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Parmar B, Phiri M, Caron C, Bright T, Mulwafu W. Development of a public audiology service in Southern Malawi: profile of patients across two years. Int J Audiol 2021; 60:789-796. [PMID: 33433249 DOI: 10.1080/14992027.2020.1864486] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
OBJECTIVE To describe the profile of patients attending the Queen Elizabeth Central Hospital (QECH) audiology clinic in Malawi, over a two-year period (2016-2017). DESIGN A retrospective patient record review. STUDY SAMPLE There were 2299 patients assessed at the QECH audiology department between January 2016 and December 2017. Adult patients' ages ranged from 18 to 94 years (M = 45.8, SD = 19.22). The mean age of children included in this study was 7.7 years (SD= 5.21). Overall, 45.4% of patients were female. RESULTS Of the 61.6% of adults and 41.7% of children found to have some degree of hearing loss, 28.3% and 15.4% were fitted with hearing aids, respectively. The number of patients seen in 2017 (n = 1385) was 34% higher than that of 2016 (n = 914). CONCLUSION This study found that demand for hearing services is increasing in this public sector Malawian audiology department but uptake of hearing aids for those in need is low. Future evaluation of service provision and treatment outcomes is needed. Results from this study can be used to inform the development of future audiology clinics in low resource settings.
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Affiliation(s)
| | | | - Courtney Caron
- Veterans Health Administration, Veterans Affairs Southern Nevada Health Care System, Audiology Clinic, North Las Vegas, NV, USA
| | - Tess Bright
- International Centre for Evidence in Disability, London School of Hygiene & Tropical Medicine, London, UK
| | - Wakisa Mulwafu
- Department of Surgery, College of Medicine, University of Malawi, Blantyre, Malawi
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A comprehensive review of otorhinolaryngological global health concerns. The Journal of Laryngology & Otology 2019; 133:930-935. [DOI: 10.1017/s002221511900197x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
AbstractBackgroundENT disease prevalence, risk factors and treatment vary between developed and developing countries. Health provision, particularly disease prevention strategies and surgery, in developing countries is poor, manifesting as a high frequency of common and preventable diseases. Healthcare systems in developing countries are unsustainable, and the technological advances that provide ENT surgery with novel diagnostic and treatment opportunities are inaccessible.ConclusionA multifaceted approach is essential to improve the care of patients with ENT diseases in developing countries. Public health efforts must focus on educating the local community, reducing high-risk behaviours and decreasing the frequency of preventable diseases. Governments must be pressured to prioritise the funding of long-term, sustainable efforts with effective disease prevention strategies. Providing local healthcare professionals with high-quality ENT training so that self-sustaining and low-cost care can be delivered, mainly in a primary care setting, is key.
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Bhutta MF, Bu X, de Muñoz PC, Garg S, Kong K. Training for hearing care providers. Bull World Health Organ 2019; 97:691-698. [PMID: 31656334 PMCID: PMC6796672 DOI: 10.2471/blt.18.224659] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2018] [Revised: 05/12/2019] [Accepted: 05/14/2019] [Indexed: 12/31/2022] Open
Abstract
The lack of an appropriately trained global hearing-care workforce is recognized as a barrier to developing and implementing services to treat ear and hearing disorders. In this article we examine some of the published literature on the current global workforce for ear and hearing care. We outline the status of both the primary-care workforce, including community health workers, and specialist services, including audiologists, ear, nose and throat specialists, speech and language therapists, and teachers of the deaf. We discuss models of training health workers in ear and hearing care, including the role of task-sharing and the challenges of training in low and middle-income countries. We structure the article by the components of ear and hearing care that may be delivered in isolation or in integrated models of care: primary care assessment and intervention; screening; hearing tests; hearing rehabilitation; middle-ear surgery; deaf services; and cochlear implant programmes. We highlight important knowledge gaps and areas for future research and reporting.
