Hundreds of Kenyans studying unknown 'medical' courses

Hundreds of young Kenyans are studying unrecognised medical courses and may have trouble getting jobs in future, the regulator has said.

The Kenya Medical Practitioners and Dentists Council said these courses were quickly cobbled together by some colleges to cash in on the craze for medical training in Kenya.

Some of the curriculums are also not approved.

The council, which regulates the training of doctors, said this was caused by amendments to laws, limiting the role of regulators in training.

“We are the link between the training institutions and the industry. But now there are so many people in the industry that we don’t recognise,” said CEO Dr David Kariuki.

He mentioned dental nursing and caregiving as some of the courses not known by the council.

The courses are also not recognised by the Nursing Council of Kenya, which regulates nursing.

“We are not against them, they have a role to play. But before TVETs or private colleges begin a medical course, it should be approved by the professional institutions under the Ministry of Health,” he said.

Kariuki said in many cases this is not happening, because parliament has passed laws that limit the role of professional bodies in approval of courses.

“While regulatory authorities draw their mandate from their respective Act, the performance of some of the mandate has been criminalised by another Act of Parliament, for instance Commission for University Education Amendments that prohibited the council from inspecting training institutions,” he said.

Section 5A of the Universities (Amendment) Act 2016 provides that the accreditation, recognition, licensing, student indexing and approval of any academic programme offered at a university be done by CUE.

The act says any other party person who, without the authority of CUE, purports to do so, commits an offence punishable by a fine not exceeding Sh2 million or two years’ imprisonment.

This was affirmed in 2020 by Court of Appeal Judges Mohammed Warsame, Daniel Musinga and Fatuma Sichale, who on December 4 ruled that CUE was the only mandated body to regulate the standards and accredit courses in consultation with individual universities, as provided in Section 5 of the Universities Act.

Kariuki said the council and other professional bodies are unable to assess facilities that are training health workers in colleges and universities.

He said universities have even stopped indexing, a process that made them share with the council the register of the students they admit.

He said the result is a rise in courses that are not marketable or necessary.

Some of them may also be unrecognised by the Salaries and Remuneration Commission, which means holders may have trouble getting jobs in the public service.

The SRC says health worker cadres in Kenya include, doctors, pharmacists, dentists, nurses, clinical officers, lab technicians and other paramedics.

Physiotherapist, radiographers, occupational therapists, nutrition and dietetics officers, entomologists, chemists, technologists and technicians are also health workers.

Others are public health officers, health record officers, medical social workers, community oral health officers, parasitologist, biochemists, anaesthetists, mortuary attendants, orthopaedics, radiation protection officers and biomedical engineers.

Kariuki said for many years KMPDC was the only registrar of health facilities in Kenya.

“But parliament has made amendments allowing other institutions to also register health facilities,” he said.

Early this month, National Assembly Health Committee vice chairperson Patrick Munene said the committee will recommend that registration of services and professionals be left with KMPDC, but classification and inspection be given to another body.

“It is a great conflict of interest for KMPDC to be given the mandate to license health facilities, because most health facilities are owned by medical doctors. Doctors are fully paid members of KMPDC, so they are checking facilities for their members," he said.

"We will recommend as a committee that registration of services and professionals, be left with KMPDC, classification and inspection be given to a different body.”

Kenya has a total 16,664 registered health facilities. The country also has 16,796 medical doctors and dentists and 13 medical schools that produce approximately 1,000 doctors every year.

According to SRC, the public health subsector is the second largest consumer of the public wage bill, after teaching.

SRC says public health subsector's share in the total public wage bill is about 12.5 per cent, equivalent to around Sh120 billion.

As at 2018, the number of health workers in the public service, excluding health workers at the Kenyatta National Hospital and Moi Teaching and Referral Hospital, was about 67,740.

The commission says the wage bill for the health subsector is majorly influenced by the number of health workers in the public service and collective negotiation agreements.

For example, between 2013 and 2018, the wage bill spiked by nearly three-fold from approximately Sh38 billion in 2013 to Sh108 billion in 2018.

According to a 2022 report by the World Health Organization, Kenya is among the top six countries in Africa with the highest concentration of health workers.

Nigeria tops followed by South Africa, Algeria, Ethiopia, Democratic Republic of the Congo and Kenya in that order.

However, Kenya still does not meet the WHO health worker-to-population ratio.

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