Physician tracking in sub-Saharan Africa: current initiatives and opportunities

Human Resources for Health

Paschalis Rugarabamu⁴  Damen Haile Mariam⁷  Melissa Ward-Peterson¹  Zohray Talib⁶  Nelson Sewankambo⁵  Jim Scott⁶  Emiola Oluwabunmi Olapade-Olaopa³  Sinit Mehtsun⁶  Katumba Ssentongo²  Sarah Baird⁶  Candice Chen⁶ 

[1] Florida International University Herbert Wertheim College of Medicine, Miami, FL, USA;Uganda Medical and Dental Practitioners’ Council, Kampala, Uganda;Ibadan, Nigeria and African Centre for Global Health and Social Transformation, University of Ibadan, Kampala, Uganda;Dar es Salaam, Tanzania and African Centre for Global Health and Social Transformation, Hubert Kairuki Memorial University, Kampala, Uganda;Makerere University College of Health Sciences, Kampala, Uganda;The George Washington University, 2121 K Street NW, Suite 210, Washington, DC 20037, USA;Addis Ababa University, Addis Ababa, Ethiopia

关键词: Medical education;    Sub-Saharan Africa;    Physician tracking systems;    Human resources for health;    Health workforce;   

Others  :  821769
DOI  :  10.1186/1478-4491-12-21

 received in 2013-11-27, accepted in 2014-03-31,  发布年份 2014

【 摘 要 】

Background

Physician tracking systems are critical for health workforce planning as well as for activities to ensure quality health care - such as physician regulation, education, and emergency response. However, information on current systems for physician tracking in sub-Saharan Africa is limited. The objective of this study is to provide information on the current state of physician tracking systems in the region, highlighting emerging themes and innovative practices.

Methods

This study included a review of the literature, an online search for physician licensing systems, and a document review of publicly available physician registration forms for sub-Saharan African countries. Primary data on physician tracking activities was collected as part of the Medical Education Partnership Initiative (MEPI) - through two rounds over two years of annual surveys to 13 medical schools in 12 sub-Saharan countries. Two innovations were identified during two MEPI school site visits in Uganda and Ghana.

Results

Out of twelve countries, nine had existing frameworks for physician tracking through licensing requirements. Most countries collected basic demographic information: name, address, date of birth, nationality/citizenship, and training institution. Practice information was less frequently collected. The most frequently collected practice fields were specialty/degree and current title/position. Location of employment and name and sector of current employer were less frequently collected. Many medical schools are taking steps to implement graduate tracking systems. We also highlight two innovative practices: mobile technology access to physician registries in Uganda and MDNet, a public-private partnership providing free mobile-to-mobile voice and text messages to all doctors registered with the Ghana Medical Association.

Conclusion

While physician tracking systems vary widely between countries and a number of challenges remain, there appears to be increasing interest in developing these systems and many innovative developments in the area. Opportunities exist to expand these systems in a more coordinated manner that will ultimately lead to better workforce planning, implementation of the workforce, and better health.