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Affiliation(s)
- Mahmood F Bhutta
- Department of Ear, Nose and Throat, Royal Sussex County Hospital, Eastern Road, Brighton BN2 5BE, England
| | - Xingkuan Bu
- Jiangsu Ear and Hearing Centre, Jiangsu Province Hospital, Nanjing, China
| | | | - Suneela Garg
- Department of Community Medicine, Maulana Azad Medical College, New Delhi, India
| | - Kelvin Kong
- School of Medicine and Public Health, University of Newcastle, Callaghan, Australia
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Mulwafu W, Tataryn M, Polack S, Viste A, Goplen FK, Kuper H. Children with hearing impairment in Malawi, a cohort study. Bull World Health Organ 2019; 97:654-662. [PMID: 31656330 PMCID: PMC6796677 DOI: 10.2471/blt.18.226241] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2018] [Revised: 03/27/2019] [Accepted: 03/27/2019] [Indexed: 11/27/2022] Open
Abstract
Objective To assess the outcomes of children diagnosed with hearing impairment 3 years earlier in terms of referral uptake, treatment received and satisfaction with this treatment, and social participation. Methods We conducted a population-based longitudinal analysis of children with a hearing impairment in two rural districts of Malawi. Key informants within the community identified the cohort in 2013 (baseline). Informants clinically screened children at baseline, and by questionnaires at baseline and follow-up in 2016. We investigated associations between sociodemographic characteristics and outcomes by multivariate logistic regression. Results We diagnosed 752 children in 2013 as having a hearing impairment and traced 307 (40.8%) children of these for follow-up in 2016. Referral uptake was low (102/184; 55.4%), more likely among older children (odds ratio, OR: 3.5; 95% confidence interval, CI: 1.2–10.2) and less likely for those with an illiterate caregiver (OR: 0.5; 95% CI: 0.2–0.9). Few of the children who attended hospital received any treatment (33/102; 32.4%) and 63.6% (21/33) of caregivers reported satisfaction with treatment. Difficulty making friends and communicating needs was reported for 10.0% (30/299) and 35.6% (107/301) of the children, respectively. Lack of school enrolment was observed for 29.5% (72/244) of children, and was more likely for older children (OR: 28.6; 95% CI: 10.3–79.6), girls (OR: 2.4; 95% CI: 1.2–4.8) and those with an illiterate caregiver (OR: 2.1; 95% CI: 1.0–4.1). Conclusion More widespread and holistic services are required to improve the outcomes of children with a hearing impairment in Malawi.
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Affiliation(s)
- Wakisa Mulwafu
- Department of Surgery, College of Medicine, Private Bag 360, Blantyre, Malawi
| | - Myroslava Tataryn
- International Centre for Evidence in Disability, London School of Hygiene & Tropical Medicine, London, England
| | - Sarah Polack
- International Centre for Evidence in Disability, London School of Hygiene & Tropical Medicine, London, England
| | - Asgaut Viste
- Department of Clinical Medicine, Haukeland University Hospital, Bergen, Norway
| | | | - Hannah Kuper
- International Centre for Evidence in Disability, London School of Hygiene & Tropical Medicine, London, England
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Mulwafu W, Ensink R, Kuper H, Fagan J. Survey of ENT services in sub-Saharan Africa: little progress between 2009 and 2015. Glob Health Action 2018; 10:1289736. [PMID: 28485648 PMCID: PMC5496047 DOI: 10.1080/16549716.2017.1289736] [Citation(s) in RCA: 94] [Impact Index Per Article: 15.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
Abstract
BACKGROUND A 2009 survey of ENT, audiology, and speech therapy services and training opportunities in 18 Sub-Saharan African countries reported that the availability of services was extremely poor, the distribution of services was very inequitable, and training opportunities were limited. Objective: We conducted a new survey to determine the current status of ear, nose, and throat (ENT), audiology, and speech therapy services in sub-Saharan Africa. METHOD This study is a cross-sectional study. A questionnaire was distributed by email to an ad hoc group of ENT surgeons and audiologists in 30 sub-Saharan African countries. Data from the current survey were