More Than Goodwill: A Look at Volunteer Allowances in Tanzania's Health System
Introduction
When you hear the word "volunteer," the first thing that often comes to mind is unpaid work done purely for the good of the community. While the spirit of service is central, Tanzania's Ministry of Health has formalized a system to recognize and support those who step up to fill critical gaps in the nation's health workforce.
The National Health Workforce Volunteering Guideline provides a structured framework for compensating skilled health personnel who volunteer their time.
Is It a Salary or an Allowance?
The guideline doesn't offer a traditional "salary," which is a fixed payment for regular employment. Instead, it establishes a volunteer allowance.
The primary goal of this allowance is to compensate volunteers for costs they incur while providing their services.
This approach formalizes a practice that was previously informal and lacked uniformity, creating a standardized system across all public health facilities.
The Remuneration Structure Explained
The allowance for health volunteers is calculated as a percentage of the official Tanzania Government Health Scale (TGHS). The specific package depends on the level of the health facility where the volunteer serves.
Table 4: Remuneration package for health volunteers at the Tertiary level facilities
(Zonal Referral Hospitals and National Hospital)
Service delivery Level: National Level MDAS
Salary category: Respective Salary Scale
Incentive Package: 50%
Service delivery Level: Zonal Referral Hospitals
Salary category: Tanzania Government Health Scale (TGHS)
Incentive Package: 50%
Table 5: Remuneration package for health volunteers at the Secondary level facilities
(Regional Referral Hospitals and Specialized Hospitals)
Service delivery Level: Regional Referral Hospitals
Salary category: Tanzania Government Health Scale (TGHS)
Package: 50%
Service delivery Level: Specialized Hospitals
Salary category: Tanzania Government Health Scale (TGHS)
Package: 50%
Table 6: Incentive Guidelines for health volunteers at the Primary level facilities
(District Hospital, Health Centers, Dispensary, Community interventions)
Service delivery Level: District Hospital
Salary category: Tanzania Government Health Scale (TGHS)
Package: 50%
Service delivery Level: Health Centre
Salary category: Tanzania Government Health Scale (TGHS)
Package: 50%
Service delivery Level: Dispensary
Salary category: Tanzania Government Health Scale (TGHS)
Package: 50%
Service delivery Level: Community Level
Salary category: Tanzania Government Health Scale (TGHS) and Tanzania Government Scale related cadre
Package: 30%
As shown, most facilities from primary to tertiary levels offer 50% of the relevant government scale. Community level volunteers receive 30%.
Are There Other Incentives?
Yes, volunteers may also receive extra incentives, depending on duties performed:
- Extra Duty Allowance
- On-call Allowance
- Post Mortem Allowance
- Per Diem (as per public service regulations)
This flexibility ensures that volunteers can be compensated for demanding or specialized tasks.
Where Does the Funding Come From?
The program’s sustainability relies on diverse funding streams, including:
- Cost-sharing returns from NHIF, CHF, and user fees
- Government Budget (OC budget) through CCHP and MTEF
- Development Partners (direct budget support or projects)
- NGO-funded projects
- Other income generated by health facilities
This multi-source funding aims to secure the long-term sustainability of the volunteer initiative, bridging HRH shortages while offering graduates invaluable practical experience.