impact of rhris on regulation of medical and ...registration of medical and dental practitioners by...

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


• 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


• 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


• 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


• 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

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Registration of Medical and Dental practitioners by year (2006-2015)

Dentists Med doctors

• Newly Registered/Entering workforce

52

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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/]

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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

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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]

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