impact of rhris on regulation of medical and ...registration of medical and dental practitioners by...
TRANSCRIPT
IMPACT OF rHRIS ON REGULATION OF MEDICAL AND DENTAL PRACTICE
Emory University Kenya Project PresentationEmory University Kenya Project Presentation
Summary of Emory KHW Project
• Sponsored by PEPFAR through CDC and implemented by Emory University in collaboration with Ministries of Health, professional councils and boards in Kenya.
• Kenya is serving as a model in ECSA region for best practices on improvement of HR planning & management to meet the Millennium development management to meet the Millennium development goals (MDGs).
• Currently partnering with the Emory project in Zambia to assist the Health Professionals Council of Zambia and General Nursing Council of Zambia to implement rHRIS
Vision: To improve and strengthen health profession regulatory
functions in Kenya and the African region
Mission: To support health profession regulatory bodies to effectively
and efficiently provide quality services to their clients by
establishing electronic health workforce information systems
and capacity building on data use for health program planning
and management of Human Resource for Health (HRH)and management of Human Resource for Health (HRH)
•Kenya healthcare workforce’s supply and demand data existed in paper forms that were difficult to retrieve and use for HR management
•Regulatory Boards were unable to produce reliable national workforce data in an efficient manner
•MOH lacked accurate data on the number of professional
Background
•MOH lacked accurate data on the number of professional health workers by age, position, cadre/ qualification, region, rate of attrition etc.
•Kenyan training institutions lacked data on national training & deployment needs with regards to the health professionals they were training
Background
MPDB
Project Objectives• Establish electronic health workforce information systems that can
provide accurate data for national policy and planning for HRH
• Increase the capacity of the Kenyan leaders in data driven decision
making for HRH management, research, and policy development.
• Provide a system to track training for health professionals to meet
deployment needs for quality service deliverydeployment needs for quality service delivery
• Utilize data for program planning especially the roll out of HIV
prevention, care and treatment programs.
• Strengthen health professionals regulatory boards/councils for
efficient service delivery to clients and public
KMPDB Current Status
• Developing of regulatory HRIS
• Assists in running core regulatory functions of the Board and provides
critical data for decision making
• Online Services
• Online exam release functionality
• Online registers for retention status verification
Activities Implemented at KMPDB
• Bulk SMS platform for communication with stakeholders
• Business Process Analysis and Standard Operating Procedures Development
• Enabled documentation of KMPDB core regulatory activities
• Ratified by the board
• Was the reference document for KMPDB Strategic plan 2013-2017
• Developing IT Policies, data management and data protection and
sharing policies
• KMPDB has a developed and ratified an IT policy that is greatly
assisting in the management of IT resources at the Board
Activities Implemented at KMPDB
• Supporting decentralization of Regulatory Functions
• Provision of online services for easy accessibility at national,
county and other levels
• Capacity Building
• Training on basic ICT skills has helped secretariat embrace technology and
move from manual processes
• Training on data management and database administration for the data
coordinator and ICT Officer
• Data for decision making training for management level staff
Activities Implemented at KMPDB
• Developing Sustainability plans and procedures
• Gap analysis to identify priority areas for improvement
• Sustainability and maintenance plan is to be developed. This will prepare the
KMPDB for transition
• Continuous user training on system maintenance and sustainability
• Support dissemination of data
• National conferences and meetings:
• KMA annual conference
• Medical and Dental practitioners orientations
• Joint Regulatory Collaborative (JRC) meetings
• 1st National HRH Conference in Kenya
Activities Implemented at KMPDB
• Regional and International conferences:
• EAC regulatory bodies conference in Kigali Rwanda
• ECSA Health Ministers conference in Mombasa Kenya
• ECSA DJCC in Arusha Tanzania
• WHO Global forum (Brazil 2013)
• Facilitating Joint Regulatory Collaborative (JRC), a collaborative of
registrars and CEOs of health regulatory Boards and Councils, and
Joint Technical Advisory Committee (JTAC), constituted of ICT
officers and data coordinators from the Boards and Councils
• JRC is enabling regulatory bodies to collaborate and share on
Activities Implemented at KMPDB
• JRC is enabling regulatory bodies to collaborate and share on
best practices for regulation. This has lead to synergies in
matters of regulation, standards and policies
• JTAC holds monthly consultative meetings to develop technical
advise to the JRC
KMPDB Data on Conference Sub-ThemesSub-Themes
Registration StatusRegistered Active
• Medical Doctors 9,500 5,660
• Dentists 1,067 603
• Specialists 1, 861 1762
• Foreign Doctors on Temporary License 1187 904
• Medical Schools in Kenya 10 10
• Dental Schools in Kenya 2 2
• Medical Schools in EAC 18 18
Dental schools in EAC 3 3• Dental schools in EAC 3 3
• Internship Training Centers
• Medical 72 72
• Dental 10 10
• Specialist Recognition 2 2
• Post graduate Teaching Hospitals 4 4
• Health Institutions (Various categories) 3,175 2019
Fitness To Practice
611
300
400
500
600
700
No
. o
f p
ract
itio
ne
rs
Registration of Medical and Dental practitioners by year (2006-2015)
Dentists Med doctors
• Newly Registered/Entering workforce
52
0
100
200
300
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015
No
.
