AMCOA€¦ · Web viewQUALITY MANAGEMENT SYSTEM. SEE ATTACHED DOCUMENT GROUP 2 PLENARY REPORT. AMCOSA QUALITY MANAGEMENT SYSTEMS AND ENFORCEMENT TOOLS. Members present. Dr I Katjitae

2007 AMCOSA CONFERENCE REPORT

11 – 14 SEPTEMBER 2007

TRIANGLE HOTEL, JINJAUGANDA

12TH ANNUAL AMCOSA CONFERENCE11-14 SEPTEMBER 2007TRIANGLE HOTEL, JINJA

UGANDA

TABLE OF CONTENTS

1. CONFERENCE REPORT............................................................................................3-4

2. OPENING ADDRESS BY MINISTER OF STATE FOR HEALTH: UGANDA...........6-7

3. KEYNOTE ADDRESS BY PROF KHWA-OTSYULA...............................................9-11

4. MINUTES OF ANNUAL GENERAL MEETING......................................................13-20

5. PLENARY GROUP REPORTS

5.1 TERMS OF REFERENCE FOR GROUP SESSIONS ..........................................22-23

5.2 GROUP 1: PROMOTION OF QUALITY MEDICAL EDUCATION.........................25-29

5.3 GROUP 2: QUALITY MANAGEMENT SYSTEM...................................................31-33

5.4 GROUP 3: PRACTICE PROTOCOLS................................................................35-37

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12TH ANNUAL AMCOSA CONFERENCE REPORT11-14 SEPTEMBER 2007

OPENING AND WELCOME

Prof John Ssali, Chairman of the Medical and Dental Practitioners Council of Uganda and President of AMCOSA extended a hearty welcome to the delegates of the 12 th Annual AMCOSA meeting. Special words of welcome were extended to delegates from the Medical Councils of Ghana, Nigeria, Rwanda and Sudan who had attended the AMCOSA conference for the first time and to the Medical, Dental and Pharmacy Council of Lesotho and Medical Council of Tanganyika who attended the AMCOSA conference after a long period of absence.

In his opening remarks, Prof John Ssali underlined the objectives of AMCOSA as to create a platform for the representatives of medical regulatory authorities in the Region to share views and exchange information on matters of common concern, liaise with each other in regard to standards for registration of medical practitioners and where applicable, other healthcare personnel; promote liaison among member bodies in regard to the standards of education and training of health professionals registered with the respective medical councils, etc. He further mentioned that since its establishment in 1996, members of AMCOSA had been meeting annually to discuss means of ensuring an integrated process of medical regulation in the Region, standardisation/harmonisation of education and training, the enhancement of quality healthcare across the Region and standardisation of professional conduct management processes. He mentioned that AMCOSA had successfully completed protocols on Internship Training, Continuing Professional Development, Management of Impaired Physicians, Disciplinary Measures and Procedures and Information Exchange.

In his concluding remarks, Prof Ssali made mention of the fact that the success of regulatory work depended largely on strategic alliances with its political heads of Health in the Region as the latter set policy frameworks which ought to shape regulatory processes of medical councils. For this reason, AMCOSA had initiated the process of interaction with the SADC Health Desk for purposes of establishing links for greater and effective collaboration in the promotion of quality health in the Region.

Finally, Prof Ssali challenged the delegates to gear themselves up for two days of hard work to ensure the finalisation of protocols which were commenced with at the 2006 conference, namely Quality Management System, Promotion of Quality Medical Education and Practice Protocols.

Dr Richard Nduhura, Minister of State for Health in Uganda in his opening address underlined the importance of networking and information sharing among health regulatory bodies in the Region in order to improve healthcare delivery. He called upon AMCOSA to use its professional interactions to address issues such as the migration of health workers from the Region to the developed countries with a view to possibly prescribe appropriate measures aimed at reducing the rate of brain drain. He further underlined the need to develop a protocol aimed at strengthening the linkage between Research and Ethics Committees at various levels and the Medical Councils in order to adequately regulate medical research thereby eliminating unauthorised research on societal members without their consent as it had been observed in

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some countries within the Region. He then wished all delegates fruitful deliberations at the conference.

KEYNOTE ADDRESS BY PROFESSOR BO KHWA-OTSYULA, ON THE THEME: “TOWARDS A LEADING MEDICAL REGULATORY BODY FOR THE AMCOSA REGION”

Prof Otsyula presented a talk which challenged AMCOSA to strive towards achieving its goal of being a leading regulatory body in the Region. He defined a regulatory body as an organisation that exists to further a particular profession and protect both public interest and the interest of the professionals. He further underscored the structure and functions of regulatory bodies and the obligations thereof to the public.

The following was highlighted as essential elements of a “leading regulatory body:-

Sound legal framework; Clear defined standards; Responsiveness to changes in the environment; Independent funding; Stable (permanent) membership

Prof Otsyula indicated that it was not possible to attain a status of a leading regulatory body in the Region if countries had varied laws and political systems as the situation prevailed in AMCOSA; and thus challenged AMCOSA to gear itself up to address the situation through the harmonisation of standards, Code of Ethics and Conduct, Statutes/Acts, Regulation, Common Registers, and joint examination for postgraduate students.

GROUP SESSIONS

The conference was then split into three groups which were mandated to finalise the protocols which were commenced with in the 2006 conference, namely:-

1. Promotion of Quality Medical Education2. Quality Management System3. Practice Protocols

The reports of the various groups are enclosed herewith for each member country to work out implementation mechanisms and report to AMCOSA through the Secretariat by end February 2008.

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2007 AMCOSA CONFERENCE

ASSOCIATION OF MEDICAL COUNCILS OF SOUTHERN AFRICA

OPENING ADDRESS BY THE MINISTER OF STATE FOR HEALTH: UGANDA

DR RICHARD NDUHURA

SEE ATTACHED DOCUMENT

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AMCOSA 2007 CONFERENCE, Hotel Triangle, Jinja, on 12/09/2007

OPENING SPEECH BY UGANDA MINISTER OF STATE FOR HEALTH

Hon. Dr. Richard Nduhura

The President of AMCOSADelegates from the Eastern and Southern AfricaInvited guestsLadies and Gentlemen.

