Zanzibar Pledges Stronger Support For Nurses And Midwives

The government of Zanzibar has committed to an aggressive overhaul of the healthcare sector, prioritizing the working conditions and welfare of nurses and midwives as frontline lifesavers.

Recognizing the foundational role of frontline caregivers, Zanzibar has launched a comprehensive initiative to elevate the professional standards and working environment for its nursing and midwifery workforce.

This strategic pivot is crucial not just for the archipelago but for the broader East African medical ecosystem. As Kenya continues to hemorrhage medical talent to the Global North—a phenomenon often dubbed the 'brain drain'—Zanzibar's proactive retention strategy offers a compelling blueprint for how regional governments can incentivize and protect their most critical healthcare assets.

The Frontline of Maternal Health

The announcement was formalized by the Permanent Secretary in Zanzibar's Ministry of Health, Mngereza Mzee Miraji, during an address to a cohort of newly licensed practitioners. Having successfully navigated the rigorous 2025/2026 registration examinations, these professionals represent the vanguard of Zanzibar's healthcare future. Miraji explicitly acknowledged their indispensable role in mitigating maternal and infant mortality rates—a persistent metric of development that continues to challenge health ministries across East Africa, including Kenya.

The commitment extends beyond rhetorical praise. The government has pledged tangible improvements, focusing on equipping medical facilities with state-of-the-art technology and significantly enhancing the daily working conditions of staff. This approach recognizes that clinical excellence is inextricably linked to the operational environment. In Kenya, where strikes over working conditions and resource scarcity have historically disrupted public health services, Zanzibar's pre-emptive focus on staff welfare provides a stark contrast in health sector governance.

Ethics, Integrity, and Regional Standards

Central to this new initiative is a stringent reinforcement of professional ethics. Director of Nursing and Midwifery Services, Mwanaisha Juma Fakihi, emphasized during a specialized two-day orientation that ethical conduct is not merely a supplementary guideline but the very core of medical caregiving. The training was specifically designed to fortify the participants' comprehension of complex professional laws and regulatory frameworks.

This focus on statutory understanding is highly relevant. Across the border in Kenya, medical negligence cases and ethical breaches often stem from systemic pressures and a lack of continuous regulatory training. By investing in orientation and legal literacy for its nurses, Zanzibar is actively mitigating these risks. Chairperson of the Zanzibar Nurses and Midwives Council, Sharifa Awadh Salim, reiterated that the licensing examinations are meticulously calibrated to meet exacting international standards, ensuring that local competencies are globally competitive.

Economic Implications of Healthcare Retention

The economic dimension of this policy is significant. Training a registered nurse or midwife requires a substantial investment of state resources. When these professionals migrate due to poor working conditions, the state effectively subsidizes the healthcare systems of wealthier nations. By improving welfare, Zanzibar aims to secure a return on this educational investment.

• Targeted reduction in maternal and infant mortality rates through enhanced frontline care.
• Implementation of stringent international standards in localized licensing examinations.
• Strategic financial investment in facility upgrades and advanced medical equipment procurement.
• Comprehensive training on legislative frameworks and rigorous professional ethics.

If Zanzibar successfully implements these reforms, it could establish a regional benchmark. The financial commitment required to overhaul facility infrastructure and increase remuneration is substantial, potentially running into billions of Tanzanian Shillings—equivalent to hundreds of millions of Kenyan Shillings (KES). Yet, the cost of inaction—measured in preventable mortality and a degraded healthcare system—is exponentially higher.

As East Africa wrestles with complex public health challenges, Zanzibar's decision to champion its nurses and midwives may well be the most critical medical intervention of the decade.