Kenya Medical Practitioners and Dentists Council

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KMPDC plays critical role in COVID-19 mitigation measures

by kmpdc

On March 12th 2020, Kenya confirmed its first case of coronavirus triggering the country into a response and preparedness mode. In its regulatory and advisory capacity, KMPDC was mobilized through the Ministry of health to assist in national coordination, compilation of action and implementation plans to curb the deadly virus as the government continued to review and implement more measures to curtail the pandemic nationally.

Evidenced by the spreading pandemic in the counties, the Cabinet Secretary Ministry of Health, Sen. Mutahi Kagwe, rapidly constituted a national team of experts under the leadership of KMPDC Chair, Dr Eva Njenga in July 2020, to provide technical assistance to all 47 counties with a view to enhance the county governments’ pandemic preparedness and response mechanisms. The Council’s Chief Executive Officer, Daniel Yumbya, was the Secretariat Head., where KMPDC was a key player in supporting the COVID National Task force and providing vital technical information to inform the government COVID-19 response strategies.

In collaboration with the County Health Management Teams, the technical experts’ team conducted a countrywide exercise of health facilities in each county, to establish the counties’ capacities to effectively manage the coronavirus cases when presented. Data based evidence indicated that the outbreaks in the various counties were through inter/intra county importation of the virus, it was acknowledged that some counties were stretched to adequately cope with the public- health emergency due to various limitations in health physical, financial and health resourcing, and technical and expertise knowledge of the novel virus.

The exercise identified key challenges such as limited health infrastructure, delayed laboratory test results, and inadequate supply of testing kits. In fact, the lack of fully equipped lab services, timely testing and reliable transportation, including long turnaround times for sample collection and results was seen as a weak link in management of the pandemic It also cited infections among health workers and extreme understaffing in the public health sector as major challenges in Kenya’s ability to tackle COVID-19.

One of the key activities of the exercise was an assessment of the availability and reliable supply of high-quality oxygen whether by gas cylinders, liquid oxygen tanks through central oxygen piping system, concentrators or liquid oxygen plants. The findings necessitated the formation of a task force to formulate policy and strategic mechanisms to enhance adequate availability and reliable supply of oxygen, a critical component in the treatment of pandemic cases.

The team embarked on capacity building on rapid response, multi-agency team mobilization, management and supplies of essential medicines, communication and publicity, monitoring and evaluation, and risk management. Scientific evidence available demonstrated that quarantine, social distancing, and isolation of infected populations help in containing the epidemic, the team assessed 290 facilities in 47 counties. The team found out that about 47 percent of the assessed facilities needed significant upgrading to effectively handle the pandemic.

The team also trained health workers on referral system to health facilities when the need arises, criteria for determining recovery and discharge of patients. Anticipating a surge in COVID-19 cases, the team also disseminated and supported the roll out of Home-Based Isolation and Care guidelines to provide an alternative solution in the management of the increasing numbers of asymptomatic or mildly symptomatic patients which will serve to decongest health facilities in the country.

The Council opines that the pandemic hastened upgrading of healthcare facilities across the counties adding that the response by the government has greatly improved health systems that will be useful post-COVID-19.

The country also improved its ICU beds to 826 as at 30 th 0f October 2020 an improvement from 153 that existed in March before the onset of Covid-19. Over 15,600 isolation beds have so far been identified nationally and 272 facilities licensed by KMPDC as infectious Disease.

Treatment Centers. Kenya has so far experienced better epidemiological outcomes than many countries outside the African continent, an evidence that could be cited to government’s stringent response; which Mathenge says, was science based. “The government commissioned several studies that have informed policy and response. The data collected will serve to inform many other decisions in the future.

This approach has also ushered in an enhanced era of data driven policy and strategy formulation. I think we are headed into the right direction,” she notes with optimism. KMPDC’s role in COVID-19 mitigation measures cannot be gainsaid. As the regulator in medical and dental practice, KMPDC lived up to its mantra and stepped up activities in a bid to guarantee delivery of quality health services.

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Telemedicine Gains Pace In Kenya as KMPDC approves 20 Hospitals to roll out services amid Covid-19 containment measures

by Diana Madegwa

The COVID-19 pandemic has brought about a lot of changes in several sectors not only in Kenya, but the world at large. It is no longer business as usual and the health sector has not been left behind.

When the first case of COVID-19 was reported in Kenya, the number of people going to health facilities to seek treatment dropped as Kenyans shunned hospitals due to fears of contracting the virus from the said institutions.

