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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.

In February 2021, a team from the Kenya Medical Practitioners and Dentists Council (KMPDC) together with its associates conducted an inspection exercise of College of Surgeons of East & Central Africa (COSECSA) training institutions in Kenya, as part of KMPDC’s monitoring and evaluation framework.

The inspections, which took place between the 22^nd and the 26^th of February 2021, marked the second such exercise conducted by KMPDC, and was in line with the Council’s mandate to regulate the training of all medical and dental practitioners and community oral health officers (COHOs).

The team, appointed by the Council’s Chief Executive Officer Mr. Daniel Yumbya, also visited existing and proposed COSECSA training sites in order to ascertain whether or not they meet the minimum requirements to train residents in general surgery.

The week-long exercise targeted 24 sites and was aimed at advancing education, training, standards, research and practice in surgical care in the country. This will in turn, help increase the number of surgeons in Kenya which still remains very low.  

According to our data, there are only 581 licensed surgeons in the country. The COSECSA program therefore aims to bridge this gap through a unique in-service training, where the surgeons are taught within their countries of origin and in their respective counties. This not only reduces costs incurred by trainees if they were to study abroad, but also helps in surgeon retention post qualification at the place of study.

With most surgeons based in urban areas, this unique training program also aids in the distribution of the specialists across the country as most surgeons are retained in the specific counties where they studied.

Some of the COSECSA training sites that were inspected include the Kenyatta National Hospital, Moi Teaching and Referral Hospital, PCEA Kikuyu Hospital, AIC Kijabe Mission Hospital among others.

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. “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,” says Jean Mathenge, the Council’s Consultant and also the Lead Coordinator and Chief Rapporteur of the technical exercise.

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. “With Data based evidence showing 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,” says Mathenge.

The exercise, according to Mathenge, 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 healthsector 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.

Mathenge further says that 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. “With Scientific evidence demonstrating that quarantine, social distancing, and isolation of infected populations help in containing the epidemic, the team assessed 290 facilities in 47 counties,” Mathenge says. “We 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.

Mathenge 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.