WHO Abuja Declaration 2001  Heads of State of African Union countries set a target of 15% of annual budget to improve the health sector by the year 2015  Sadly to-date only7counties have complies as follows:  Rwanda  South Africa  Liberia  Madagascar  Malawi  Togo  Zambia 1

WHO Abuja Declaration 2001 …  Five other countries are spending at least 13% of their annual budget on health  About a quarter of the 54 AU member states have regressed and are now spending less than they were in

Background Africa has 24% of world’s disease burden but only 3% of the world’s health work force. The need to train more health professionals cannot be overemphasized. 1.Doctor to Patient Ratio Data Sub-Saharan Africa18:100,000 India60:100,000 Brazil170:100,000 France370:100,000 3

4 Institutions, graduates and workforce by region (2008 )  Frenk et al Vol 376 December 4, 2010www.lancet.com

5 Global Perspective of Training and Financing Medical and Nursing Graduates  Frenk et al Vol 376 December 4, 2010www.lancet.com

Foundation Dates of Medical Schools in Sub-Saharan Africa 6  Mullan et al Vol 377 March 26, 2011www.lancet.com

Estimated location of graduates from medical schools in Sub-Saharan Africa 5 years after graduation 7  Mullan et al Vol 377 March 26, 2011www.lancet.com

Study Findings – Medical Schools (Sub-Saharan Africa 1.Need to scale up of Medical Education 2.Effect of the Country’s Health System 3.Shortages within Medical Faculties 4.Weakness in Medical Education Infrastructure 5.Coordination between Ministry of Education and Health 6.Accreditation and quality measurement 7.Education Planning Focused on Health needs 8.Importance of research 8  Mullan et al Vol 377 March 26, 2011www.lancet.com

9.Curricular innovations 10.Significance of postgraduate medical education 11.Quality of secondary schools 12.Private medical schools 13.International Partnerships 9 Study Findings – Medical Schools (Sub-Saharan Africa …  Mullan et al Vol 377 March 26, 2011www.lancet.com

Recommendations to promote and improve medical education and population health in sub-Saharan Africa 10  Mullan et al Vol 377 March 26, 2011www.lancet.com

CURRENT REGISTRATION STATISTICS - KENYA The board has the following registered practitioners and institutions:  Medical Doctors 8,553  Dentists 1,014  Specialists 1, 793  Medical Schools in EAC 18  Dental schools in EAC 3  Internship Training Centers  Medical 63  Dental 7  Specialist Recognition 2  Post graduate Teaching Hospitals 4  Health Institutions (Various categories) 3,237 11

Registration statistics

TRAINING INSTITUTIONS WITH REGISTERED PRACTITIONERS IN THE DATABASE Training Institution Medical practitionersDentists Institutions in Kenya University of Nairobi87.3 %98.4 % Moi University12.6 %1.6 % Kenyatta University0.1 %- East Africa Community Reciprocal (EAC) Registration Mbarara University of Science & Tech, Uganda 34.3 %48.5% Kampala International University 36%- Makerere University, Kampala 25.2 %3.0% Hubert Kairuki Memorial University 7.0 %3.0% International Medical and Technological University - Tanzania 1.4 %3.0% University of Dar es salaam 0.7 %12.1% 13

I NTERNATIONAL T RAINING INSTITUTIONS WITH REGISTERED PRACTITIONERS IN THE DATABASE CountryMedical PractitionersDentists International colleges Turkey31020 Russia27225 Malaysia1302 UK1078 Denmark554 India527 Pakistan391 Dominican327 Australia28 China283 Czec.224 US200 Others428 14

Approved Medical & Dental Schools with reciprocal recognition in EAC 1. Kenya  University of Nairobi  Moi University  Aga Khan University(Post Graduate)  Kenyatta University  Egerton University  Kenya Methodist University  Maseno University  Uzima University 2. Tanzania  University of Dar-es-salaam - Muhimbili College of Health and Allied Sciences  Tumaini University -Kilimanjaro Christian Medical College  Dodoma Medical College  Ifakara Medical College - Morogoro  Hubert Kairuki Memorial University  St. Augustine’s Bugando University College of Health Sciences 15

Approved Medical and Dental Schools with reciprocal recognition in EAC 3. Uganda  Makerere University, Kampala  Gulu University  Kampala International University  Mbarara University  Uganda Martyrs University (for postgraduate) 4. Rwanda  National University of Rwanda faculty of Medicine 5. Burundi  University of Burundi Faculty of Medicine  Hope Africa University  Ngozi University Faculty of Medicine 16

Registration status for doctors in Kenya Professional TypeStatusN( Percent) Reason for inactivity# Medical Practitioner (N=7,637) Active5285 (70.6%) 14.4/ 100,000 Pop. Inactive2352 (29.4%) Deceased209 Retired6 Outmigration8 Not retained >5 yrs2129 Dental Practitioner (N=863) Active649 (72.9%) 1.7/ 100,000 Pop. Inactive213 (27.1%) Deceased20 Retired4 Outmigration44 Not retained >5 yrs145

CPD Compliance levels/ License renewals- Kenya 62% of active 2% of active 12% of active 18

Distribution of medical and Dental professionals per Province/Region

DOCTORS IN GOVERNMENT AND PRIVATE PRACTICE MedicalDental Specialists72935 General Practitioners Total Doctors in Government Employment 2,831 WHO RECOMMENDED PATIENT DOCTOR RATIO 1:600 Total Kenya Population 40,000,000 Total Doctors employed by the government 2,831 Thus; 40,000,000 / 2,831 Kenyan Position 1:14,129 Doctors in Private Practice 2,260 20

Role of networking within Africa and Internationally 1.Encouraging to leverage on using training institutions in the language block regions in African to benefit from centres of excellence in each country, especially in postgraduate and fellowship training. 2.Limiting retention of graduates from Africa trained in high resource countries to return to their home countries. 3.Encouraging reciprocal recognition of graduates. 4.Encouraging securing of best practices in all countries in education, research, and health systems management 22

5.Sharing of curriculi that are well tested with time. 6.Maintaining North-South and South-South collaborations 7.Encourage for a for sharing ideas -Deans of medical schools -Medical councils 8.Paying the health professionals equitable rational remuneration to curb migration 9.Adequate infrastructure for training and working environment 23 Role of networking within Africa and Internationally …

References 1.Medical Schools in Sub-Saharan Africa Vol 377 March Health Professionals for a new century. Transforming Education to strengthen Health Systems in an interdependent world. Vol 376 Dec Doctor to Patient Ratio in Africa MPDB Kenya 5.Keeping Doctors in Kenya. – keeping_doctors_in_Kenya/ 24

THANK YOU University of Nairobi ISO 9001: Certified