In line with KMPDC’s mandate of regulating the practice and licensing of medicine & dentistry and healthcare institutions in the country, the Council moved swiftly to respond to this growing concern by looking into ways of ensuring patients still got quality healthcare from their healthcare providers despite the prevailing circumstances.

To enable patients consult with their doctors virtually KMPDC commenced the issuance of provisional approvals for various registered and licensed health institutions to offer virtual medical services. So far, about 20 health facilities have received approvals from KMPDC to offer telemedicine services in the country.

The approvals only granted permission for the health facilities to offer virtual consultation health services. These approvals were subject to review every three months from date of issue. 

“The move by the Council to approve the facilities to offer telemedicine is a response to a growing need for the services due to physical distancing rules imposed by the government to curb the spread of COVID-19,” said KMPDC Ag. Corporation Secretary, Michael Onyango.

The Council has now taken it up not just as a COVID-19 mitigation measure but as a way of increasing access to healthcare in an effort to promote Universal Health Coverage and is now issuing annual licenses to health facilities to offer virtual consultation health services. Facilities receive licenses after satisfying the Council that telemedicine services offered are aligned to data protection and medical records regulations.

Even though Kenya currently is yet to enact laws regulating telemedicine, the Council developed e-Health guidelines back in 2019, and shared the same with the relevant government authorities for approval and subsequent gazettement.

“The rules will offer a base for the full roll out of telemedicine services in Kenya,” Onyango says.

According to the Centre for Disease Control (CDC), “telemedicine is the use of electronic information and telecommunication technology to get the health care you need while practicing social distancing.  All you need is a phone or device with the internet to continue your medical care while protecting yourself and your healthcare provider from COVID-19.”

Onyango however says only existing health facilities received approvals to offer the services.

“The facilities receive approvals after satisfying the Council that telemedicine services offered are aligned to data protection and medical records regulations,” he says.

Onyango adds that telemedicine services are “here to stay” after COVID-19 accelerated the adoption of technology in healthcare.

According to the Telemedicine Services Market Global Report 2020-30: COVID-19 Growth and Change “the global telemedicine services market is expected grow from $39.3 billion in 2019 to $48.3 billion in 2020 at a compound annual growth rate (CAGR) of 23.0%. The growth is mainly due to the lockdown across countries owing to the COVID-19 outbreak and the preference for contactless medical services. The market is then expected to stabilize and reach $78.3 billion in 2023 at CAGR of 17.4%.”

In line with the anticipated growth, KMPDC has set up a regulatory framework for E-health in Kenya. Already, the Council has plans to review the Code of Conduct for medical and dental practitioners in a bid to align it to technology driven health services.

That is not without concerns. First, ensuring patient data security is a challenge due to the vast and boundless nature of the Internet, Onyango says. “But we are in the early stages of telemedicine. People may be skeptical but the regulator is ready for the shift in medical services.”

“Regulating the Internet is very difficult,” Onyango adds.

The proposed e-Health regulations, drafted in 2019, bar health service providers from hosting the platforms outside Kenya.

The draft regulations cover areas of virtual medicine, use of artificial intelligence in health and e-Learning including training of medical personnel and online based continuous professional development (CPD) points.

Further, the regulations address establishment of virtual medical facilities prescribing disciplinary measures for any form of misconduct.

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Foreign doctors can now acquire temporary registration in Kenya in revised regulations

by Diana Madegwa

After years of red registration and licensing of foreign doctors to practice in Kenya, KMPDC has announced new and ‘friendlier” procedures in enlisting foreigners to practice in the country.

This comes at a time when the regulator moves to improve oversight in the sector as Kenya intensifies efforts to achieve Universal Health Coverage by 2022.

In an interview with The Practitioner, KMPDC Licensing Manager John Kariuki said the Council has started issuing temporary registration certificates to foreign doctors. He says once they acquire the certificate, the doctors are then able to apply for a temporary license that can be used for up to one year, unlike in previous years.

According to Kariuki, if given the temporary licenses, the doctors will be subjected to same regulations and code of conduct that guide the practice of medicine and dentistry in the country. This includes garnering 50 continuing professional development (CPD) points yearly, before they are able to renew their practicing licenses online.

Kariuki however maintains that despite this, Kenyan doctors still get preferential treatment and are entitled to work anywhere in the country and in several health institutions, unlike foreigners who are only allowed to provide medical and or dental services in only one health facility in Kenya.

“It is important that our stakeholders understand that the practicing licenses issued to foreign doctors limit them to only one hospital. Only Kenyans are able to practice anywhere in the country subject to license renewal,” said Kariuki, “We do not just register and license foreign doctors. Kenya has a rich pool of qualified and competent doctors and dentists offering medical services. We have no intentions to replace Kenyans with foreigners.”