On behalf of the Ministry of Health of the Republic of Uganda, it is with great pleasure that I wish to welcome you all to this conference. I also wish to thank AMCOSA members for having selected our country to host this important conference this year. I am sure that it may be the first time for some of you to visit Uganda. You are welcome to the Pearl of Africa. Please feel at home. Karibu saana;

We appreciate this type of networking among health regulatory bodies in the region because it will result in improved health care delivery in our countries through information sharing, harmonization of various regulatory processes and information dissemination on practitioners who are involved in malpractice. As regulators, you are a powerful force to cause change; a change for the better, and this means a healthier population.

During this conference, or in future ones, I wish you could get time and focus on the following critical issues, which afflict our region:

1. Brain drain

The migration of health workers from our countries to the developed world is a matter of great concern in the region. We are investing heavily in training these indispensable cadres of staff, but we are harvesting little! I am aware that young doctors and nurses are leaving our countries for greener pastures in developed countries at a fast rate that is out of step with the prevailing socio-economic situation. It costs the governments in our region a lot of money to train a doctor for 5-7 years, to train a pharmacist for 4-5 years, to train a nurse for 3-4 years, to train a midwife for 3-4 years and to train a clinical officer for 3 years. According to the State of the World Health Report for 2006, about 300 Ugandan doctors and nurses are working abroad. Yet, these are the frontline workers not only in the provision of primary health care services that are on high demand, but also at higher levels of health care.

As regulatory bodies, you need to discuss this and prescribe appropriate measures to the decision-makers so that the rate of brain drain is stemmed as soon as possible.

2. Research and ethics

The primary purpose of medical research involving human subjects is to improve prophylactic, diagnostic and therapeutic procedures and the understanding of the aetiology and pathogenesis of disease (World Medical Association’s Helsinki Declaration, 1964) Our region is endowed with rich clinical material for medical research, particularly in HIV/AIDS, malaria and other tropical diseases. As a result, there is a tendency for some people, especially from outside the region, to evade the established ethics committees and carry out unauthorized research on our people without their consent and other norms pertaining to acceptable legal, ethical and regulatory requirements for carrying out medical research.

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There is need therefore to develop a protocol that will strengthen the necessary linkage between Research and Ethics Committees at various levels and the Medical Councils so that medical research is adequately regulated. I believe that, through the existing network, you should be able to share information about the violators of these requirements so that they are isolated from the region.

3. Regulation of complementary practices

Besides the formal health professions of medical doctors and dentists, nurses and midwives, pharmacists as well as allied health workers, other categories of complementary practitioners have emerged in the recent past. These include, but are not limited to, practitioners of acupuncture, acupressure, homoeopathy, optometry, audiometry, reflexology and ayurvedics. These are practitioners who are recognized, not only in the countries of their training, but also in several countries of the world.

It is necessary that you compare experiences and develop a protocol on how these practitioners can be regulated in the region.

Mr. President, colleagues, ladies and gentlemen, I wish to advise that, outside this room, please take some time to relax and visit some of our scenic places and enjoy the hospitality that Uganda can offer. I would not like to discuss what awaits you at this juncture, but rather say that do not miss this lifetime opportunity.

I have the greatest pleasure to declare this AMCOSA 2007 conference officially open.

For God and my country.

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KEYNOTE ADDRESS BY PROF BO KHWA-OTSYULA:“TOWARDS A LEADING MEDICAL REGULATORY BODY FOR

THE AMCOSA REGION”


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TOWARDS A LEADING MEDICAL REGULATORY BODY FOR THE AMCOSA

REGION

Prof. B.O. Khwa-OtsyulaJinja

12-09-07Topic “Towards a Leading Regulatory Body for the AMCOSA Region” to touch

on:- Robust regulatory frameworks; Ethical and professional behaviour; Measures that Regulatory Bodies need to put in place in order to advance public protection

Definition● A regulatory body is an organization, usually non-profit, that exists to further a particular

profession and protect both public interest and the interest of the professionals.

Structure● Membership is normally limited to the professionals

● Membership may be drawn from regulatory bodies of professionals working in the same sector

● Regulatory Bodies are normally headed by a Board or Council consisting of either professionals only or both professionals and representatives of the public.

● Regulatory Bodies are usually funded by members or government

Establishment• By constitution, Act of Parliament, Treaty, or in rare cases Voluntary Association

define the purpose

● Starting 4th century BC Hippocratic Oath guided the profession specifically dealing with: Relationship between doctors Public interest – safety, confidentiality Ethics – including corruption Discipline

● General Medical Council of UK, established in 1858 by Act of Parliament, is the legal authority and gives power to protect, promote and maintain the health and safety of the public

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Establishment Cont● April 26th 2002: East African Ministers of Health signed a joint communiqué to establish “Health

regulation and standards framework”

Functions Affected by law, knowledge, technology and new way of thinking ● Establish standards and ensure consistent compliance and improvement

training Qualification and credentials for registration and licensing good medical practice Continuing professional development

● Code of ethics Consent Confidentiality Relationship with colleagues

• Sharing knowledge• Consulting• Praising one self• Derogating colleague

Human rights Conflict of interest

● Conduct or behavior Abuse of professional privileges or skill

• Medical certificates• Prescribing drugs• Abuse of professional confidence• Abuse of relationship with patients• Abuse of financial opportunities

Disregard of personal responsibilities to patients• Gross neglect in diagnosis, treatment or care• Associating with unregistered persons

Conduct derogatory to the reputation of the profession Improper attempt to profit Advertising and canvassing Corruption

● Discipline● Maintain own privileged and powerful position● Changing areas include termination of pregnancy and euthanasia

Public protection● A clear statement on functions and adhering to the same

● Establishment of quality assurance

● Minimise conflict between protection of interest of the public and protection of interest of the professional to avoid accusation such as being “secretive, tolerant of sub-standard practice and dominated by professional interest, rather than that of the patient”

