A security guard keeps vigil in an empty ward at the Coast General
Hospital August 18, 2014 following a doctors’ strike. WHO says Kenya
lacks more than 30,000 doctors to attain the recommended doctor-patient
ratio. PHOTO | LABAN WALLOGA |
NATION MEDIA GROUP
By EDWARD OMETE
In his autobiography From Simple to Complex, Prof Joseph Maina Mungai, a pioneer Kenyan medic, recalled the strides taken to train more Kenyan doctors.
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The recent move to accredit more universities to offer
medicine and dentistry courses certainly made him content in seeing the
fruits of the seeds he sowed sprout although he is now deceased.
According to the Kenya Medical Practitioners Board,
only about 8,000 doctors are certified in Kenya. Of these fewer than
7,000 are retained in the 2014 register which is a reflection of those
actively practising this year.
This scenario is also captured in a 2011 World
Health Organisation (WHO) statistic on our projected healthcare human
resource needs. The data indicated that we lacked more than 30,000
doctors to attain the recommended doctor- patient ratio.
The question is why 30 years after Prof Mungai’s
initiative to start the first medical school we are still lagging behind
in the number of doctors.
For a long time this training was solely in the
hands of the government. With its limited resources to fund the heavily
subsidised medical students fees and escalating wage bills from
lecturers the government is unlikely to do a lot. Increasing student
enrolment means more infrastructure, salaries and other associated costs
to the government.
Given the prevailing harsh economic times this is
an unlikely option. The alternative route is to increase the number of
private universities offering medicine because these are self-funding.
Like other areas, the realisation that the private
sector can support public health systems in delivering our objectives is
finally dawning on the policy makers. The previous regulations that
placed entry barriers on private institutions to train doctors are now
slowly beginning to ease.
Popular course
The move to allow Mount Kenya University to start
its inaugural intake creates room for other private universities to
follow suit. As a business, training of doctors is not a bad bet.
Medicine is easily one of the most popular courses
selected by aspiring university entrants. Alongside other affiliated
courses like dentistry and pharmacy, it perhaps has the highest fees for
students even in public universities.
But one obstacle is the huge capital outlay needed
to start and run a medical school. The good thing about the MKU model is
that it is leveraging on the public private partnership model. This not
only helps improve public infrastructure and services, but also reduces
the amount of capital needed to launch.
In their case the commitment to invest resources in
the public facilities they will train their students at will certainly
make a positive impact to these hospitals.
A common pitfall for such partnerships however is
that in the long-term sustaining quality of such facilities becomes
harder. No sooner do the facilities improve than they become popular
with patients and then get overwhelmed.
Withdrawal of the private partner also leads to a gradual downwards slide in the quality of care.
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