The Kenya Medical Practitioners and Dentist Council (KMPDC) has released a new report detailing findings and recommendations to achieve Universal health Coverage (UHC) by year 2022.

Released in October 2020, the Universal Health Coverage Systems Strengthening in the Counties report underpins the need for enactment of sound policies and legislation in health as a means to attaining UHC.

In the report, KMPDC details recommendations in human resources for health, universal health care structures, essential health services, primary health care networks, quality of health care monitoring and evaluations, health products and technologies (HPTs) and health care financing mechanism.

“There is need replace, procure or improve dilapidated health facilities and target conformance to the guidelines that uphold the health systems,” says Jean Mathenge, KMPDC consultant and Lead Coordinator & Chief Rapporteur Secretariat, Ministry of Health (MoH) Technical Assistance Team.

The KMPDC study highlighted limitations in basic infrastructure and equipment required to achieve basic health services.

“One of the most tenacious finding is the extreme deficit in the human resource for health category, widely considered a cornerstone in achieving UHC,” she said.

The report calls for strategic investments in the human resource capacity calling on MoH to address shortages in health workforce for optimal provision of quality health services.

KMPDC advises counties to allocate adequate budgets in capacity building for health care workers. Further, the report urges county governments to draft policies that seek to retain health workers, addressing interruptions in service delivery because of labour turnover.

To achieve UHC, there is need to build capacity in professional cadres that include pediatric dentistry, nuclear medicine, clinical pathologists, critical care physicians, forensic psychiatrists, child and adolescent psychiatrists, medical endocrinologists and pediatric neurologists.

Mathenge added that the technical committee findings recommended the establishment of a task force that will steer the formation of a Health Service Commission (HSC) to mechanize, normalize, and centrally coordinate the human resources for health at the national level.

Moreover, the report also calls for a national census of health workers to accurately establish the numbers of health workers per 10,000 population. Further recommendations include the training of healthcare staff on UHC and the national insurance claims process.

In ensuring that healthcare is affordable to all Kenyans, the report recommends continuous sensitization and enrolment of all households to national health insurance fund (NHIF).

Kenya has adopted social health insurance model provided through NHIF to achieve UHC. Under the model, citizens are enlisted to affordable health insurance cover aimed at reducing out of pocket expenditure in financing healthcare services.

In ensuring that facilities have uninterrupted supply of quality health care products and technologies (HPTs), KMPDC recommends that Kenya Medical Supplies Agency (KEMSA) –the government body mandated with ensuring HPTs supply- automate its bill card to ensure end-to-end procurement and consumption data.

The report says that health care facilities whose current fill rate averages 60%, should aim to achieve over 70-90 percent of forecasted medicines and health technologies supplied to each county to avoid stock out of essential commodities.

Furthermore, the report recommends that all facilities should have a stand-alone Information and Communication Technology (ICT) departments and invest in IT upgrades to support essential health care provision. KMPDC encourages all facilities to improve internet infrastructures and upgrade biometric registration systems to strengthen UHC registration and claims processing mechanisms.

County Governments have also been urged to allocate at least 30 percent of their budgets to healthcare and sustain the funding to support the implementation of UHC.

Counties are advised to ensure that primary health community networks (PCHN) are fully implemented and all county residents are registered to PCHN.

Further, the report recommends an enhanced referral system as well as re-categorization of all health facilities to validate the current classifications.

The report highly recommends strengthening and promotion of oral health as an essential health service at all levels and inclusion into community health system to make it accessible under UHC.

It advises collaboration and partnerships with the county governments to complete this exercise as it emphasizes inter-governmental collaborations.

In March 2020, a joint team of the East African Community (EAC) Medical and Dental Regulatory Boards/Councils carried out the third Joint inspection of Medical and Dental Schools and Teaching Hospitals in Kenya. The inspections were conducted between 2nd to 6^th March 2020.

The exercise, targeting 11 health-training institutions in Kenya, was in line with a directive of the 19^th Ordinary Meeting of the EAC Sectoral Council of Ministers of Health held in Nairobi last year.

The directive requires EAC member States to ensure Medical and Dental Universities as well as their respective Teaching Hospitals to conform to the standards and guidelines governing medical and dental schools in the region with an aim to improving health training and promote harmony in education.

“During the inspections, the teams focused on governance, management, academic programs, human resource, student affairs, infrastructure, monitoring and evaluation of programs and research and innovation. We interacted with University Management, Teaching Hospital Management and Academic Staff to get a view of how they conduct the training programs, and the students to understand their learning experience,” said KMPDC CEO Daniel Yumbya.

A technical team composed of Chairpersons, CEOs/Registrars and Chairpersons of Education Committees of the EAC Partner States Medical and Dental Councils carried out the inspections. Also present were representatives of the Commissionfor University Education (CUE) Kenya, Kenya Health Professions Oversight Authority (KHPOA) and staff of East African Community Secretariat. Chaired by Dr. Nyemazi Alex from Rwanda Medical and Dental Council with KMPDC CEO Mr. Daniel Yumbya as the rapporteur, the team visited training centers in the country assessing compliance levels.