• Improvement in tracking of registration/ qualification to practice
• Annual Output 2014: Medicine= 568 ; Dentistry= 58
• No. of newly registered each year more than doubled in the last 10 years
Estimates: Active practitioners
3000
4000
5000
6000
Retention trend for Medical and Dental Practitioners (2006 – 2015)
DENTISTRY MEDICINE
• Kenya has 5, 660 doctors and 603 Dentists actively employed in the country
• This translates to approximately 1.47 doctors and 1.6 Dentists to 10,000
population.
[Retention registers: http://medicalboard.co.ke/online-services/retention/]
0
1000
2000
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015
ca
pa
cit
y
to m
ee
t e
me
rgin
g d
ise
as
e
bu
rde
n
38
7
33
8
29
6
29
5
13
9
12
3
99
82
78
71
69
43
24
17
9 6 4 3 2 1 1 1 1
0
100
200
300
400
500
Ob
ste
tric
s &
…
Ge
ne
ral
Su
rge
ry
Inte
rna
l Me
dic
ine
Pe
ad
iatr
ics
An
ae
sth
esi
a
Ra
dio
log
y
Op
hth
am
olo
gy
Ort
ho
pa
ed
ics/
Tra
um
a …
Pa
tho
log
y
Psy
chia
try
Oto
rhin
ola
ryn
(E
NT
)
Pu
bli
c H
ea
lth
De
rma
tolo
gy
Fam
ily
me
dic
ine
On
colo
gy
/ R
ad
ioth
era
py
Mic
rob
iolo
gy
Ra
dio
the
rap
y
Pla
stic
Su
rge
ry
Occ
up
ati
on
al M
ed
icin
e
Dia
be
tolo
gy
Ne
ph
rolo
gy
Pa
llia
tiv
e M
ed
icin
e
No
of
spe
cia
list
s
Main areas of specialization (MDs); N=2,090S
pe
cia
lize
d S
kills
ca
pa
cit
y
to m
ee
t e
me
rgin
g d
ise
as
e
bu
rde
n
On
colo
gy
/ R
ad
ioth
era
py
31
17 17
8 7 75 5 4 3
1 1 10
5
10
15
20
25
30
35
Ora
l a
nd
ma
xif
aci
al …
Pe
ad
iatr
ic
De
nti
stry
Pu
bli
c H
ea
lth
Ort
ho
do
nti
cs
Pe
rio
do
nto
log
y
Pro
sth
od
on
tics
Ora
l P
ath
olo
gy
Re
sto
rati
ve
De
nti
stry
Co
nse
rva
tiv
e
De
nti
stry
Pro
sth
eti
c
De
nti
stry
Bio
ma
teri
als
Sci
en
ce
De
nta
l
Ra
dio
log
y
Ed
od
on
tics
No
of
spe
cia
list
s
Main Areas of Specialization (Dentists); N=107
Private Practice
Ever
registered
doctors
Total/
proportion in
private
practice
In Private Practice
Type:
Specialists (%)
Mode:% in full
time Private
Practice
Employer:
Own behalf
(%)
Medicine 9500 3552 (37%) 49% 78% 70%
Dentistry 1067 419 (39%) 20% 85% 63%
All 10567 3971 (38%)
• Nairobi County enjoys the majority (70%) of the dentists and 58.6% of medical
doctors in private practice
• 4 of 47 counties have no medical or dental specialist, while 48% of the counties
have no dental specialist
Benchmarking on County Population Densities2
.7 3.5
1.7 3.9 1
0.0
4.3
3.0
1.6
20
.9
7.7
3.0
23
.9
4.4
2.2 9
.8 13
.1
2.9
1.7 5.8
1.5
62
.0
3.3
0.9
1.1 2.7 4.9
2.4
27
.9
4.8
94
