Physician tracking systems vary widely between countries - in data collected, frequency of data collection, and authority of the collecting body. However, momentum appears to be building to expand tracking systems and use these databases to support basic workforce planning activities as well as to advance the quality of health care through innovative practices.
Our review of the literature and existing physician registration systems in SSA suggests there is much variability in the physician tracking systems of different countries. While some are collecting more practice data, many still largely focus on basic demographic information. Expanded data collection will be needed to maximize physician and other health workforce planning activities. Our review also suggests a need to match data with changing health systems. For example, as private sectors grow in the region, information on which sector physicians are working in and the relative movement between the two sectors will be important to ensure appropriate access for all citizens. This information will act as a guide for students when considering their career prospects, for medical schools when reviewing their curricula and policies, and for governments when making policies and deciding on distribution of resources.
Findings from the MEPI survey suggest medical schools are beginning to embark on developing graduate tracking and alumni systems and many are already able to access information from their medical councils. Medical schools will be important stakeholders and partners in the development of country level physician tracking systems. Coordination of data collection and registration between medical schools and medical councils could significantly advance tracking systems by capturing all medical students into the country level physician tracking system and gathering additional background information that can be studied to understand what factors are related to desired workforce outcomes. Robust tracking systems will allow medical schools to track the outcomes of investments in their institutions, and close involvement in tracking systems is ultimately in the best interest of medical schools as HRH policies affecting medical schools will result from the workforce analysis and planning developed from these systems.
Further movement on tracking systems is occurring at country and regional levels. The African Health Workforce Observatory is supporting regional and country level development of health workforce information systems to inform human resources for health policies and initiatives .
Innovative approaches appear to be arising to address the challenge of how to incentivize physician participation in registration systems. The Uganda system incentivizes physician registration by making registration status available to patients, so that patients can make informed decisions about the doctors they choose. The Ghana MDNet programme creates an everyone wins situation where physicians benefit by being able to connect with other physicians, receive health alerts, and receive information on meetings; and the government and people benefit by having better informed physicians.
The Ghana MDNet programme demonstrates that technology can facilitate tracking systems as well as the thoughtful use of the systems to improve health. The MDNet programme’s use of mobile technology to provide health alerts to nearly all physicians in the country at once represents an advanced emergency response capability that rivals systems worldwide. Additional technology-based resources exist that will advance physician tracking systems. For example, CapacityPlus offers open source software that can be downloaded and adapted to country specific parameters . Availability of such software means countries will not need to create new systems, and offers the opportunity to develop coordinated systems between countries to follow physicians regionally and globally.
It should also be noted that the increasing interest in SSA by international funding agencies means there are often multiple - sometimes fragmented and duplicative - efforts on offer that local parties must consider. In addition, local context, infrastructure, and resources must always be taken into account in adopting and adapting any of the described approaches to other locations.