“The objectives of the inspection were to ascertain whether the Medical and Dental Schools are operating in compliance with the set standards and guidelines as approved by the East African Community Partner States,” said Mr. Yumbya further noting that they wanted to determine whether the institutions inspected during the second joint inspection, had fully complied with the recommendations made.

Medical and Dental Schools inspected include, Kisii University, University of Nairobi, Jomo Kenyatta University of Agriculture & Technology, Moi University, Kenya Methodist University, Egerton University, Kenyatta University, Uzima University and Moi University.

Ten out of 11 institutions were compliant with the set guidelines with Mount Kenya University School of Medicine being ranked the best performing University after scoring 82 points out of 100.

However, inspectors ordered closure of Uzima University College Medical School for noncompliance to training standards. The institution was ordered to redistribute all continuing students to the other medical schools.

Graduates from the 10 institutions approved to continue training, are eligible for recognition within the EAC States. This means they can practice their internships and work in any country in the region without the need for further training or being subjected to internship qualifying or pre-registration examinations as set out in the Mutual Recognition Agreement.

Mr. Yumbya says the Council will continue with routine inspections of training facilities to promote quality training.

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The Licensing Department at KMPDC has intensifed efforts to ensure all medical and dental practitioners acquire at least 50 continuing professional development (CPD) points before acquiring annual practicing licenses.

According to KMPDC Licensing Manager John Kariuki, all medical and dental practitioners must attain 50 points per calendar year before the Council can issue a practicing license.

“The purpose of CPD is to ensure professional competency at all times as a way of improving patients care. It is mandatory under CAP 253, Laws of Kenya (CPD rules, 2019) for every medical and dental practitioner to comply with CPD requirements,” says Kariuki adding that the Council has automated the CPD approval process to make it easier for practitioners.

Last year, KMPDC, in response to physical distancing requirements to curb the spread of COVID-19, launched an online platform where medical practitioners can claim CPD points from learning activities.

The online platform dubbed integrated CPD management system (iCMS), enabled practitioners to claim CPD points for learning activities which are not organized by CPD providers accredited in Kenya.

KMPDC’s CPD Officer Sarah Were notes that this platform enabled users to earn CPD points from participation in online conferences or through publishing scientific papers in journals abroad.

Last year, at the height of the COVID-19 pandemic, Sarah notes KMPDC received a significant increase in CPD compliance as per the KMPDC guidelines issued in 2019.

“Our members registered very high compliance levels with the CPD guidelines. This pandemic has shifted our operations and boosted online-based service delivery,” she adds.

The Continuing Professional Development Guidelines state: CPD is a quality assurance mechanism instituted to ensure that practitioners maintain their fitness to practice. Further, an individual and collective commitment to CPD by practitioners and providers will help reduce cases of professional malpractice, build public confidence in our health care system, and enhance the standing of the profession.

According to Sarah, KMPDC will conduct vigorous assessments of the submitted documents to ensure doctors and dentists only earn points from accredited CPD providers.

“Unlike when we dealt with a lot of manual work, we have a digital system where users submit proof of CPD. That will help us conduct thorough inquiries into the documents to ascertain only credible activities provide CPDs,” she said in an interview.

Sarah further noted KMPDC is working towards calcifying the CPD requirements unlike any other time before.

“CPD is a central component of the licensing process. We have allowed medics and dentists to earn points from a variety of CPD providers. As we enforce this requirement, KMPDC is alive to the challenging environment we are living in,” Sarah clarifies.

She however noted that while universities and hospitals are CPD providers, lecturers and medical practitioners only earn points from activities other than the main job.

“Your main job is not a CPD duty,” says Sarah. “We only accredit CPDs from duties outside the daily job activities.”

She however added that KMPDC recognizes internship and postgraduate as CPD providers. “Earning a Master’s Degree automatically gives one 50 CPD points. We also recognize internship as a CPD activity that garners 50 points,” she says.

Sarah concludes by calling on doctors and dentists to “be honest when submitting documents for CPD approval” noting the medical profession is premised on “trust and fidelity to the code of conduct”.

Health CS Sicily Kariuki inaugurates new Medical Council

Cabinet Secretary for Health Honorable Sicily Kariuki has today, 30^th January 2020, inaugurated the new Kenya Medical Practitioners and Dentists Council. The new Council will be chaired by Dr. Eva Njenga, who was appointed by His Excellency, President Uhuru Kenyatta.

During the event, the Cabinet Secretary said the Council is exected to be transparent and have ethical leadership and accountability in executing its mandate and further directed the new members to regulate provision of health services in all health institutions from the public and private sectors.

In her acceptance speech, the new Chairperson, Dr. Eva Njenga said the Council remains committed to the realization of Universal Health Coverage HC by supporting professionalism in practice and expanding education and training priorities to increase the workforce required to adequately service the anticipated increased demands of the health sector.

She further assured that the Council members diligently discharge their duties bearing in mind the interest of the patient, the interest of the medical and dental practitioners, health institutions and of the country at large while ensuring they strike a balance with the patients’ interests, being supreme.

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