OMETE: Medical training partnerships a jab in the arm for healthcare
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 |
In his autobiography From Simple to Complex, Prof Joseph Maina Mungai, a pioneer Kenyan medic, recalled the strides taken to train more Kenyan doctors.
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.
Of course there is also the issue of quality of training given private institutions unlike public ones have operational expenses to be met and may need to make some “profit”.
The fear has been that in such situations entry to these medical schools could be offered to the “highest paying students”. The regulators fortunately have this covered.