● Publication of the register

● Education of patients on their rights● Compulsory indemnity

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● Working closely with other regulatory bodies in healthcare

A leading Regulatory Body● Required

Sound legal framework Clear defined standards Respond to changes in the environment Independent funding Stable (permanent) membership

● It is not possible to achieve this in countries with varied laws and political system as we have in the AMCOSA region

• What can be done Harmonization of independent national bodies

Standards Code of Ethics and Conduct Statutes/Acts Regulation Common register Joint examination for postgraduate

Establish a secretariat by voluntary association

Thank You

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ANNUAL GENERAL MEETING

MINUTES OF THE 12TH ANNUAL GENERAL MEETING


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MINUTES OF THE 12TH ANNUAL GENERAL MEETING OF THEASSOCIATION OF MEDICAL COUNCILS OF SOUTHERN AFRICA [AMCOSA]

HELD ON 13 SEPTEMBER 2007 AT TRIANGLE HOTEL, JINJA, UGANDA

1. OPENING AND WELCOME

The President, Prof John Ssali welcomed all members present and declared the meeting opened.

A special word of welcome was extended to the representatives of the following Medical Councils who attended the Annual General Meeting as Observers:-

Medical Council of GhanaMedical Council of NigeriaMedical Council of RwandaMedical Council of Sudan

IN ATTENDANCE

NOTED that in terms of Section 3(b) of the Constitution of AMCOSA attendance of the Annual General Meeting was limited to two [2] representatives per member council / board being the Chairman/President and Registrar/CEO or nominated representative/s in their absence, one [1] of whom was to be a voting delegate.

In line with this provision of the Constitution of AMCOSA, the following members participated in the Annual General Meeting of 2007:-

Dr E Nyaim Opot Medical Practitioners and Dentists Board of KenyaMr D Yumbya Medical Practitioners and Dentists Board of KenyaProf J Ssali Medical and Dental Practitioners Council of UgandaDr J Ndiku Medical and Dental Practitioners Council of UgandaDr C Majinge Medical Council of TanganyikaMr CS Kyuki Medical Council of TanganyikaProf LM Moja Health Professions Council of South AfricaAdv. BM Mkhize Health Professions Council of South AfricaDr P Makurira Medical and Dental Practitioners Council of ZimbabweMrs J Mwakutuya Medical and Dental Practitioners Council of ZimbabweDr G Chiudzu Medical Council of MalawiMr P Msakambewa Medical Council of MalawiDr I Katjitae Health Professions Council of NamibiaMs E Barlow Health Professions Council of NamibiaDr M Mokete Medical, Dental and Pharmacy Council of LesothoMs M Ramathebane Medical, Dental and Pharmacy Council of LesothoDr MM Zulu Medical Council of ZambiaDr D Beeharry Dental Council of MauritiusDr R Goordoyal Medical Council of MauritiusDr K Deepchand Medical Council of Mauritius

The following were present at the meeting as observers:

Prof B Otsyula Medical Practitioners and Dentists Board of KenyaDr J Nyaumah Medical Practitioners and Dentists Board of KenyaDr S Ndege Medical Practitioners and Dentists Board of KenyaDr E Ndobe Medical, Dental and Pharmacy Council of LesothoDr F Oshoba Medical Council of Nigeria

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Dr J Sebeza Medical Council of RwandaDr A Nyakayiro Medical Council of RwandaProf A Musa Medical Council of SudanDr R Kigdye Medical Council of TanganyikaProf BS Lembariti Medical Council of TanganyikaDr DM Mtasiwa Medical Council of TanganyikaProf C Ndugwa Medical and Dental Practitioners Council of UgandaProf M Kawuma Medical and Dental Practitioners Council of UgandaDr S Zaramba Medical and Dental Practitioners Council of UgandaDr B Kiwanuka Medical and Dental Practitioners Council of UgandaDr A Twinamasiko Medical and Dental Practitioners Council of UgandaDr L Muwazi Medical and Dental Practitioners Council of UgandaDr A Kangwende Medical and Dental Practitioners Council of ZimbabweProf I Gangaidzo Medical and Dental Practitioners Council of ZimbabweDr F Chiwora Medical and Dental Practitioners Council of Zimbabwe

2. APOLOGIES

NOTED apologies from:-

Mrs D Ntsaba Registrar: Medical, Dental and Pharmacy Council of Lesotho

Dr N Padayachee President: Health Professions Council of South Africa

Prof MR de Villiers Vice Chairperson: Medical and Dental Professions Board, Health Professions Council of South Africa and member of the Management Committee of AMCOSA

Mr P Luena Registrar: Medical Council of Tanganyika

Dr S Magagula Registrar: Medical and Dental Council of Swaziland

3. NOTICE OF THE MEETING

NOTED that the notice convening the 12th Annual General Meeting of AMCOSA had been duly circulated to all members and was taken as read.

4. CONFIRMATION OF A QUORUM

The Secretariat confirmed that the members present at the meeting constituted a quorum in line with Section 3(c) of the Constitution of AMCOSA which stated that a quorum at a meeting shall consist of 50 % of compliant member Councils/Boards.

5. PERSONALIA / ANNOUNCEMENTS

NOTED that the following Councils had expressed an interest in AMCOSA and had sent representatives to the 2007 AMCOSA conference which took place between the 11th and 13th

September 2007 who were also in attendance at the Annual General Meeting:-

Ghana Medical Council represented by the Registrar, Dr E AtikpuiNigeria Medical Council represented by the Registrar, Dr F OshobaRwanda Medical Council represented by Council members, viz. Drs Sebeza & Nyakayiro

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Sudan Medical Council represented by the President, Prof. A Musa

6. MATTERS FOR DISCUSSION UNDER “OTHER COMPETENT BUSINESS”

NOTED that the following items were added for discussion under the item other competent business:-

(i) Reinstatement of the Medical Council of Tanganyika (ii) Acceptance of Rwanda Medical Council to AMCOSA(iii) Change of name of AMCOSA(iv) Power to accept members: Management Committee

7. ORDER OF BUSINESS AND DEBATE

NOTED that the following items would be brought forward in order to enable the members of the respective Councils to participate at the AGM of 2007:-

(i) Reinstatement of the Medical Council of Tanganyika(ii) Acceptance of Rwanda Medical Council to AMCOSA

8. MINUTES OF THE 11TH ANNUAL GENERAL MEETING OF AMCOSA

8.1 MATTERS FOR CORRECTION / AMENDMENT

NOTED that there were no corrections and/or amendments to be effected on the minutes of the 11th Annual General Meeting of AMCOSA.