【 授权许可】

   
2014 Chen et al.; licensee BioMed Central Ltd.

【 参考文献 】

• [1]World Health Organization world health report: Working Together for Health. World Health Organization; 2006:3-15.
• [2]World Health Organization: African health workforce observatory. 2013. Retrieved 24 April 2013, from [http://www.hrh-observatory.afro.who.int/ webcite]
• [3]Gross J, Rogers MT, Oywer E, Wambua D, Kamenju A, Arudo Riley PL, Higgins M, Rakuom C, Kiriinya R, Waudo A: The impact of out-migration on the nursing workforce in Kenya. Health Serv Res 2011, 46(4):1300-1318.
• [4]Kinfu Y, Dal Poz MR, Mercer H, Evans DB: The health worker shortage in Africa: are enough physicians and nurses being trained? World Health Org 2009, 87:225-230.
• [5]McNabb M, Hiner C, Pritzer A, Abduljewad Y, Nadew M, Falatamo P, Anderson J: Tracking working status of HIV/AIDS-trained service providers by means of a training information monitoring system in Ethiopia. Hum Resour Health 2009, 7:29.
• [6]Munga M, Maestad O: Measuring inequalities in the distribution of health workers: the case of Tanzania. Hum Resour Health 2009, 7:4.
• [7]Gupta N, Surn P, Diallo K, Dal Poz M: Uses of population census data for monitoring geographical imbalance in the health workforce: snapshots from the developing countries. Int J Equity Health 2003, 2:11.
• [8]Muula A: Nationality and country of training of medical doctors in Malawi. Afr Health Sci 2006, 6(2):118-119.
• [9]Arah OA: The metrics and correlates of physician migration from Africa. BMC Public Health 2007, 7:83.
• [10]Hallock J, McKinley DW, Boulet J: Migration of doctors for undergraduate medical education. Med Teach 2007, 29(2–3):98-105.
• [11]Mullan F, Frehywot S, Omaswa F, Sewankambo N, Talib Z, Chen C, Kiarie J, Kiguli-Malwadde E: The medical education partnership initiative: PEPFAR’s effort to boost health worker education to strengthen health systems. Health Aff 2012, 31(7):1561-1572.
• [12]General medial council: regulating doctors, ensuring good medical practice Retrieved 24 April 2013, from [http://www.gmc-uk.org/about/role.asp webcite]
• [13]Riley PL, Zuber A, Vindigni SM, Gupta N, Verani AR, Sunderland NL, Friedman M, Zurn P, Okoro C, Patrick H, Campbell J: Information systems on human resources for health: a global review. Hum Resour Health 2012, 10:7.
• [14]Dal P, Mario R, World Health Organization: Handbook on monitoring and evaluation of human resources for health with special applications for low-and middle-income countries. World Health Organization; 2009.
• [15]Chen L, Evans T, Anand S, Goufford JI, Brown H, Chowdhury M, Cueto M, Dare L, Dussault G, Elxinga G, Fee E, Habte D, Hanvoravongchai P, Jacobs M, Kurowski C, Michael S, Pablos Mendez A, Sewankambo N, Solimano G, Stilwell B, de Waal A, Wibulpoprasert S: Human resources for health: overcoming the crisis. Lancet 2004, 364:1984-1990.
• [16]Settle D, Leitner C, Bales C, Blair G: Using routine human resources information systems to manage, measure, and monitor the health workforce. http://www.capacityplus.org/files/resources/Using-Routine-HR-InformationSystems.pdf webcite
• [17]Chaulagai CN, Moyo CM, Koot J, Moyo HB, Sambakunsi TC, Khunga FM, Naphini PD: Design and implementation of health management information system in Malawi: issues, innovations and results. Health Policy Plan 2005, 20:375-384.
• [18]Gladwin J, Dixon R, Wilson T: Implementing a new health management information system in Uganda. Health Policy Plan 2003, 18(2):214-224.
• [19]Gupta B, Dal Poz M: Assessment of human resources for health using cross- national comparison of facility surveys in six countries. Hum Resour Health 2009, 7:22.
• [20]Lungo J: The reliability and usability of district health information software: case studies from Tanzania. Tanzan J Health Res 2008, 10:39-45.
• [21]Mahundi M, Kaasboll J, Twaakyondo H: Health information systems integration in Tanzania: tapping the contextual advantages. Proceedings of IST-Africa Conference 2011.
• [22]Maokola W, Willey B, Shirima K, Chemba M, Armstrong JRM, Mshinda H, Alonso P, Tanner M, Schellenberg D: Enhancing the routine health information system in rural Southern Tanzania: successes, challenges, and lessons learned. Trop Med Int Health 2011, 16(6):721-730.
