Empirical effect of the Dr LEE Jong-wook Fellowship Program to empower sustainable change for the health workforce in Tanzania: a mixed-methods study

TL;DR

This study assesses how a fellowship program in Tanzania improved healthcare workers' skills and service quality, but found sustainability challenges.

Contribution

The study provides empirical evidence on the effectiveness and sustainability of a health workforce fellowship program in Tanzania.

Findings

The program showed high relevance, effectiveness, and impact with improved skills and service quality.

Sustainability scored lower due to lack of follow-up support and resources.

Tailored training was valued, but practical components and language barriers were identified as challenges.

Abstract

This study evaluated the Dr LEE Jong-wook Fellowship Program’s impact on Tanzania’s health workforce, focusing on relevance, effectiveness, efficiency, impact, and sustainability in addressing healthcare gaps.

A mixed-methods research design was employed. Data were collected from 97 out of 140 alumni through an online survey, 35 in-depth interviews, and one focus group discussion. The study was conducted from November to December 2023 and included alumni from 2009 to 2022. Measurement instruments included structured questionnaires for quantitative data and semi-structured guides for qualitative data. Quantitative analysis involved descriptive and inferential statistics (Spearman’s rank correlation, non-parametric tests) using Python ver. 3.11.0 and Stata ver. 14.0. Thematic analysis was employed to analyze qualitative data using NVivo ver. 12.0.

Findings indicated high relevance (mean=91.6, standard deviation [SD]=8.6), effectiveness (mean=86.1, SD=11.2), efficiency (mean=82.7, SD=10.2), and impact (mean=87.7, SD=9.9), with improved skills, confidence, and institutional service quality. However, sustainability had a lower score (mean=58.0, SD=11.1), reflecting challenges in follow-up support and resource allocation. Effectiveness strongly correlated with impact (ρ=0.746, P<0.001). The qualitative findings revealed that participants valued tailored training but highlighted barriers, such as language challenges and insufficient practical components. Alumni-led initiatives contributed to knowledge sharing, but limited resources constrained sustainability.

The Fellowship Program enhanced Tanzania’s health workforce capacity, but it requires localized curricula and strengthened alumni networks for sustainability. These findings provide actionable insights for improving similar programs globally, confirming the hypothesis that tailored training positively influences workforce and institutional outcomes.

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