8.2 ADOPTION OF THE MINUTES

NOTED that the Minutes of the 11th Annual General Meeting of AMCOSA were adopted as a true reflection of the proceedings of the meeting.

PROPOSER : Dr K Deepchand, Medical Council of Mauritius

SECONDER : Dr P Makurira, Medical & Dental Practitioners Council of Zimbabwe

8.3 MATTERS ARISING FROM THE MINUTES OF THE PREVIOUS MEETING

8.3.1 AMCOSA WEBSITE

NOTED that in September 2006, the Annual General Meeting of AMCOSA had received a report from the Secretariat on unsuccessful attempts that had been made to obtain assistance for the establishment of a website owing to funding challenges.

FURTHER NOTED that the Secretariat had approached the General Medical Council with a request that AMCOSA be hosted on the General Medical Council’s website until such time as AMCOSA was able to establish its own website.

RESOLVED(i) that since the financial position of AMCOSA was improving, the

Management Committee be requested to once again explore the

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possibility of AMCOSA establishing its own website and the financial implications thereof;

(ii) that each member country be requested to commit itself to contribute financially to the development of the AMCOSA website over and above the annual subscription fees.

8.3.2 NON-ATTENDANCE OF AMCOSA: SUSPENSION OF MEMBERS

NOTED that the following members were suspended from membership at the 2006 Annual General Meeting for failure to pay their annual membership fees:-

Medical and Dental Council of SeychellesMedical, Dental and Pharmacy Council of LesothoHealth Professions Council of BotswanaConsel National De L’orde Des Medecins De MadagascarMedical Council of Tanganyika [Tanzania]

FURTHER NOTED that subsequent to the Annual General Meeting’s resolution to suspend these members, the Lesotho Medical, Dental and Pharmacy Council settled its total outstanding membership fees and was reinstated to membership by the Management Committee of AMCOSA in November 2006.

FURTHER NOTED that an amount of US $13 800 in respect of outstanding membership fees for Botswana, Madagascar, Tanzania and Seychelles had been written off in August 2007 on the recommendation of the auditors and approval of the Management Committee with the proviso that these members would be liable for their respective debt upon reinstatement of their membership.

RESOLVED:-

(i) to ratify the Management Committee’s decision to reinstate the Lesotho Medical, Dental and Pharmacy Council back to membership of AMCOSA with effect from November 2006;

(ii) to ratify the Management Committee’s decision to write off an amount of US $ 13 800 in respect of outstanding membership fees for Botswana, Madagascar, Tanzania and Seychelles with the proviso that the members remain liable to AMCOSA for their respective debts upon reinstatement of their membership.

8.3.3 INTERACTIONS WITH SADC

NOTED that the SADC Health Desk had extended an invitation to AMCOSA to attend the Conference of SADC Health Ministers between the 13 and 16 November 2006 in Namibia, which conference was attended by the Secretariat and a representative of the management Committee of AMCOSA, Dr Katjitae. NOTED FURTHER that due to an oversight on the part of the SADC Health Desk Secretariat with regard to the observation of certain protocol where invitations to Observers at the meeting of the SADC Health Ministers was concerned, AMCOSA was not able to present at the meeting as had been envisaged, however AMCOSA’s presence at the meeting created a platform for recognition of the structure.

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FURTHER NOTED that the Secretariat had put a process in place to continually engage with the SADC Health Desk and that the draft Memorandum of Understanding between AMCOSA and the SADC Health Desk which was approved by the Annual General Meeting of AMCOSA in September 2006 had been submitted to the SADC Health Desk for their input which was still awaited.

RESOLVEDto request the Secretariat to engage structures such as the East African Community of Health Ministers with a view to formally introducing AMCOSA and identifying possible areas of collaboration; and to also identify other structures with which AMCOSA should possibly establish links and accordingly engage them.

NEW MATTERS

9. REINSTATEMENT OF THE MEDICAL COUNCIL OF TANGANYIKA

NOTED that the Medical Council of Tanganyika had expressed its desire to have its membership reinstated and to actively participate in all activities of AMCOSA as expected of all members.

FURTHER NOTED that the Medical Council of Tanganyika was prepared to settle its outstanding membership fees of US$ 3 300 over a period of time which would be agreed to between the Medical Council of Tanganyika and AMCOSA.

RESOLVEDto reinstate the Medical Council of Tanganyika to AMCOSA membership and to request the Management Committee of AMCOSA to structure favourable arrangements for the Medical Council of Tanganyika to repay its outstanding membership fees.

10. ACCEPTANCE OF RWANDA MEDICAL COUNCIL TO AMCOSA

NOTED that the Medical Council of Rwanda had expressed interest in AMCOSA and was desirous to become a member of AMCOSA in the furtherance and pursuit of its objectives.

RESOLVEDto accept the Rwanda Medical Council into the membership of AMCOSA with effect from 13 September 2007.

11. CHAIRMAN’S REPORT 2006/7

NOTED that the item was removed from the agenda and would be tabled at the 2008 Annual General Meeting when the term of the current Chairman would lapse.

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12. MATTERS PERTAINING TO FINANCIAL ASPECTS

12.1 AUDITED FINANCIAL STATEMENTS 2006/7

NOTED the Audited Financial Statements for the 2006/7 financial year and the additional notes thereto as submitted and presented by the Secretariat.

