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Content Article
Confraternity of Patients Kenya (COFPAK)
Patient Safety Learning posted an article in International patient safety
The Confraternity of Patients Kenya (COFPAK) is a registered non-profit organisation, independent of politics or religion, supporting health and social well-being of the public in Kenya. Their mandate is to advance, represent, safeguard and promote the interests of healthcare services seekers at all levels. COFPAK aims to collaborate with all stakeholders in the health sector to advance access to high quality, safe, accountable, affordable and sustainable healthcare ecosystem in Kenya. It exerts influence on policies and programmes toward the attainment of Universal Health Coverage. -
News Article
‘Every chemist has a backroom’: the rise of secret FGM in Kenya
Patient Safety Learning posted a news article in News
In Kisii town, south-west Kenya, a rundown roadside building houses a pharmacy. Like many others in the area, the pharmacy doubles as a clinic. Lilian Kemunto (not her real name), a former surgical nurse, set it up after she retired in 2018. She mainly does health check-ups but has also offered female genital mutilation (FGM) services on request. Kemunto has performed cuts since the 90s, after receiving training in basic surgical techniques from male colleagues in the local hospital where she worked. She would do the cuts in the hospital at night, but it was risky, she says, because management didn’t approve. “They would tell us: ‘Just do it, but if you’re caught, you’re on your own.’” She preferred cutting girls in a private home, in the middle of the night, saying it was much easier: “By 6am, the girls are back in their own homes, like nothing happened.” In Kisii county, medicalisation is standard. Two out of three cases of cutting are performed by health practitioners, in contrast to much of the country, where 70% of FGM cases are performed by traditional practitioners. Kemunto says she tries to avoid mishaps, and at a minimum requires some anaesthesia, a surgical blade, sterile towels, and cleaning solution to proceed. She also claims to use a non-invasive procedure: a small incision of the clitoris that practitioners call a “signature”. Kisii’s FGM practice is considered less severe than other areas, and anti-FGM campaigners are concerned that there’s a growing acceptance of the practice as more safe, hygienic and cosmetic. FGM rates in Kenya have gone down significantly over the past decade. The country passed strong laws in 2011, imposed hefty fines on practitioners, and stepped up surveillance and enforcement. But medicalisation is posing a new challenge for the east African nation, which has a 15% medicalisation rate: one of the highest in Africa. Earlier this month, Kenyan president William Ruto backed the country’s chief justice who said that FGM “should not be a conversation we are having in Kenya in the 21st century”, and reiterated his administration’s commitment to eradicating the practice. Read full story Source: The Guardian, 15 December 2022- Posted
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Content ArticleHealth systems in low and middle income countries (LMIC) are increasingly pluralistic, involving a wide mix of public, not-for-profit and for-profit providers. Regulation should be a key foundation of the Government's stewardship role of these heterogeneous facilities, but performance of this function is generally weak, with serious consequence for patient safety and quality of care. There has been little evaluation of strategies to strengthen regulation in LMIC, a notable exception being the Kenya Patient Safety Impact Evaluation (KePSIE), a collaboration between the Kenyan Ministry of Health and the World Bank. This randomised controlled trial is assessing the impact of a set of innovative regulatory interventions in public and private facilities in three Kenyan counties. These comprise the use of the Joint Health Inspections Checklist (JHIC), which synthesises the areas covered by all the regulatory Boards and Councils; increased inspection frequency; risk-based inspections where warnings, sanctions and time to re-inspection depend on inspection scores; and display of regulatory results outside facilities. The KePSIE trial will provide a rigorous quantitative assessment of these regulatory strategies. The results are expected to make an important contribution to the limited evidence base on regulation and regulatory reform. The findings will be of substantial benefit to those concerned with regulatory reform and the improvement of quality and safety more generally in Kenya and other LMIC settings.
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Content ArticleThere has been little evaluation of strategies to strengthen regulation in LMIC, a notable exception being the Kenya Patient Safety Impact Evaluation (KePSIE), a collaboration between the Kenyan Ministry of Health and the World Bank. KePSIE is one of the worlds largest trials on improving patient safety, testing at scale complementary approaches to protect patients and prevent disease outbreaks. KePSIE provides validated tools to measure patient safety and assess facility performance in resource-poor primary care settings across multiple domains; development of an inspection checklist in collaboration with the country and large-scale pilot of inspections using a professional cadre and globally relevant empirical evidence on the effectiveness of government inspections and consumer empowerment to ensure patient safety.
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Content ArticlePatient safety is a key goal of the WHO as a central component of high-quality health systems. Increasing efforts have been made to improve quality of care in low-resource settings but identifying harms and developing strategies to deliver safe care has been given less attention. Charles Vincent and colleagues describe a ‘portfolio’ approach to safety improvement in four broad categories: prioritising critical processes, improving the organisation of care, control of risks and enhancing responses to hazardous situations that they believe is relevant to low-resource settings. They consider how practitioners, especially those in low-resource setting hospitals, might employ these strategies and focus attention on the possible roles of practitioner groups and professional associations as key to advancing patient safety through collaboration and skill development in this field.
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Content ArticleThere is an overall dearth of information on implementation and compliance with patient safety standards in developing countries. In recognition of this, the World Bank Group’s Health in Africa Initiative, WHO and the PharmAccess Foundation came together with the ministries of health to conduct an assessment of patient safety at Kenyan health facilities. The study is the first nationwide assessment of patient safety levels based on documented processes and levels of risk, and is meant to serve as a baseline against which future interventions can be measured.