Kenya Association of Dermatologists. Biennial Conference Abadare Country Club, Nyeri. 4/29/2016.

Transcription

1 Kenya Association of Dermatologists Biennial Conference Abadare Country Club, Nyeri. 4/29/2016.

2 Prof. T.M.Munyao. Department of Clinical Medicine And Therapeutics. School Of Medicine. College Of Health Sciences University of Nairobi.

3 KEY NOTE SPEECH. Medical Specialist Training in Kenya. The case of Dermatology.

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5 Outline. Background. Burden of Skin disease. Population Trends. Capacity Building. Strategies. Conclusions. Conference Theme:

6 Objectives. At the end of this speech, delegates shall be able to: Describe the challenge of achieving the vision 2030 health goals due to overwhelming disease burden and extremely constricted specialist numbers and other resources. Describe the stakeholders, procedures, process map and sreategies for establishment of a specialist training programme in Kenya.

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8 Background. Specialist training is required to achieve mandate. All postgraduate Medical Specialists including Dermatologists have had to be trained outside the country. Numbers of specialists remain very, very low and serve in major urban centers. This paper discusses current status, increasing demand, processes, stakeholders and feasibility of specialist training in Kenya with highlights on dermatology.

9 PHYSICIANS REQUIRED PER 100,000 POPULATION. SPECIALTIES GMENAC GOODMAN Hicks & GLENN Medical Specialties SOLUCIENT Cardiology Dermatology Mean Endocrinology Gastroenterology Hematology/Oncology Infectious Disease Nephrology 1.1 NA NA Neurology Psychiatry Pulmonology Rheumatology Statesman Drive Irving, Texas (800) MerrittHawkins.com

10 MEDICAL SPECIALTIES Cardiology Dermatology Endocrinology Gastroenterology Oncology Infectious Disease Nephrology Neurology Psychiatry Pulmonology Rheumatology LOCAL TRAINING AVAILABLE Post MMed. No No No No To start 2016/17 UoN Yes 2015/16 UoN No No No No No.

11 Dermatologists: Pop Ratios for Kenya Population % pa 2015 Population pa Population 2.62 % pa Dermatologists= 20 (Medical specialists) 2 Ratio 1:2,302,500. UNDP ratio 1:25,000 Dermatologists/Standard= 20/

12 Population Trends. Relentless population growth 2.6%. Reduced Infant mortality rate. Reduced mortality rates. Inspite of limiting factors: Disease related mortality: Social: RTAs, Homicides, emigration Increased demand for specialised services.

13 PHYSICIANS REQUIRED PER 100,000 POPULATION. SPECIALTIES Ideal Mean Inservice Mean Cardiology Dermatology Endocrinology 0.8 < Gastroenterology Hematology/Oncology Infectious Disease Nephrology Neurology Psychiatry Pulmonology Inservice Nos

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15 Burden of Skin disease. Developing country, Prevalence skin diseases 20 to 80 percent % in rural Ethiopia; 50-80% infections & infestations: Scabies, pediculosis, dermatophytes, pyoderma. Others: eczema, HIV/AIDS, psoriasis, Acne..

16 Burden of Skin disease Generally low mortality except: Skin failure syndrome- high Mortality rates. All dermatoses: Marked DLQI impairment. eg acne comparable to asthma, diabetes, arthritis. No Recognition and management skills Health care providers.

17 Recent Epidemiological Trends. Environmental/social factors: Global warming- Ecological, food production, Overcrowding- communicable diseases. Longevity. Increased incidence of: New and emerging infectious diseases. NCDs: Metabolic syndrome, Malignant disease. Epidemics: Influenza,Ebola,Zika microcephaly

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19 Capacity Building. Overwhelming disease burden, < 0.1% of specialists. Improvement of quality and access. Capacity building by Stakeholders is required: Central Government: Policy, legislation, resources. Ministries of Health, Education, Finance and others. Regulatory organs: MPDB. Professional Associations: (KAD, KAP, KPA, KCS, etc) Industry: pharmaceutical Companies. Consumers: Patient community.

20 Establishment of New Courses. Start: Finish: TNA (Champion, DMS, MPDB, KAD, KAP, KPA, KCS, KESHO etc) Stakeholders meeting. Presentation to dept. SWOT analysis, develop curriculum. School academic Board. College Academic Board Senate.

21 Evidence of Stakeholders Commitment. Central government and agencies and Partners: Vision 2030, Health, Education pillars. Ministries strategic plans: Health, Education, Finance.. Health institutions: Established service units and Scholarships for staff. Universities Strategic plan and Cascaded Administrative unit strategic objectives. Undergraduate and postgraduate Curricula. Scholarships for staff.

22 Evidence of Stakeholders Commitment.. Professional Associations: KESHO..Fell. Medical Oncology course. IDSK..Fell. Clinical Infectious disease course. Surgical Several fellowship courses. KAD.. Constitution. Recurrent Scientific conference topic. Past affirmative action for training support.

23 Evidence of Stakeholders Commitment Industry Pharmaceutical companies. Training support portfolio. Numerous cases of: CME sponsorship. Scholarships and Faculty remuneration support. Strategy: Marketing. Precaution: COI.

24 Evidence of Stakeholders Commitment.. Consumers: Patient community. Past history of cooperation. Large numbers of consumers in public service Minimal probability of access to specialist.

25 Limitations To Establishment of Specialist Training. Quality control Trainers. Infrastructure. Financial resources. Accreditation/Benchmarking. Institutional temporal policy guidelines.

26 Strategies for Success. Commitment by all stakeholders. Concerted effort to achieve objectives. Adherence to laid down procedures process map. Maximise on opportunities, clout and goodwill

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28 SUMMARY. The specialist to population ratio including dermatologists in Kenya is very low. >90% specialists serve urban populations. Specialised services are not accessible to the majority of citizens. There are policies and legislations for specialist training. Training in local universities is feasible subject to addressing limitations and adhering to process maps.

29 Conclusions. Local training of Medical specialists (Dermatologists) shall remain a standing agendum for KAD. We should pursuade key stakeholders to address limitations and establishing Postgraduate Dermatology Training within FIVE (5) years.

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31 Theme: New Horizons in Dermatology. Subthemes. Challenges in skin colour. Advances in Aesthetic dermatology Impact of dermatopathology in clinical practice Research in Dermatology.

32 I commend the executive committee for excellent organisisation of this scientific conference and I look forward to an exciting innovative presentations.

33 Thank you.