Nurse Practitioners (NPs) as Game Changers in Tanzania Health Delivery System: Lessons Learnt from Fujita Bantane Hospital in Japan

Grace Emmanuel Kombe, Jumaa Tram Almasi, Yoko Kato, B. Liew
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Abstract

Shortage of physicians/doctors in the primary health care system has been evidenced in various countries. Among other things, these countries deployed nurse practitioners (NPs) in the health care delivery system to address this shortage. Countries in America, Europe, and Asia use NPs to address physicians/doctors shortage in the primary health care delivery systems. Various studies have shown that NPs have been deployed in primary health care facilities to curb these shortages.While in Tanzania shortage of physicians/doctors and other health professionals is evidenced in every sector of the health care system, nurses play a crucial role to cover this shortage by providing care and support for individuals and communities. Nurses work in various settings from being a nurse, counselor, laboratory technologist, social worker, educationist, and physician, to name a few. Nurses play a key role in preventing, diagnosing, and attending to common health problems. The question is, “When will the Tanzanian health delivery system recognize the pivotal role of these nurses and upgrade them to NPs?” This study suggests that deployment of NPs in Tanzania's health care systems could be a “game changer.” As a fellow on Critical Care Nursing Course at Fujita Health University Bantane Hospital in Japan, witnessed deployment of NPs in health care delivery and the reaped benefits are enormous; increased access to health care services, reduction in health care costs, reduced hospital stays, and customer satisfaction through client empowerment and comfort. This is an observational study of tasks performed by NPs in Fujita Health University Bantane Hospital and their relevance as a positive innovation to curb physician shortages for effective health care delivery. The duration of the study at Bantane Hospital was 2 months from January 15 to March 16, 2024. One-to-one interviews with NPs on duty were conducted. Also, collected and reviewed information from Tanzanian government Web sites, published government documents, and academic literature. Results show that NPs perform a lot of procedures that physicians/doctors were supposed to do. In the wards, theater, laboratories, and clinics, they play a pivotal role to curb shortage of physicians/doctors in health settings. NPs are an effective addition to medical facilities. They perform various procedures in the absence of the doctors. The findings from this study have important implications for improving health care delivery in Tanzania. NPs could be “game changers” in the health care landscape in Tanzania. Investment on nurses' education, proper training, and policy changes in nurse practice regulations are key for this to succeed.
执业护士(NPs)是坦桑尼亚医疗服务体系中的游戏规则改变者:从日本藤田万丹医院汲取的经验教训
许多国家的初级医疗保健系统都存在内科医生/医生短缺的问题。除其他外,这些国家在医疗保健服务系统中部署了执业护士(NPs),以解决这一短缺问题。美洲、欧洲和亚洲国家利用护士来解决初级卫生保健服务系统中医生短缺的问题。在坦桑尼亚,医疗保健系统的各个部门都存在内科医师/医生和其他医疗专业人员短缺的问题,而护士则通过为个人和社区提供护理和支持,在弥补这一短缺方面发挥着至关重要的作用。护士的工作环境多种多样,包括护士、咨询师、实验室技术员、社会工作者、教育工作者和医生等等。护士在预防、诊断和治疗常见健康问题方面发挥着关键作用。问题是,"坦桑尼亚的医疗服务系统何时才能认识到这些护士的关键作用,并将其提升为 NP?这项研究表明,在坦桑尼亚的医疗保健系统中部署 NP 可能会 "改变游戏规则"。作为日本富士田保健大学 Bantane 医院重症护理课程的研究员,我亲眼目睹了 NPs 在医疗保健服务中的应用,并从中获得了巨大的收益:增加了医疗保健服务的可及性,降低了医疗保健成本,减少了住院时间,并通过增强客户的能力和舒适度提高了客户满意度。这是对富士田保健大学班坦医院护士所执行任务的观察研究,其意义在于积极创新,遏制医生短缺,有效提供医疗保健服务。这项研究在 Bantane 医院进行,为期 2 个月,从 2024 年 1 月 15 日至 3 月 16 日。对在岗的非营利性医疗机构进行了一对一访谈。此外,还从坦桑尼亚政府网站、公开出版的政府文件和学术文献中收集和查阅了相关信息。结果显示,护士执行了许多医生/内科医生应该执行的程序。在病房、剧院、实验室和诊所,他们发挥着关键作用,遏制了医疗机构中内科医生/医生的短缺。护士是医疗机构的有效补充。他们在医生不在的情况下执行各种程序。这项研究的结果对改善坦桑尼亚的医疗服务具有重要意义。护士可以成为坦桑尼亚医疗保健领域的 "游戏规则改变者"。对护士教育的投资、适当的培训以及护士执业条例的政策变化是取得成功的关键。
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