Agency that purged quacks keen to improve healthcare

It is now three years since the Health ministry started enacting the Health Act in a bid to implement the Constitution. The Act became effective on September 20, 2017.

The Act provided for the establishment of various institutions, including the Kenya Health Professions Oversight Authority (KHPOA), mandated with several functions.

On the first anniversary of the authority, the CEO Dr Jackson Kioko spoke to the Star about the journey. Kioko doubles up as the Director Medical Service.

Kindly introduce KHPOA and tell us the gaps in health regulation the authority seeks to address?

KHPOA was established with very obvious reasons. There were challenges of providing the quality of care, regulating the health professionals and their training, how they are licensed, how they practise, how they relate with the health facilities and also how they relate with the communities and the patients.

Now these were the gaps that were realised that the ministry and the health sector has not been addressing. And therefore, the need for the KHPOA to come and look at these challenges, these gaps from far above and to see how they can be sorted out.

In what ways has the establishment of KHPOA improved health services? 

The successes are many, the challenges are also many. But remember that establishing a new institution is very challenging. Ensuring that both the organisational and legal structures are in place really takes a lot of time.

We have convened all the regulatory bodies that are recognised under the laws of Kenya and sat down with them. We mapped out all the regulatory bodies, all the training institutions, the universities and the colleges and the professional associations because we will be working with them.

But above all, we realised that the first thing we needed to do is to take an inventory of everyone who is providing services in this country, whether it is private or public, whether is a clinic or nursing home. So we embarked on a very serious exercise of doing joint health inspections.

We were targeting to reach 11,600 health facilities, we managed 11,400 the rest we could not trace them because it is an exercise that began in July 2019 and ended in January this year. So we did 98 per cent of what we had targeted to do.

We closed 1,200 clinics and facilities. This because either they were not registered or the people who were working there were not qualified. We are supposed to have developed the legal instruments for the authority. We have already finished drafting those regulations with the support of the AG's office and the legal team from the ministry, and soon we are going to subject them to stakeholders because they have to go through that process before they become legal tools to be used.

We have also developed the organisation, the staffing and the grading structure of the authority, which is very key in recruitment and career progression.

What is the role of KHPOA in the UHC agenda?

When we came in as an authority, we were also given a task to make sure the hospitals, health centres and dispensaries, especially in the public sector, are actually prepared towards the UHC. So we have done a lot of inspection, preparation of hospitals and ensured that things are in place for the UHC.

Do you have a role as an authority in the fight against Covid-19 as the virus ravages the country?

We are the ones who have been spearheading the facility preparedness in the counties for Covid-19, so what we have been doing is that because we are tasked to carry out joint inspections, the authority has been providing leadership in the inspection and preparedness in counties towards the establishment of the isolation centres and quarantine centres.

How do you handle patient complains against health professionals?

One of the functions of the authority is to receive and facilitate conflict resolutions from patients or aggrieved parties or disputes. We have developed regulations to this function and provided procedures for handling and receiving these complaints from the facility level itself. 

Let it be handled at that level first. If not, let it be handled at the respective regulatory body, but in the event the authority is dissatisfied with how this is handled, the authority shall take over that investigation/the handling of that complaint. The facility is supposed to be giving the conclusion of every case they handle to the authority for scrutiny and to certify that this complaint was efficiently and correctly handled. The same will apply to the regulatory authority.

There has been a lot of agitation from health professionals for the formation of a Health Service Commission. Do you think its formation will create overlaps in your work?

No. What is being proposed in the HSC is totally different because it is not talking about service delivery. It is not talking about the issues of quality, the issues of training or about the regulatory space. It is talking about the human resource for health, the issues of job opportunities, the issues of employment, their welfare, their salaries, remunerations, promotions, transfers. That is human resources. In fact, it would affect more the Kenya Human Resource Advisory Council. For us, we are okay.

Some hospitals and medical practitioners are said to deny patients emergency services for lack of money. Has KHPOA made any attempt to rectify this?

The good thing is I am all aware about the entire health sector, the challenges it has gone through and the issues that have affected it, whether in the private or the public sector. So when we are seated here, drafting guidelines and policies, we are actually using the experience we have already seen is affecting the health sector.

There is a code of conduct for standards of health facilities. What is it that health facilities have to do or what is it we expect them to do in regards to providing care and especially emergency care? Especially in situations where patients may not have the finances to settle the healthcare costs. And what are the penalties you are actually going to go through if you fail to provide a service to a patient?

Improper training is often blamed for malpractices and unethical behaviour in healthcare. What are the plans in place to ensure quality health training?

We have developed regulations on standards of training on where the training standards can be compromised, and we are going to start using them the moment they become law. But we are aware that, of course, patients die either because of misdiagnosis or maybe they die because of wrong treatment, wrong procedures, or delays, even initiating that treatment or even delays in referrals, and we have taken all these into consideration when we are doing our regulations.

What are the future short-term and long-term plans for the authority?

We are training the county health inspectors at least three or four in each county, who then would be involved in visiting various facilities to check on the implementation of quality improvement to tell us which facility is not doing well, which one needs to be supported or which one needs to be closed. They would not be closing because the closing is the mandate of the authority, but they will only be advising, they will only be supporting the teams working in hospitals on how to improve on services.

Edited by T Jalio