• [23]Mutemwa R: HMIS and decision-making in Zambia: re-thinking information solutions for district health management in decentralized health systems. Health Policy Plan 2006, 21:40-52.
• [24]Nyamtema AS: Bridging the gaps in the health management information system in the context of a changing health sector. BMC Med Inform Decis Mak 2010, 10:36.
• [25]Odhiambo-Otieno G, Odero W: Evaluation criteria for the district health management information systems: lessons from the ministry of health, Kenya. Afr Health Sci 2005, 74:59-64.
• [26]Spero J, McQuide P, Matte R: Tracking and monitoring the health workforce: a new human resources information system (HRIS) in Uganda. Hum Resour Health 2011, 9:6.
• [27]Benade MM: Distribution of health personnel in the republic of South Africa with special reference to medical practitioners. S Afr Med J 1992, 82(4):260-263.
• [28]Gething PW, Noor AM, Gikandi PW, Ogara EAA, Hay SI, Nixon MS, Snow RW, Atkinson PM: Improving imperfect data from health management information systems in Africa using space-time geostatistics. PLoS Med 2006, 3(6):0825-0831.
• [29]Tobias PV, Apartheid and medical education: The training of black doctors in South Africa. Int J Health Serv 1983, 13(1):131-153.
• [30]Waters E, Rafter J, Douglas GP, Bwanali M, Jazayeri D, Fraser HSF: Experience implementing a point-of-care electronic medical record system for primary care in Malawi. In Proceedings of the 13th World Congress on Medical and Health Informatics, Volume 160. (Part 1). Cape Town: 96–100. Studies in Health Technology and Informatics, Volume 160 MEDINFO 2010 - Proceedings of the 13th World Congress on Medical Informatics, Pages 96-100 Experience Implementing a Point-of-Care Electronic Medical Record System for Primary Care in Malawi (978-1-60750-587-7:SHTI160-0096); 2010.
• [31]Mullan F, Frehywot S, Omaswa F, Buch E, Chen C, Greysen SR, Wassermann T, ElGaili Abubakr DE, Awases M, Boelen C, Isidore Diomande MJ, Dovlo D, Ferro J, Haileamlak A, Iputo J, Jacobs M, Koumaré AK, Mipando M, Monekosso GL, Olapade-Olaopa EO, Rugarabamu P, Sewankambo NK, Ross H, Ayas H, Chale SB, Cyprien S, Cohen J, Haile-Mariam T, Hamburger E, Jolley L, et al.: Medical schools in sub-Saharan Africa. Lancet 2011, 377(9771):1113-1121.
• [32]Botswana Health Professions Council 2013. Retrieved 24 April 2013, from [http://www.botswanamedical.org.bw webcite]
• [33]Ghana Medical and Dental Council 2013. Retrieved 24 April 2013, from [http://www.mdcghana.org webcite]
• [34]Medical Practitioners and Dentists Board of Kenya 2013. Retrieved 24 April 2013, from [http://www.medicalboard.co.ke webcite]
• [35]Medical Council of Malawi 2012. Retrieved 24 April 2013, from [http://medicalcouncilmw.org webcite]
• [36]Health Professions Council of Namibia 2013. Retrieved 24 April 2013, from [http://www.hpcna.com/form_factory.php webcite]
• [37]Medical and Dental council of Nigeria 2013. Retrieved 24 April 2013, from [http://www.mdcnigeria.org webcite]
• [38]Health Professions Council of South Africa 2013. Retrieved 24 April 2013, from [http://www.hpcsa.co.za webcite]
• [39]Medical Council of Tanganyika 2012. Retrieved 24 April 2013, from [http://www.maf.or.tz/files/MedRegApplicationForm.pdf webcite]
• [40]Uganda Medical & Dental Practitioners Council 2013. Retrieved 24 April 2013, from [http://www.umdpc.com webcite]
• [41]Medical Council of Zambia 2013. Retrieved 24 April 2013,from [http://www.hpcz.org.zm/ webcite]
• [42]Medical and Dental Practitioners Council of Zimbabwe 2013. Retrieved 24 April 2013, from [http://www.mdpcz.co.zw webcite]
• [43]Switchboard: Switchboard. 2013. Retrieved 29 April 2013, from: [http://www.switchboard.org/ webcite]
• [44]World Health Organization: Mhealth: New Horizons for Health Through Mobile Technologies. Geneva: World Health Organization; 2011.
• [45]Global health observatory data repository Retrieved 24 April 2013, from World Health Organization: [http://www.who.int/gho/health_workforce/physicians_density/en/ webcite]
• [46]iHRIS: iHRIS. 2013. Retrieved 24 April 2013, from iHRIS: [ http://www.ihris.org/ webcite]