministry has problems retaining staff who can earn much more – 2 or 3 times more – on the mainland. This affects the most specialist posts most – the ‘brain drain’ is for example, medical doctors, more specialist and experienced nurses and pharmacists. The College can’t recruit to some key teaching posts – for example to the pharmaceutical sciences course. 

team members missing?

It’s difficult to compare salaries with those in Europe because purchasing power is so different. A registered nurse after training full time for three years and with experience earns about 220,000 Tanzanian Shillings a month. This is the salary of most tutors at the college. In comparison, my volunteer’s allowance, which is for basic living expenses only – food, utilities, transport by ‘bus, but excluding accommodation costs - is 360,000 Tanzanian Shillings a month. My VSO colleagues who work in education say that teachers earn even less, and people trained to be schoolteachers with reasonable English make more from driving taxis for a living than teaching.

Given these low salaries, it is perhaps not surprising that one of the most efficient parts of the public sector seems to be the administration of the ‘Sitting Allowance’ – an additional payment staff get if they attend in-service training or a special meeting, like the ones I have run to develop the strategy.

Age profile of Ministry of Health employed health workers

The Danish development agency Danida’s has invested in capacity building at the Ministry of Health for some years. This has resulted in a very good information sources on public health and the health workforce.  To sum up the public health situation, average life expectancy in Zanzibar is 52.  Some of the workforce findings are startling, for example the age profile of Ministry staff in health facilities shows that two thirds of staff are over 40 and nearly a third over 50. The College I work for has produced perhaps 200- 300 graduates a year in their early ‘20s for the last 10 years who are intended to work for the Ministry, yet only 200 ministry employees are under 30. The level of salaries is likely to be a contributory factor, with younger people voting with their feet.

sacred ibis..

The College’s policy on salaries

I believe the Government has been considering raising public sector salaries for some time and I thought that the ‘Top Up Allowance’ that the College recently began to pay to its 50 staff from its tuition fees income was just bringing forward by a few months a general pay increase that the Ministry would pay in future. College tuition fees were raised for 2011/12 and now contribute a significant amount to the College. They are collected by the College rather than the Ministry and students now cannot proceed without paying, whereas in previous years there was no enforcement of payment.

The ‘Top up Allowance’ is on average 100%!  I asked whether there were any conditions attached to the additional payment to staff, like a performance review system. Apparently not, but at the staff meeting in December to discuss the College’s strategy several members of staff said there should be performance appraisal. It is in the draft Strategy – I know this may not mean much but the head of human resources at the college says performance appraisal is in his work plan, so it is not just me who is driving this!

I thought the College was relying on the Ministry to pick up the cost of the Top Up Allowance in 2012, which seemed a bit of a risk to take. I misunderstood what was going on. Recently I was given a document explaining the salary increase being negotiated with the Government, fortunately mostly in English. What is under discussion is the transfer of College staff to academic pay scales and it is these that are to be adopted from March 2012. For teaching staff at the College these are on average five times as much as currently!

post prandial lions





Amongst other things, this must worry the hospital and other health facilitiers, whose staff are likely to want to work at the College rather than delivering services.

lions' lunch - ex-zebra..

Interestingly, there is a major dispute at the moment in Dar es Salaam between the medical doctors and the Government of Tanzania. The doctors have been on strike for several days because the MPs have voted themselves much more generous allowances on top of the very generous salaries that they already have but have not done anything about the salaries of health workers which have been in dispute on the mainland for a long time.

vultures waiting for lunch..

Reorganisation?

The budget for the new salaries may be transferred from the Ministry of Health to another Government Department – apparently there are other tertiary colleges in Zanzibar whose staff are paid by the Ministry of Finance.  It is also possible that the salaries, and employment of staff, will be transfer to the College. If this happens, the new salary scales will more than absorb the income from the fee rise and a new financial settlement with the Government will be necessary.

The resolution of who pays the salaries is likely to be made when the outcome of an investigation in to whether the College should become part of the State University of Zanzibar. The President of Zanzibar, an elected executive position, set up a Committee to look into bringing together the Zanzibar Medical School and this College into a Faculty of Medicine and Health Sciences of the University. This seems likely to happen although apparently opinion is divided. The Vice Chancellor of the University is the Chairman of the College Council..  

lizard..

I appreciate that the Strategic Plan may prove not to have much utility in a merger/takeover situation, but the College will be better off in discussions with a Plan than without it.

This change to the College’s status will be the first major one since it was set up as a Nursing School in the late ‘30s – maybe that is because I arrived, as it continues the pattern of my working life for the past 20 years and five different public sector employers: within months of starting a new job every organisation I joined would be involved in a merger or break-up into a different organisation!

That's all for now!