.98
.7
2.0 2.6
2.2
1.8
13
.4
2.2 2.7 6.0
1.2 3.0 3.8
1.1
21
.1
2.5
1.4
1.0
0102030405060708090
100
BA
RIN
GO
BO
ME
T
BU
NG
OM
A
BU
SIA
EM
BU
GA
RIS
SA
HO
MA
BA
Y
ISIO
LO
KA
JIA
DO
KA
KA
ME
GA
KE
RIC
HO
KIA
MB
U
KIL
IFI
KIR
INY
AG
A
KIS
II
KIS
UM
U
KIT
UI
KW
ALE
LAIK
IPIA
LAM
U
MA
CH
AK
OS
MA
KU
EN
I
MA
ND
ER
A
MA
RA
KW
ET
/ELG
…
MA
RS
AB
IT
ME
RU
MIG
OR
I
MO
MB
AS
A
MU
RA
NG
'A
NA
IRO
BI
NA
KU
RU
NA
ND
I
NA
RO
K
NY
AM
IRA
NY
AN
DA
RU
A
NY
ER
I
SA
MB
UR
U
SIA
YA
TA
ITA
TA
VE
TA
TA
NA
RIV
ER
TH
AR
AK
A N
ITH
I
TR
AN
S N
ZO
IA
TU
RK
AN
A
UA
SIN
GIS
HU
VIH
IGA
WA
JIR
WE
ST
PO
KO
T
Active Medical Practitioners per 100000 population density 0
.2
0.1
0.2 0.4
0.3
0.2 0.3
0.2
2.1
0.1 0.2
2.5
0.2 0.3
0.0 0
.7
0.2
0.1
0.2 0.5
6.9
0.0
0.0 0.4
0.0 0.4
0.0
4.6
0.4
11
.40
.7
0.3
0.0 0.2
0.2
1.4
0.0 0.2
0.0
0.0 0
.8
0.1
0.1
3.1
0.2 0.3
0.0
0
2
4
6
8
10
12
BA
RIN
GO
BO
ME
T
BU
NG
OM
A
BU
SIA
EM
BU
GA
RIS
SA
HO
MA
BA
Y
ISIO
LO
KA
JIA
DO
KA
KA
ME
GA
KE
RIC
HO
KIA
MB
U
KIL
IFI
KIR
INY
AG
A
KIS
II
KIS
UM
U
KIT
UI
KW
ALE
LAIK
IPIA
LAM
U
MA
CH
AK
OS
MA
KU
EN
I
MA
ND
ER
A
MA
RA
KW
ET
/ELG
EY
O
MA
RS
AB
IT
ME
RU
MIG
OR
I
MO
MB
AS
A
MU
RA
NG
'A
NA
IRO
BI
NA
KU
RU
NA
ND
I
NA
RO
K
NY
AM
IRA
NY
AN
DA
RU
A
NY
ER
I
SA
MB
UR
U
SIA
YA
TA
ITA
TA
VE
TA
TA
NA
RIV
ER
TH
AR
AK
A N
ITH
I
TR
AN
S N
ZO
IA
TU
RK
AN
A
UA
SIN
GIS
HU
VIH
IGA
WA
JIR
WE
ST
PO
KO
T
Active Dental Practitioners per 100000 population density
Certificate of Status
DENTISTRY, 17
MEDICINE, 452
Number of cases with Certificate of good standing by
cadre
MEDICINE, 452
REASON FOR APPLICATION DENTISTRY MEDICINE Total
EXTERNAL RESIDENCY ROTATION 0 1 1
OUT-MIGRATING / RELOCATING 2 3 5
POST GRADUATE / FURTHER STUDIES 5 368 373
POTENTIAL EMPLOYER REQUIREMENT 9 74 83
PROFESSIONAL REGISTRATION REQUIREMENT 1 6 7
Total 17 452 469
Mutual Recognition & Reciprocal LicensingTraining Institution Training Program
Medical School Dental School
UGANDA
GULU UNIVERSITY X _
KAMPALA INTERNATIONAL UNIVERSITY X X
MAKERERE UNIVERSITY X X
MBARARA UNIVERSITY OF SCIENCE & TECHNOLOGY X _
TANZANIA
BUGANDO UNIVERSITY X _
HUBERT KAIRUKI MEMORIAL UNIVERSITY X _HUBERT KAIRUKI MEMORIAL UNIVERSITY X _
INTERNATIONAL MEDICAL & TECHNOLOGICAL UNIVERSITY X _
KILIMANJARO CHRISTIAN MEDICAL CENTRE X _
MUHIMBILI UNIVERSITY HEALTH SERVICES & ALLIED SCIENCES X X
SAINT AUGUSTINE UNIVERSITY X _
TUMAINI UNIVERSITY MAKUMIRA X _
UNIVERSITY OF DAR ES SALAAM X X
RWANDA
NATIONAL UNIVERSITY OF RWANDA X _
GULU UNIVERSITY X _