compared to those of a 2009 survey. The numbers of ENT surgeons, audiologists, and speech therapists/100,000 people were compared to the ratios in the United Kingdom. RESULTS A total of 22 countries responded to the questionnaire. When data of the 15 countries that responded in both 2009 and 2015 are compared, the number of ENT surgeons had increased by 43%, audiologists had increased by 2.5%, and speech therapists by 30%. When the 23% population growth is taken into account, the numbers of ENT surgeons, audiologists, and speech therapists per 100,000 people had declined in four countries, and there remains a severe shortfall of ENT surgeons, audiologists, and speech therapists when compared to the UK Respondents cited lack of availability of basic equipment as the most frequent limitation in providing ENT services. Other important factors causing limitations in daily practice were: lack of ENT training facilities and audiological rehabilitation, low awareness of the burden of ENT pathology, as well as poor human resources management. CONCLUSIONS There has been a lack of progress in ENT, audiology, and speech therapy services and training opportunities in sub-Saharan Africa between 2009 and 2015. There is a need to look at increased collaboration with developed countries and non-governmental organisations, establishing new and improving existing training centres in Africa, and task-shifting of some ENT services to primary health workers.
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Affiliation(s)
- Wakisa Mulwafu
- a Department of Surgery , College of Medicine , Blantyre , Malawi.,b Centre for International Health , University of Bergen , Bergen , Norway
| | - Robbert Ensink
- c Division of Oto-rhino-laryngology , Gelre Hospitals Zutphen , The Netherlands
| | - Hannah Kuper
- d International Centre for Evidence in Disability (ICED) , London School of Hygiene and Tropical Medicine , London , UK
| | - Johannes Fagan
- e Division of Otolaryngology , University of Cape Town , Cape Town , South Africa
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Master A, Wilkinson E, Wagner R. Management of Chronic Suppurative Otitis Media and Otosclerosis in Developing Countries. Otolaryngol Clin North Am 2018. [DOI: 10.1016/j.otc.2018.01.017] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
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Prevalence of paediatric chronic suppurative otitis media and hearing impairment in rural Malawi: A cross-sectional survey. PLoS One 2017. [PMID: 29267304 DOI: 10.1371/journal.pone.0188950.] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE To estimate the prevalence of World Health Organization-defined chronic suppurative otitis media (CSOM) and mild hearing impairment in a population representative sample of school-entry age children in rural Malawi. A secondary objective was to explore factors associated with CSOM in this population. METHODS We performed a community-based cross-sectional study of children aged 4-6 years in Chikhwawa District, Southern Malawi, utilising a village-level cluster design. Participants underwent a structured clinical assessment, including video-otoscopy and screening audiometry. Diagnoses were made remotely by two otolaryngologists who independently reviewed clinical data and images collected in the field. Hearing impairment was classified as failure to hear a pure tone of 25dB or greater at 1, 2 or 4kHz. RESULTS We recruited 281 children across 10 clusters. The prevalence estimates of CSOM, unilateral hearing impairment and bilateral hearing impairment were 5.4% (95%CI 2.2-8.6), 24.5% (95%CI 16.3-30.0), and 12.5% (95%CI 6.2-16.9) respectively. Middle ear disease was seen in 46.9% of children with hearing impairment. A trend towards increased risk of CSOM was observed with sleeping in a house with >2 other children. INTERPRETATION We found a high burden of middle ear disease and preventable hearing impairment in our sample of school-entry age children in rural Malawi. There are important public health implications of these findings as CSOM and hearing impairment can affect educational outcomes, and may impact subsequent development. The identification and management of middle ear disease and hearing impairment represent major unmet needs in this population.
