The quest for time and change: methodologies and training discourse in Tanzania’s tertiary health institutions, 1960–2020

Abstract

Healthcare provision in Tanzania has changed substantially over time, with important implications for training practices in tertiary institutions. Yet these transformations have received limited scholarly attention, particularly from a historical perspective. Drawing on a range of archival and secondary sources, this study explores how colonial legacies, local conditions, and global forces have influenced the evolution of healthcare training in Tanzania. Findings show that healthcare training methodologies in Tanzania have evolved in line with broader local and global forces. Under colonial rule, training was limited in scope and method, serving administrative and military needs rather than the entire population. In the postcolonial period, rising demand for healthcare workers drove institutional expansion and more standardized training approaches. Neoliberal reforms marked a key methodological shift by constraining public-sector training and enabling private institutions to introduce flexible models, such as in-service, distance, and competency-based education. More recently, digitalization has further transformed training methodologies by integrating digital tools that enhance skills development and professional practice. Despite the reforms, staff shortages persist because policy changes have not been matched with sustained government investment in medical education. Inadequate funding continues to constrain faculty recruitment, student intake, and training capacity, leaving the system unable to meet national healthcare needs. Addressing these gaps requires prioritizing expanded admissions, increased staffing across institutions, and greater use of innovative and digital training approaches.