In Kenya, in late 1960s, the first Medical Records Officer was employed by Ministry of Health. By 1970 there were only 2 qualified medical records staff in Kenyatta National Hospital. Through the 1970s collaboration between Kenya and the UK, many Kenyans received scholarships to study medical records in Britain and become registered by the Association of Medical Records Officers – United Kingdom (AMRO (UK)). The demand for registration of an association grew and in 1975, the Association of Medical Records Officers Kenya (AMRO-K) was established and registered under Cap 108 of Registration of Societies. Since then, the AMRO-K has remained an active member of the International Federation of Health Information Management Associations (IFHIMA).
The Association’s objectives for the Health Records and Information Management profession are:
- Develop guidelines and standards for professional practice.
- Promote universal growth in the profession in terms of numbers and recognizing quality training.
- Ensure availability of quality workforce for the management of health records, and health and related information systems within the health sector and beyond the borders.
- To enrol and renew memberships, retain, and maintain members in the professional practices.
In 1976, to further improve the professional establishment of Health Information Managers in Kenya, there was a collaboration with the Directorate of Personnel Management for assistance. In 1978, scholarships were limited while the demand for the personnel was high, as such the Kenyan government began training health information professionals locally with a two-year certificate course in Medical Records. In 1990, a diploma course was included to the program, and in 2009, a degree course. So far over 6000 personnel have been trained in various levels, with about 4000 registered by AMRO-K working in both the public and private health sector, and about 600 active members contributing to AMRO-K.
Despite having been in existence for several years, the profession of medical records and health information management services in Kenya has not managed to make a breakthrough in terms of transforming the profession in its critical interventions and operations towards meeting the most significant targets and indicators as expected by many of the members. This has been attributed to a set of factors, most of which are inter-related, such as:
- Absence of a legislative framework to support the profession within the health sector and management of the affairs of medical records and health information management services
- Weak networks among the health information professionals
- Inadequate funding and limited or low levels of resources
- Limited recognition which resulted in de-motivated members
- Lack of professional advancement locally
- Varied working titles and non-acceptance of job titles
- Poor structure within the Ministry of Health
- Association had been dormant for several years and in the
- Low subscription of members to the Association
- Low enumeration of the health information professionals
- Lack of qualified staff in highly placed positions
- Lack of a well-articulated, prioritized strategic plan; and
- Weak health information management systems in the sector.
The combination of these factors led to the stagnation of various activities towards effectively delivering the services as described in the constitution of the association and in the scheme of service of the medical records and health information profession.
The scheme of service was developed and first revised in 2012, then again in 2018 and 2022 as carrier guidelines with the aim of:
- Providing for a well-defined career structure which will attract, motivate and retain competent and suitably qualified Medical Records and Health Information Management professionals in the Civil Service.
- Providing for clearly defined job descriptions and specifications with clear delineation of duties and responsibilities at all levels within the career structure to enable the officers understand the requirements and demands of their jobs.
- Establishing standards for recruitment, training, development and advancement within the career structure on the basis of knowledge, qualification, merit and ability as reflected in work performance and results and ensure appropriate career planning and succession management.
In 2015, as a Private Members Bill, the National Assembly House Health Committee members supported the Bill. The Act was signed off herein referred as The Health Records and Information Managers Act 2016. In the Kenya Gazette Supplement Acts 2016 Number 81 (Acts No. 15). In 2019 to 2022 AMRO-K lobbied to members of the National assembly, the Cabinet Secretary responsible for Health as well another process of amendment of the Health Acts began in the ministry to align all Acts to the Health Act 2017. It was also imperative that under the Presidential executive orders, we ensured that among the Acts pending implementation in the Ministry of Health and most Ministry of Health strategic documents, the Health Records and Information Managers Act was among the other Acts on the list.
All these resulted to the current Kenya Gazettement No 9323 of 2022 to the Board for HRIM with the following members:
- Onesmus Kamau
- Mercy Kahare
- Silas Otieno
- Amos Rangang
- Olive Muchene
- Esabel Juma
- Anne Waihura
- Pepela Wanjala
The main lessons learned throughout this process are:
- Members of the association must be cohesive enough to push and facilitate the Bill to the end. In our case members contributed towards the facilitation of the private bill.
- Consistent lobbying, and communication to the leadership.
- Work with other professionals and through other organisations or committees. In our case AMRO-K pushed some of the issues for the profession through the Kenya Health Professionals Society where it is a member, The Kenya Health professional oversight authority (KHPOA) and the parliamentary Health committee.
- Collaboration with different institutions. During the nomination it’s imperative that all stakeholders from training institutions, regions, different organisations (finance, etc.) must be engaged.
- Cabinet Secretary Ministry of Health Sen. Mutahi Kakwe EGH for Gazettement of the Board
- The Principal Secretary Ministry of health Susan Mochache for facilitating the nominations and communication to the different organisations
- Chair parliamentary Health Committee Hon. Sabina Chege
- Drafter and mover of the Bill Hon. Neto
- AMRO-K Members for consistent guidance and support including financial
- AMRO-K executive members (Alice, Kahare, Odira, Sikolia, Yusuf, Wanjala) and all previous executive members AMRO-K
- Ministry of Health Legal team
- Submission of nominees from the different enties / institutions
Author: Pepela Wanjala