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Hunt L, Mulwafu W, Knott V, Ndamala CB, Naunje AW, Dewhurst S, Hall A, Mortimer K. Prevalence of paediatric chronic suppurative otitis media and hearing impairment in rural Malawi: A cross-sectional survey. PLoS One 2017; 12:e0188950. [PMID: 29267304 PMCID: PMC5739401 DOI: 10.1371/journal.pone.0188950] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2017] [Accepted: 11/16/2017] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVE To estimate the prevalence of World Health Organization-defined chronic suppurative otitis media (CSOM) and mild hearing impairment in a population representative sample of school-entry age children in rural Malawi. A secondary objective was to explore factors associated with CSOM in this population. METHODS We performed a community-based cross-sectional study of children aged 4-6 years in Chikhwawa District, Southern Malawi, utilising a village-level cluster design. Participants underwent a structured clinical assessment, including video-otoscopy and screening audiometry. Diagnoses were made remotely by two otolaryngologists who independently reviewed clinical data and images collected in the field. Hearing impairment was classified as failure to hear a pure tone of 25dB or greater at 1, 2 or 4kHz. RESULTS We recruited 281 children across 10 clusters. The prevalence estimates of CSOM, unilateral hearing impairment and bilateral hearing impairment were 5.4% (95%CI 2.2-8.6), 24.5% (95%CI 16.3-30.0), and 12.5% (95%CI 6.2-16.9) respectively. Middle ear disease was seen in 46.9% of children with hearing impairment. A trend towards increased risk of CSOM was observed with sleeping in a house with >2 other children. INTERPRETATION We found a high burden of middle ear disease and preventable hearing impairment in our sample of school-entry age children in rural Malawi. There are important public health implications of these findings as CSOM and hearing impairment can affect educational outcomes, and may impact subsequent development. The identification and management of middle ear disease and hearing impairment represent major unmet needs in this population.
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Affiliation(s)
- Luke Hunt
- Liverpool School of Tropical Medicine, Liverpool, United Kingdom
| | | | - Victoria Knott
- Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, United Kingdom
| | | | - Andrew W. Naunje
- Malawi-Liverpool-Wellcome Trust Clinical Research Program, Blantyre, Malawi
| | - Sam Dewhurst
- University Hospitals Leicester NHS Foundation Trust, Leicester, United Kingdom
| | - Andrew Hall
- Independent Scholar, Sheffield, United Kingdom
| | - Kevin Mortimer
- Liverpool School of Tropical Medicine, Liverpool, United Kingdom
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Mulwafu W, Kuper H, Viste A, Goplen FK. Feasibility and acceptability of training community health workers in ear and hearing care in Malawi: a cluster randomised controlled trial. BMJ Open 2017; 7:e016457. [PMID: 29025832 PMCID: PMC5652500 DOI: 10.1136/bmjopen-2017-016457] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVE To assess the feasibility and acceptability of training community health workers (CHWs) in ear and hearing care, and their ability to identify patients with ear and hearing disorders. DESIGN Cluster randomised controlled trial (RCT). SETTING Health centres in Thyolo district, Malawi. PARTICIPANTS Ten health centres participated, 5 intervention (29 CHWs) and 5 control (28 CHWs). INTERVENTION Intervention CHWs received 3 days of training in primary ear and hearing care, while among control CHWs, training was delayed for 6 months. Both groups were given a pretest that assessed knowledge about ear and hearing care, only the intervention group was given the posttest on the third day of training. The intervention group was given 1 month to identify patients with ear and hearing disorders in their communities, and these people were screened for hearing disorders by ear, nose and throat clinical specialists. OUTCOME MEASURES Primary outcome measure was improvement in knowledge of ear and hearing care among CHWs after the training. Secondary outcome measures were number of patients with ear or hearing disorders identified by CHWs and number recorded at health centres during routine activities, and the perceived feasibility and acceptability of the intervention. RESULTS The average overall correct answers increased from 55% to 68% (95% CI 65 to 71) in the intervention group (p<0.001). A total of 1739 patients with potential ear and hearing disorders were identified by CHWs and 860 patients attended the screening camps, of whom 400 had hearing loss (73 patients determined through bilateral fail on otoacoustic emissions, 327 patients through audiometry). Where cause could be determined, the most common cause of ear and hearing disorders was chronic suppurative otitis media followed by impacted wax. The intervention was perceived as feasible and acceptable to implement. CONCLUSIONS Training was effective in improving the knowledge of CHW in ear and hearing care in Malawi and allowing them to identify patients with ear and hearing disorders. This intervention could be scaled up to other CHWs in low-income and middle-income countries. TRIAL REGISTRATION NUMBER Pan African Clinical Trial Registry (201705002285194); Results.