FURTHER NOTED that the financial position of AMCOSA had changed significantly since the previous financial year as could be noted from the report of the Auditors who had expressed a favourable audit opinion; and given that a surplus had been realised in the 2006/7 financial year which was indicative of a shift towards a stable financial environment for AMCOSA.

RESOLVED (i) that the Audited Financial Statements 2006/7 be adopted;

(ii) to congratulate the Secretariat on its sound management of AMCOSA’s financial affairs; and

(iii) to thank the Health Professions Council of South Africa for its continued support to AMCOSA particularly for agreeing to share the costs pertaining to travel and accommodation for the Secretariat.

12.2 CONFERENCE REGISTRATION FEES

NOTED that in an effort to stabilise the financial environment, the Management Committee resolved in July 2007 to levy a conference registration fee of US$ 300 per delegate for the 2007 conference based on the conference budget against the estimated number of conference delegates.

FURTHER NOTED that at the time of drawing up the 2007 conference budget, no clear indications had been received in terms of the costs that would be carried by the hosting country, and thus, the budget was inclusive of all costs pertaining to the logistical arrangements for the conference with the exception of airport transfers.

NOTED FURTHER that following the Management Committee’s consultation with the Uganda Medical and Dental Practitioners Council on 12 September 2007, it was resolved that all members be refunded their US$ 300 registration fees, and that the Uganda Medical and Dental Practitioners Council would carry all costs pertaining to the hire of the conference venue and facilities including meals. The Management Committee further recommended that non-members be refunded only US$ 100 of the registration fee per delegate.

NOTED FURTHER the Management Committee’s recommendation to the Annual General Meeting to consider its proposal of a registration fee for future conferences which registration fee would be determined based on a conference budget which would be submitted by the Secretariat and reviewed by the Management Committee on an annual basis.

RESOLVED(i) that for all annual conferences of AMCOSA, the hosting country would be

responsible for the following costs:-

Conference venue hire and facilities;

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Meals for the duration of the conference; Gala Dinner costs (entertainment, etc); Airport transfers

(ii) that a non-refundable conference registration fee of US$ 50 be levied for each attending delegate for all future conferences of AMCOSA with effect from the year 2008; and

(iii) that a hosting country be exempted from paying conference registration fees for their members given the financial burden that the hosting of the conference would have on such a member country.

(iv) that each delegate would be responsible for their accommodation costs.

13. MATTERS PERTAINING TO EXTERNAL LIAISON

13.1 REPORT ON THE 7TH CONFERENCE OF THE INTERNATIONAL ASSOCIATION OF MEDICAL REGULATORY AUTHORITIES [IAMRA]

NOTED the report on the 7th Conference of the International Association of Medical Regulatory Authorities [IAMRA] which was held between the 11th and 14th

November 2006 in New Zealand.

FURTHER NOTED that the Health Professions Council of South Africa would host the 8th Conference of IAMRA between the 6th and 9th October 2008 at the Cape Town International Convention Centre.

RESOLVEDto congratulate the Health Professions Council of South Africa for having been awarded the bid to host the IAMRA Conference and that as far as possible, all member countries would attend the IAMRA conference in Cape Town in the year 2008.

14. CHANGE OF NAME OF AMCOSA

NOTED that the name AMCOSA an acronym for Association of Medical Councils of Southern Africa was adopted by the founding members of the association based on the territory of the members as it then was. NOTED FURTHER that countries from other sub-regions of the African continent such as the Eastern and Western African regions had expressed a desire to participate or were already participating in AMCOSA as members;

FURTHER NOTEDthat AMCOSA was desirous to embrace member states from other regions of the African continent outside the Southern Africa Development Community and recognised that the name AMCOSA restricted or had a potential of restricting membership and/or to inaccurately describe the constituency of the participating regulatory bodies.

RESOLVEDthat the name Association of Medical Councils of Africa [AMCOA] be adopted with immediate effect to replace the name AMCOSA.

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FURTHER RESOLVED to accordingly amend the Constitution to reflect the change of name from AMCOSA [Association of Medical Councils of Southern Africa] to AMCOA [Association of Medical Councils of Africa].

15. POWER TO ACCEPT MEMBERS: MANAGEMENT COMMITTEE

RESOLVED to grant the Management Committee authority to accept into membership those states falling within the African continent who may express a desire to join AMCOA in-between the annual conferences of AMCOA provided that such states subscribe to the philosophy, objectives and principles of AMCOA.

16. VENUE OF NEXT MEETING

RESOLVED that the next meeting would be hosted by the Medical, Dental and Pharmacy Council of Lesotho.

FURTHER RESOLVED to request that the Secretariat in liaison with the Medical, Dental and Pharmacy Council of Lesotho be requested to structure the dates of the next meeting of AMCOA with due regard to the dates of the IAMRA conference in 2008.

17. CLOSURE

The Annual General Meeting extended its appreciation to the Secretariat for the efficiency with which it continued to support AMCOA.

The Annual General Meeting further extended its appreciation to the Medical and Dental Practitioners Council of Uganda for its hospitality.

There being no further business to discuss, the President of AMCOA, Prof John Ssali thanked all members for their contributions and declared the meeting officially closed at 12h45.

CONFIRMED : PROF JOHN SSALIPRESIDENT

SIGNED : ___________________

DATE : ___________________

/qcm

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PLENARY GROUP REPORTS


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TERMS OF REFERENCE FOR GROUP SESSIONS

(i) PROMOTION OF QUALITY MEDICAL EDUCATION

(a) Identify current core competencies and outcomes for undergraduate training of medical practitioners in the Region;

(b) Analyse and review adequacy of these competencies/outcomes;

(c) Propose measures to plug the gaps between existing core competencies and the ideal standards with international benchmarks;

(d) Consider measures to enhance capacity in terms of Human Resources in the Region thereby enhancing access to quality healthcare;

(e) Consider the Regional health needs and practice requirements and propose a generic core curriculum for undergraduate medical degrees in context.

