Given the frequent media reports of serious injury and deaths of patients caused by negligent health providers, Kenyans may be surprised to learn that only one doctor has been deregistered by the medical board in the past two decades.
Data from the Kenya Medical Practitioners and Dentists Board (KPMDB) shows that four doctors had their licences cancelled while six had theirs suspended for a period of six to 12 months for misconduct over the same period.
But a majority walked away with a slap on the wrist with 16 being sent for supervised training for a period of six to 12 months while 106 were ordered to go through continuous professional development.
Other sanctions included referrals to mediation or alternative dispute resolution (141), admonishment of medical or dental practitioners or health facilities (105) and directives to pay part of the cost of the board hearings (51).
While some medics have been found guilty by courts of law over the years, they continue practising with the Board failing to act — or having absolved some of them of blame.
From 1997 to March this year, 985 cases were lodged with the board. Of these, 70 cases are pending and 915 have been determined. About 97 per cent of them were resolved at the preliminary inquiry committee, two per cent at the national tribunal and two per cent at the national professional conduct committee.
“These are cases pending at various stages of investigations,” notes the board’s report.
The complaints peaked in 2008, when 85 cases were filed.
According to the board, 51 of the reported cases reported arose from other issues such as doctors failing to give medical reports, medics’ attitudes towards patients, sexual harassment as well as absconding duty. About third (29 per cent) of health providers in public facilities were found to be absent, compared to a fifth (21 per cent) in private facilities, according to a recent World Bank study on Service Delivery Indicators.
Public providers followed less than half (44 per cent) of the correct treatment actions needed for managing maternal and neonatal complications, according the World Bank study
Several studies on the competency of health providers suggest that the complaints received by the board could be the tip of the iceberg. Public providers followed less than half (44 per cent) of the correct treatment actions needed for managing maternal and neonatal complications, according the World Bank study
Figures from the study show that only 58 per cent of public health providers could correctly diagnose at least four out of five very common conditions, such diarrhoea with dehydration and malaria with anaemia.
The findings were affirmed in The First Confidential Enquiry into Maternal Deaths in Kenya released recently that identified one or more health worker-related factors in three-quarters of the maternal deaths in hospitals. The most frequent issues identified included: delaying starting treatment (a third); inadequate clinical skills (28 per cent); insufficient monitoring (27 per cent); prolonged abnormal observation without action (24 per cent); and incomplete initial assessment (23 per cent). Others were wrong diagnosis, wrong treatment and no treatment.
A Nation Newsplex review of stories in mainstream media about major medical misconduct that resulted in death or injury of patients in the past six months finds that incidents occurred in all categories of facilities (private, public and faith-based) and affected men and women across different ages. The review compiled seven cases, of which four happened in public health facilities, two in private institutions and one in a faith-based organisation. In more than half the cases the patients died.