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Affiliation(s)
- Wakisa Mulwafu
- Department of Surgery, College of Medicine Blantyre Malawi, Blantyre, Malawi
| | - Hannah Kuper
- Department of Clinical Research, The London School of Hygiene & Tropical Medicine, London, UK
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Kligerman MP, Alexandre A, Jean-Gilles P, Walmer D, Cheney ML, Messner AH. Otorhinolaryngology/Head and Neck Surgery in a low income country: The Haitian experience. Int J Pediatr Otorhinolaryngol 2017; 93:128-132. [PMID: 28109483 DOI: 10.1016/j.ijporl.2016.12.041] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2016] [Revised: 12/28/2016] [Accepted: 12/28/2016] [Indexed: 12/26/2022]
Abstract
OBJECTIVE Little is known regarding the diagnosis and management of pediatric surgical conditions of the head and neck in low-income countries. Haiti, the western hemisphere's poorest country, recently developed its first Otorhinolaryngology (ORL) department at the Hopital de L'Universite d'Etat d'Haiti (HUEH). This manuscript assesses the caseload at HUEH with a special emphasis on pediatric cases, with the aim of characterizing ORL related conditions and their treatments in low-income countries. METHODS We conducted a retrospective chart review of surgical case logs at HUEH for the calendar year of 2014 and recorded patient age, diagnosis, and surgical intervention for all ORL surgeries. RESULTS A total of 229 ORL surgeries were performed at HUEH during this time. The average age of the patient was 21.8 years and 54.2% of patients were 18 years or younger. The five most common diagnoses were tonsillar hypertrophy (23.6%), ingested foreign body (18%), mandibular fracture (9.2%), unspecified head or neck mass (6%), and thyroid goiter (4.8%). The five most common surgeries performed were tonsillectomy (23.6%), foreign body retrieval (17.9%), open reduction of mandibular fracture with direct skeletal fixation (6.9%), thyroidectomy (7.9%), and excision of unspecified mass. Trauma accounted for 33.6% of all ORL surgeries. CONCLUSIONS Diseases related to the head and neck constitute a common yet underserved surgical problem. Strengthening ORL surgical capacity in Haiti should focus on improving capacity for the most common conditions including tonsillar disease, ingested foreign bodies, and facial trauma, as well as improving capacity for rarely performed surgeries, such as ear surgery, nose and sinus surgery, and cancer resections.
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Affiliation(s)
- Maxwell P Kligerman
- Stanford University School of Medicine, Stanford, CA, USA; Family Health Ministries, 501-C3, Durham, NC, USA.