ABOVE COVERED IN PART AT THE 2006 CONFERENCE. STILL NEED TO ADDRESS THE FOLLOWING:-

KNOWLEDGE

- Basic science (core elements)- Clinical science (core elements)- Legal / Regulatory Framework (core elements)- Medical ethics & Human Rights (core elements)

Formulate key outcomes in terms of which institutions will formulate and measure their own curricula for compliance with the set standards by Boards/Councils;

Over and above the knowledge set, propose modules on social skills including communication, financial management and social relations;

Review current accreditation processes in member countries and make proposals for plugging gaps with a view to accrediting both the institution and the qualification;

Review incentive models and make necessary proposals for improvement of same.

(ii) QUALITY MANAGEMENT SYSTEM

(a) Identify quality of healthcare concerns and causes in the Region;

(b) Identify adequacy of current quality measurement and enforcement tools;

(c) Make recommendations on total quality management approach, quality measures and quality enforcement tools.


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Assess current levels of and establish mechanisms for revalidation of all health professionals and propose requirements and regularity for such revalidation;

Assess current capacity requirements for health professionals and recommend practical strategies for deployment of staff, e.g. how do we introduce and manage community service throughout;

Assess member countries’ CPD programs and their adequacy;

Each member country to engage its political heads on budget allocation for infrastructure and human capital development and deployment

(iii) PRACTICE PROTOCOLS

(a) Identify various fields of practice as well as disease profiles in the Region;

(b) Establish whether practice protocols and/or disease management profiles exist and if so whether they are adequate;

(c) Consolidate existing and formulate new practice protocols for the Region.


Collate protocols from all member countries;

Analyse protocols and create synergies;

Recommend draft protocols in terms of minimum standards for the Region.

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GROUP 1:PROMOTION OF QUALITY MEDICAL EDUCATION


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GROUP 1 PLENARY REPORT10th AMCOSA meeting Livingstone Lusaka 12th -15th September 2006

Topic

Promotion of Quality Medical EducationComposition- Initial Members

Chairman Dr P S Makurira Zimbabwe

Rappoteur Dr K Bowa Zambia

Member Ms E Mwape Zambia Prof M. de Villius RSA Prof M H Moola RSA Mr R Moyo Malawi Dr D Beeharry Mauritius

MEMBERS – New [2007 GROUP]

Name COUNTRY E mail• Dr Mary M. Zulu Zambia [email protected]• Prof. Barasa Otsyula Kenya [email protected]• Prof A/Rahman Musa Sudan [email protected]• Prof. B.S. Lembariti Tanzania [email protected]• Dr. Dhaneshwar Beeharry Mauritius [email protected]• Mr. Pongolani Msakambewa Malawi [email protected]• Dr. Alexis Nyakayiro Rwanda [email protected]• Prof Thanyani Mariba South Africa [email protected]• Dr. Keshaw Deepchand Mauritius [email protected]• Dr. John R. Nyaumah Kenya [email protected]• Dr. Musi Mokete Lesotho [email protected]• Dr. Louis Muwazi Uganda [email protected]• Dr. Phenius Makurira Zimbabwe [email protected]

Approach1. Generic Template (What ?)

2. Applied it regional set up

3. Recommendations

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mailto:[email protected]













Terms of Reference• Current core competencies

• Review adequacy

• Propose changes

• Improve Human Resource capacity

• Propose a core course

GENERIC TEMPLATESTRUCTURES

PRINCIPLES

PROCESS

OUTCOMESTRUCTURES

1.Institution- physical infrastructure, staff ratios, student bed ratios MC liaison accreditation institutions. Noted the importance of this in training but is dependent on other factors e. g type of hospital and other facilities

2.Selection- (justifying an entry qualification to reduce attrition) –bridging gap. Age is not critical .Harmonization

3.Patient mix. Adequate numbers of patient. Teaching platform with multiple facilities

4.Research & Service. Community interaction (involvement) Mission statement capture 3 (education, research and services) Noted concern of researchers from outside who disregard the local Research and Ethics Committees. There is a need to work together to isolate them.

PRINCIPLES• VISION STATEMENT

• MISSION STATEMENT (competence and community focus) Member countries are free to choose their own Vision and Mission but should be in line with the

general objective.

• GOVERNANCE ISSUES

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OVERALL OBJECTIVE

“To produce a caring, ethical, competent, knowledgeable, life long learner graduate. With appropriate skills and attitudes to meet the health challenges of the region within the current cultural context”

PROCESSPROCESS

1.Methods (defn eg student centred, integrated, problem based etc1.Methods (defn eg student centred, integrated, problem based etc Community based education should be encouraged and start as early as possibleCommunity based education should be encouraged and start as early as possible

2.Student Numbers (more labour intensive e.g. problem based)2.Student Numbers (more labour intensive e.g. problem based)

3.Course Content (Modular describers eg-credit 120. Comparable and specific)3.Course Content (Modular describers eg-credit 120. Comparable and specific)4. Quality Assurance4. Quality Assurance

OUTCOME1.Knowledge basic science, clinical science ,cultural context, legal and regulator framework,

applied sciences ,medical ethics, research and local problems & challenges.

2.Attitude caring, compassion ,empathy, patient centered & good communicators 3.Skills & Competencies communications, clinical skills (history, examination & diagnosis) ,

emergency for life threatening skills

TERMS OF REFERENCEDIRECT RESPONSES

ADEQUACY Students need to learn surgical skills limited in UG. (C/S life saving ) Teaching in provincial

sites. Should be able to certify death. Other competencies which are needed should be mentioned Administrative, computer and management skills. These are the main litigation problems.

RECOMMENDATIONS1.Clear Curriculum (selection, patient mix , cultural context, communication skills etc)

2.Accreditation of institution as well as qualification

3.Regional/ international bench marks– regional accreditation by AMCOSA– regional /international exchange/exposure students/lecturer– regional & international harmonization

HUMAN RESOURCE CAPACITY

1. Proposed market related wage which is regional.

– Provide proper incentive ( public service – duty free tax) eg Mauritius , Tanzania, Kenya. Removal of business tax on clinics

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– Community service for health providers since health education subsidizes post graduate services. (this should be legislated for). (Enforce community service to enhance PG training) eg culture of learning. In-service training 8 days in a year.

