IMPACT OF rhris ON REGULATION OF MEDICAL AND DENTAL PRACTICE

Transcription

1 IMPACT OF rhris ON REGULATION OF MEDICAL AND DENTAL PRACTICE Emory University Kenya Project Presentation

2 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 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

3 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)

4 Background 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 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

5 Background MPDB

6 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 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

7 KMPDB Current Status

8 Activities Implemented at KMPDB 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 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

9 Activities Implemented at KMPDB 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 Supporting decentralization of Regulatory Functions Provision of online services for easy accessibility at national, county and other levels

10 Activities Implemented at KMPDB 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 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

11 Activities Implemented at KMPDB Support dissemination of data National conferences and meetings: KMA annual conference Medical and Dental practitioners orientations Joint Regulatory Collaborative (JRC) meetings 1 st National HRH Conference in Kenya 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)

12 Activities Implemented at KMPDB 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 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

13 KMPDB Data on Conference Sub-Themes

14 Registration Status Registered Active Medical Doctors 9,500 5,660 Dentists 1, Specialists 1, Foreign Doctors on Temporary License Medical Schools in Kenya Dental Schools in Kenya 2 2 Medical Schools in EAC Dental schools in EAC 3 3 Internship Training Centers Medical Dental Specialist Recognition 2 2 Post graduate Teaching Hospitals 4 4 Health Institutions (Various categories) 3,

15 Fitness To Practice Newly Registered/Entering workforce No. of practitioners Registration of Medical and Dental practitioners by year ( ) Dentists Med doctors 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

16 Estimates: Active practitioners Retention trend for Medical and Dental Practitioners ( ) 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:

17 Specialized Skills capacity to meet emerging disease burden Obstetrics & General Surgery Internal Medicine Peadiatrics Anaesthesia Radiology Ophthamology Orthopaedics/Trauma Pathology Psychiatry Otorhinolaryn (ENT) Public Health Dermatology Family medicine Oncology/ Radiotherapy Microbiology Radiotherapy Plastic Surgery Occupational Medicine Diabetology Nephrology Palliative Medicine Main areas of specialization (MDs); N=2, No of specialists No of specialists Oral and maxifacial Peadiatric Dentistry Public Health Orthodontics Periodontology Prosthodontics Oral Pathology Restorative Dentistry Conservative Dentistry Prosthetic Dentistry Biomaterials Science Dental Radiology Edodontics Main Areas of Specialization (Dentists); N=107

18 Private Practice In Private Practice Ever registered doctors Total/ proportion in private practice Mode:% in full Type: time Private Specialists (%) Practice Employer: Own behalf (%) Medicine (37%) 49% 78% 70% Dentistry (39%) 20% 85% 63% All (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

19 Benchmarking on County Population Densities BARINGO BOMET BUNGOMA BUSIA EMBU GARISSA HOMA BAY ISIOLO KAJIADO KAKAMEGA KERICHO KIAMBU KILIFI KIRINYAGA KISII KISUMU KITUI KWALE LAIKIPIA LAMU MACHAKOS MAKUENI MANDERA MARAKWET/ELG MARSABIT MERU MIGORI MOMBASA MURANG'A NAIROBI NAKURU NANDI NAROK NYAMIRA NYANDARUA NYERI SAMBURU SIAYA TAITA TAVETA TANA RIVER THARAKA NITHI TRANS NZOIA TURKANA UASIN GISHU VIHIGA WAJIR WEST POKOT Active Medical Practitioners per population density BARINGO BOMET BUNGOMA BUSIA EMBU GARISSA HOMA BAY ISIOLO KAJIADO KAKAMEGA KERICHO KIAMBU KILIFI KIRINYAGA KISII KISUMU KITUI KWALE LAIKIPIA LAMU MACHAKOS MAKUENI MANDERA MARAKWET/ELGEYO MARSABIT MERU MIGORI MOMBASA MURANG'A NAIROBI NAKURU NANDI NAROK NYAMIRA NYANDARUA NYERI SAMBURU SIAYA TAITA TAVETA TANA RIVER THARAKA NITHI TRANS NZOIA TURKANA UASIN GISHU VIHIGA WAJIR WEST POKOT Active Dental Practitioners per population density

20 Certificate of Status Number of cases with Certificate of good standing by cadre DENTISTRY, 17 MEDICINE, 452 REASON FOR APPLICATION DENTISTRY MEDICINE Total EXTERNAL RESIDENCY ROTATION OUT-MIGRATING / RELOCATING POST GRADUATE / FURTHER STUDIES POTENTIAL EMPLOYER REQUIREMENT PROFESSIONAL REGISTRATION REQUIREMENT Total

21 Mutual Recognition & Reciprocal Licensing Training 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 _ 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

22 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 The trend has been declining in the last 3 years Accounts for 10% for both dental and medical practitioners ever registered 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%

23 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. Establishment of JRC has led to improved commitment to ownership of the rhris JRC helped reduce the cost of implementation

24 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

25 Cloud computing Future Focus 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 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

26 THANK YOU! Contact Person: Mrs. Agnes Waudo 15 of 15