| | - Anahuma Alexandre
- Department of Otorhinolaryngology, Hopital de L'Universite d'Etat d'Haiti, Port-au-Prince, Haiti
| | - Patrick Jean-Gilles
- Department of Otorhinolaryngology, Hopital de L'Universite d'Etat d'Haiti, Port-au-Prince, Haiti
| | - David Walmer
- Duke Global Health Institute, Duke University, USA; Family Health Ministries, 501-C3, Durham, NC, USA
| | - Mack L Cheney
- Massachusetts Eye and Ear Infirmary, Harvard School of Medicine, USA
| | - Anna H Messner
- Department of Otolaryngology/Head & Neck Surgery, Stanford University, Stanford, CA, USA
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O'Hare B, Phiri A, Lang HJ, Friesen H, Kennedy N, Kawaza K, Jana CE, Chirambo G, Mulwafu W, Heikens GT, Mipando M. Task sharing within a managed clinical network to improve child health in Malawi. HUMAN RESOURCES FOR HEALTH 2015; 13:60. [PMID: 26193932 PMCID: PMC4509723 DOI: 10.1186/s12960-015-0053-z] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/12/2014] [Accepted: 06/27/2015] [Indexed: 06/04/2023]
Abstract
BACKGROUND Eighty per cent of Malawi's 8 million children live in rural areas, and there is an extensive tiered health system infrastructure from village health clinics to district hospitals which refers patients to one of the four central hospitals. The clinics and district hospitals are staffed by nurses, non-physician clinicians and recently qualified doctors. There are 16 paediatric specialists working in two of the four central hospitals which serve the urban population as well as accepting referrals from district hospitals. In order to provide expert paediatric care as close to home as possible, we describe our plan to task share within a managed clinical network and our hypothesis that this will improve paediatric care and child health. PRESENTATION OF THE HYPOTHESIS Managed clinical networks have been found to improve equity of care in rural districts and to ensure that the correct care is provided as close to home as possible. A network for paediatric care in Malawi with mentoring of non-physician clinicians based in a district hospital by paediatricians based at the central hospitals will establish and sustain clinical referral pathways in both directions. Ultimately, the plan envisages four managed paediatric clinical networks, each radiating from one of Malawi's four central hospitals and covering the entire country. This model of task sharing within four hub-and-spoke networks may facilitate wider dissemination of scarce expertise and improve child healthcare in Malawi close to the child's home. TESTING THE HYPOTHESIS Funding has been secured to train sufficient personnel to staff all central and district hospitals in Malawi with teams of paediatric specialists in the central hospitals and specialist non-physician clinicians in each government district hospital. The hypothesis will be tested using a natural experiment model. Data routinely collected by the Ministry of Health will be corroborated at the district. This will include case fatality rates for common childhood illness, perinatal mortality and process indicators. Data from different districts will be compared at baseline and annually until 2020 as the specialists of both cadres take up posts. IMPLICATIONS OF THE HYPOTHESIS If a managed clinical network improves child healthcare in Malawi, it may be a potential model for the other countries in sub-Saharan Africa with similar cadres in their healthcare system and face similar challenges in terms of scarcity of specialists.
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Affiliation(s)
- Bernadette O'Hare
- College of Medicine, Blantyre, Malawi.
- The University of St Andrews, Saint Andrews, UK.
| | - Ajib Phiri
- Department of Paediatrics and Child Health, College of Medicine, Blantyre, Malawi.
| | | | - Hanny Friesen
- Department of Paediatrics and Child Health, College of Medicine, Blantyre, Malawi.
| | - Neil Kennedy
- Department of Paediatrics and Child Health, College of Medicine, Blantyre, Malawi.
| | - Kondwani Kawaza
- Department of Paediatrics and Child Health, College of Medicine, Blantyre, Malawi.
| | - Collins E Jana
- Department of Basic Medical Sciences, College of Medicine, Blantyre, Malawi.
| | - George Chirambo
- Department of Basic Medical Sciences, College of Medicine, Blantyre, Malawi.
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Isaacson G. Framework for advancing otolaryngology: head and neck surgery in Ethiopia. Otolaryngol Head Neck Surg 2014; 151:634-7. [PMID: 25052514 DOI: 10.1177/0194599814542591] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The American Academy of Otolaryngology--Head and Neck Surgery and its members have shown continuing commitment to improving global otolaryngology care through humanitarian and international outreach programs. These efforts, based on a surgical mission model, have produced only modest improvements in otolaryngologic care in Ethiopia. In cooperation with the Ethiopian Ministry of Health and 2 Ethiopian medical schools, we present a framework for otolaryngology education for the next decade. It recognizes the limitations of the current didactic paradigm and aims to use available domestic and international resources to improve the quality and availability of head and neck surgical and medical services.
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Affiliation(s)
- Glenn Isaacson
- Temple University School of Medicine, Philadelphia, Pennsylvania, USA
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