4. Human Resources (Training the trainers). High value/ recognition on medical/health manpower. Expenditure health care 15% Abuja

URGENT NEEDS

– Tropical diseases infectious disease (Malaria, TB & HIV) Maternal mortality and child

– Traditional and western medicine synergy

– Challenges in ways herbal medicine is being place in the public domain.

4. Human resources crisis in the Health Care Sector (push & pull factors)

Next Steps• Articulate and elaborate on each of the core competencies, skills and knowledge to be

acquired by practitioners as depicted in the following slide, with an emphasis on articulating what each component should include as a bare minimum

• Knowledge- Basic Science

- Clinical Science - Legal/Regulatory Framework

- Medical ethics & Human Rights - Public Health

Basic Sciences

• Anatomy

• Biochemistry

• Physiology

• Pharmacology

• Pathology

• Microbiology

Other Foundation Course

• Ethics and Human Rights

• Communication skills

• Medical Sociology and Psychology

• Primary Health care/Public Health

• ICT

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• Management skills and leadership skills

• Financial Management skills

Clinical Sciences• Internal Medicine

• Obstetrics and Gynaecology

• Surgery and Surgical Specialties

• Mental health/Psychiatry

• Anaesthesiology

• Peadiatrics

• Family medicine/General practice

• Forensic medicine

Legal/Regulatory Framework

• Various Laws, Acts and legislations governing the practice of professional councils /boards

• Ethics and Code of Conduct

• Human Rights

Next Steps• Formulate key outcomes in terms of which institutions will formulate and measure their own

curricula for compliance with the set standards by Boards/Councils – Councils/Boards to set standards which the institutions should comply with. Training institutions to conduct self assessment and the Board/Councils to cross check/verify. Check on physical, financial and human resource, curriculum and other Quality Assurance issues

• Over and above the knowledge set, modules could be proposed on social skills including

communication, financial management and social relations

• Review current accreditation processes in member countries and make proposals for plugging gaps with a view to accrediting both the institution and the qualification. Members lacking expertise should co-opt or seek assistance from experienced member Councils/Boards

• Review incentive models and make necessary proposals for improvement of same. Recommend to governments of member countries to take measures to minimize the brain drain or retain medical personnel.

Key Points

• The regulatory role in training by some Councils/Boards is lacking in their Acts/legislations – We recommend amendments to the documents.

• The document is not prescriptive but a framework.

• Challenge to some Councils/Boards who have no medical school to register doctors trained elsewhere. – Use the WHO register to verify the schools or seek advise from AMCOSA members.

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GROUP 2:QUALITY MANAGEMENT SYSTEM


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GROUP 2 PLENARY REPORTAMCOSA QUALITY MANAGEMENT SYSTEMS AND ENFORCEMENT

TOOLS

Members presentDr I Katjitae Namibia [Convenor]Dr F Chiwora ZimbabweDr A Twinamasiko UgandaDr R Kigadye TanzaniaPof J SSali UgandaMrs M Ramathebane LesothoDr. S. Ndege KenyaMrs. E. Barlow NamibiaMrs. J. Mwakutuya ZimbabweProf L. Moja South AfricaDr. G. Chiudzu MalawiDr. Festus Oshoba NigeriaDr B Kiwanuka Uganda

PreambleOur group was tasked to look at issues that affect quality management systems and to develop AMCOSA Policy frameworks for implementation by countries where applicable. We acknowledge the work that has been done by the predecessor committee on QMS comprised of Dr. Katjitae, Prof. Mariba, Dr. Chiudzu, Dr. Waghaiyu, Dr. Munalula, and Prof. Ssali and Mrs. E. Barlow from which this document has been further developed. The group agreed to look at topical issues and come up with a framework on protocols on Quality Management Systems.

Some of the components of Quality Management Systems

1. Resources2. Infrastructure3. Political factors4. Budget5. Consumables6. Communication

Inadequate human resources

Target variables that affect the issue of Human Resources: Production, Distribution and Retention of heath professionals (HPs)

Plan of ActionCreation of Medical Training Institutions:

The relevant bodies to develop guidelines for establishment of medical schools and internship training centres

Optimal use of existing training capacity within country and where necessary, establish more health training institutions that meet the minimum requirements.

AMCOSA to support the development of capacity for specialist training and enhance the collaboration within the region.

In collaboration with relevant stakeholders, have preferential treatment of interested students from neglected areas of the country. e.g. enrolment quarters.

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AMCOSA to encourage the introduction of remunerable Compulsory Service (COMSEV) through legislation as a way of addressing the mal-distribution of the professionals.

AMCOSA to develop guidelines for accreditation of health training institutions. These guidelines should be used for benchmarking. Use existing frameworks that exist in South Africa, Nigeria.

Advocate for the political support to create incentives that motivate retention of health professionals including appropriate/adequate remuneration. This can be done through the adoption of a minimum medical salary scale and creation of an autonomous services commission

To address the brain drain, developed countries which are benefiting from the brain drain should be persuaded to invest in training more people in the affected countries. This should be done through regional bodies and Africa Union where AMCOSA to strongly recommend to Ministers of Health in Africa.

AMCOSA to encourage public-private partnership in the health sector for both training and improved remuneration.

RevalidationPlan of action

Target variables that affect competences

Implementation, monitoring, CPD Policy harmonization with AMCOSA. Mutual recognition within the region of CPD accreditation by regulatory bodies Establishing common protocols and guidelines on standards of practice and code of

ethics. Encourage councils to conduct regular performance targeted inspections to health facilities

and practices.