• EAC contributed up to 3% and 10% of the dental and medical practitioners registered
during the last 10 years, respectively
• Accounts for 0.9 % and 5.1% of the dentists and medical practitioners in private practice
Licensure of Foreign Trained Medical & Dental Practitioners
• Has contributed 30% of the dental and 25% of the medical interns
application since 1950
• The highest inflow was experienced between 2006 and 2011, but
this saw a 66.6% drop in 2012. The trend has been declining in the
last 3 years
• Accounts for 10% for both dental and medical practitioners ever
registered to practiceregistered to practice
• Majority from India (33.3%), followed by Russian Federation
(16.4%), United Kingdom (9.4%), Ukraine (5.3%), Pakistan (4.6%),
Turkey & United States- each 3.1%, China (2.4%), and others
between 1- 2% including Egypt, Germany, Ireland, Italy, South Africa
and Sudan
• The rest have contributed below 1%
Lessons Learnt• Need for more capacity building around computer literacy,
database management, and data driven decision making
• Need for implementation, monitoring and evaluation of the
developed transitioning plan to ensure agency ownership and
management.management.
• Establishment of JRC has led to improved commitment to
ownership of the rHRIS
• JRC helped reduce the cost of implementation
Lessons Learnt• JPI has harmonized the activities of various partners supporting
JRC for better cooperation and collaboration to encourage synergy
and avoid possible overlaps.
• Involvement of regulatory agencies to participate in best practices
forums has encouraged data use at both national, regional &
global levels e.g. Global HRH conferences, ESCA best practices
forum, EAC regulatory forum, ARC forum, KMA conference, NNAK
and other professional conferences
Future Focus• Cloud computing
• a shared information platform for all boards and councils for
integration and interoperability
• Joint online portals and services
• Data and reports warehouse for public, MOH and practitioners
• Adopting cutting edge ICT innovations
Short code USSD SMS functionality for verification of valid and • Short code USSD SMS functionality for verification of valid and
bona fide practitioners and health institutions
• Geo-coding of health facilities for joint inspection exercises
• Barcoding and smart card functionality on retention cards for
added security
THANK YOU! Contact Person: Mrs. Agnes WaudoContact Person: Mrs. Agnes Waudo
Email: [email protected]
15 of 15