According to the Council, any practitioner not registered in the Republic but who, having valid qualifications from a different country outside the East African Community, and who is desirous of giving medical or dental services in the course of any humanitarian or other valid cause, shall be required to obtain a license upon payment of the prescribed fees.

To acquire temporary registration, foreign doctors must submit copies of curriculum vitae; proof of proficiency in English; a certified copy of a valid registration certificate issued in the country of qualification; a certified copy of a certificate of good standing; passport photos; and national identification documents. After submission of these documents, the practitioner is then subjected to peer review or Council exams (Internship Qualifying or Pre Registration Exams). The doctor further has to submit an employment letter.

 Kariuki says the temporary registration of foreign doctors will help the Council provide more oversight in medical practice. “With digitization of our processes, KMPDC is currently able to provide real time data on the numbers of foreign doctors in the country and where they are working,” he explained.

KMPDC keeps a separate register of foreign doctors, Kariuki pointed out adding, “Only a few foreign doctors are permanently registered to practice in Kenya.”

This is because before 2014, the Council had a provision for permanent registration of foreign doctors, but after changes in regulations, KMPDC did not revoke permanent registration of already enrolled foreign doctors.

Kariuki says the move by the Council to issue foreigners with temporary registration certificates is a step towards improved healthcare.

“Health facilities can identify shortages in their workforce and hire foreigners to fill the gaps. Our work is to enable health facilities, medical and dental practitioners deliver quality health services,” Kariuki noted.

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Council unveils new organizational structure

by Diana Madegwa

The Kenya Medical Practitioners and Dentists Council (KMPDC) has redesigned its organizational structure, in a renewed effort to ensure better service provision and delivery of its mandate.

This is also aimed at aligning the Council to the requirements of State Corporations Advisory Committee (SCAC), following the categorization of the Council as regulatory agency PC6A, March, 2020.

According to KMPDC Council member and Chair of the Training, Assessment, Registration and Human Resource Committee Dr. Jacqueline Kitulu, the new structure sets forth the principles and rules which govern the administration of Human Resource and defnes the terms and conditions of service of all staff under the employment of the Council.

“The new structure couldn’t have come at a better time. The changes that come with it will ensure facilitation of the Council’s objectives through proper coordination, enhance synergy between directorates and eliminate duplication of work,” she said.

In the policy, the Council proposes reorganization into six departments and 4 stand-alone divisions, and staff establishment of 228 officers.

The departments will be: Training and Quality Assurance, Registration and Licensing, Compliance, Regulatory Affairs, Human Resource and Administration as well as Finance.

However, the Council’s Human Resource Manager, John Mburu notes that a review of its organizational structure will have financial implications occasioned by the proposed optimal staffing numbers.

“To enable the Council contain the resultant expenditure on personnel emoluments, we have recommended that the optimal staffing levels be implemented in a phased out manner,” said Mburu.

KMPDC draws its legal existence from the Medical Practitioners and Dentists Act (CAP 253) Laws of Kenya, with a mandate to regulate training, practice and licensing of medicine and dentistry and healthcare institutions that include private and mission hospitals, medical, dental centers and clinics, nursing and maternity homes and standalone funeral homes.

The training mandate, according to the new structure, will he handled by the Education, Training and Quality Assurance Department, to be headed by a Director.

“The functions of the department will entail establishing and maintaining uniform norms and standards of the learning of medicine and dentistry in Kenya. This also includes approving and registering medical and dental schools, maintain a record of medical and dental students, conducting internship qualifying exams as well as accrediting new and existing institutions for medical and dental internship,” said Dr Kitulu.

Headed by a Director, the Compliance Department will carry out regular inspections, carry out pre-registration and participate in the development of minimum requirements on infrastructure, personnel and service provision.

It is recommended that the department be organized into two divisions; accreditation and inspectorate, each headed by a Deputy Director.

The Regulatory Affairs Department will be tasked with determining and setting a framework for professional practice of medical and dental practitioners. The functions also include regulating health institutions and taking disciplinary action for any form of misconduct by a health institution.

It is recommended that the department headed by a Director and organized into two subdivision, standards and complaints handling, each headed by a deputy director.

The Human Resource and Administration Department will be responsible for providing strategic leadership and coordination of human resource while the Finance and Planning Department will ensure effective financial management.

Four standalone divisions; Corporate Communication, Supply Chain Management, Corporate Secretary and Internal Audit, will offer support services.

Mburu says the reorganization of the Council structure aims at improving service delivery and will go a long way in ensuring proper guidelines for grading of staff and their career progression. This focuses mainly on promotions and re-designations.

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