BudgetPlan of action:

AMCOSA encourage Councils to develop a framework that creates a budget line for QMS. AMCOSA recommends/motivates governments to fund regulatory bodies. by engaging Political Heads in allocation of funds that will promote QMS. Sensitize government on collaboration and liaison with relevant stake holders in the

planning of health issues on the optimal use available resources Councils to set realistic budget to meet the objectives as laid down in the legislation. They

should set priorities that can be realised given the budget. Explore all possible avenues to levy a percentage of fee from imports on medical

commodities to fund regulatory bodies.InfrastructurePlan of action

AMCOSA should come up with infrastructure standards that are maintained at all levels of health service delivery. – Review existing country standard documents and harmonise the standards to come out with minimum requirements. Borrow from some countries with minimum requirements like Zimbabwe, Tanzania, South Africa, Malawi, Namibia and Uganda.

Highlight interdepartmental cooperation between different government departments and other stakeholders including communication (roads and IT), Utilities and equipments.

Political FactorsPlan of action

AMCOSA has no direct influence on some of the issues. Example, the stability of the economy is not within the control of the AMCOSA In this case the AMCOSA can advocate

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It is the responsibility of the governments to provide for the health of its people. In this case, encourage governments to prioritise its activities and try to provide the recommended Abuja declaration of 15% of its national budget for health. Sensitize the people to know their health rights and that this is the role of the government. AMCOSA should promote public health rights.

AMCOSA should review and harmonize the prevailing/existing regulatory legislation to promote autonomy

In some countries that are not self sustaining in their funding, the Government should provide an enabling environment including budgetary allocation to enable councils run its activities.

ConsumablesPlan of action

Regular updates of essential drugs and supplies list. Ministries of Health to provide adequate funds for drugs and supplies Ministries of Health to ensure efficient procurement and distribution of quality

consumables.

CommunicationsPlan of action

AMCOSA encourages each council to develop a communication strategy with its stakeholders.

Councils should promote the dissemination of bulletins and articles as a way of communicating relevant issues with its stakeholders.

The Ministries of Health be encouraged to develop clear lines of consultations to include all stakeholders and specifically professionals when developing policy issues.

AMCOSA encourages councils to open up channels of communication with all stakeholders to maximise dissemination of information.

Make use of existing individual council websites and create relevant links. Recommend that AMCOSA should develop its own website for its stakeholders.

Thank you

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GROUP 3:PRACTICE PROTOCOLS


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GROUP 3 PLENARY REPORT

PRACTICE PROTOCOLSVarious Fields of Practice

AMCOSA: 12/09/2007

Group Members• E. M. Opot (Kenya, in chair)• D. Yumbya (Kenya)• R. A. Kangwende (Zimbabwe)• C. Kyuki (Tanzania)• E. K. Atikpui (Ghana)• Prof. M. Kawuma (Uganda)• C. Majinge (Tanzania)• E. Ndobe (Lesotho) • C. Ndugwa (Uganda)• R. Goordoyal (Mauritius)

Disease Burden:Communicable Diseases

• HIV/AIDS and related opportunistic infections and diseases

• Malaria

• Tuberculosis and Pneumonia

• Diarrhoeal diseases

• Sexually Transmitted Infections (STIs).

• Haemorraghic viral diseases

• Infectious Hepatitis

• OthersDisease Burden:

Non-Communicable Diseases (1)• Diabetes

• Hypertension

• Injuries

• Rheumatic Heart Disease

• Cancers

• Bronchial Asthma

• Malnutrition

• Ischaemic Heart Disease

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Disease Burden:Non-Communicable Diseases (2)

• Sickle Cell Disease

• Arthritides

• Oral Diseases

• Obstetric emergencies

• Mental illness

• Eye Diseases

• Others

Disease Management Protocols• Management protocols exist in several member states, especially on communicable diseases.

– Some may not be formalized or implemented

• AMCOSA, through the individual regulatory bodies should lobby for the development of protocols in each member state.

– AMCOSA to get copies of the different protocols.

Guidelines• They are about the upholding of practitioners.

– Training – Qualifications– Licensing– Institutions where they practice– Accreditation and Registration– Continuous Professional Development (CPD)– Regulation of professional fees

Development of Guidelines• To be initiated and promoted by individual Health Regulatory Bodies.

• Make use of the clinical judgment and experience of the practitioners.

• Involvement of all stakeholders, e.g.– Professional associations– Senior practitioners

• Regular reviews and appraisals will be necessary.

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Practice Protocols• The national regulatory bodies should lobby or advocate for the development of protocols.

• Protocols should be simple, user-friendly, patient-care-oriented and implementable.

• National regulatory authorities to communicate the protocols to other member states through AMCOSA.

• AMCOSA to encourage member states to share their best practices.

Role of AMCOSA (1)• AMCOSA to collate protocols from all member states.

– Ministries of Health, Teaching Institutions, Medical Councils /Boards and Professional Associations.

• AMCOSA to then analyse the protocols, pick best practices & strong points, and create synergies.– AMCOSA should also identify similarities and disparities in the protocols, especially

between neighbouring states, and encourage them to discuss these & find common ground.

Role of AMCOSA (2)• AMCOSA will then draft the minimum standards of practice protocols based on shared best

practices .

• But individual member states may vary standards as per their individual country needs.

Role of AMCOSA (3)• AMCOSA to set minimum criteria for starting medical and allied health training schools.

– These must include criteria for admission of students into the medical schools.

• AMCOSA to also come up with criteria for audit of medicals school (i.e. a checklist to be used in inspection of medical schools in the Region).

• AMCOSA to develop an M & E system which includes exchange inspections of medical schools among member states.

Role of AMCOSA (4)• AMCOSA to establish a list of medical, pharmacy, dental and other training schools in the

Region.

– To ensure that these satisfy the minimum standards for the Region.

• With this AMCOSA can work towards the reciprocal recognition of our medical and dental training institutions in the Region.

THANK YOU!

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Documents

AMCOA€¦ · Web viewQUALITY MANAGEMENT SYSTEM. SEE ATTACHED DOCUMENT GROUP 2 PLENARY REPORT. AMCOSA QUALITY MANAGEMENT SYSTEMS AND ENFORCEMENT TOOLS. Members present. Dr I Katjitae