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$3.6 million research project underway to reduce mother and baby deaths in Malawi

Wed, 03/02/2011 - 8:37am
EurekAlert

Warwick Medical School has just begun a ?2.6 million three year research and training programme to train Malawian clinical officers in a bid to reduce the country's high death rate for pregnant mothers and babies.

In a country with a population of just over 14 million, only 40 doctors complete their training each year and there is a chronic shortage of skilled obstetricians. By training up the existing network of non-physician clinicians who would be described as somewhere between midwives and obstetricians in this country - Warwick doctors are sharing their expertise to ensure they are taught the extra skills to deal with the 15 per cent of pregnancies which end up in difficult births and improve the care for mothers and newborns to increase their chances of survival.

"There are probably more Malawian doctors in Manchester, than there are in the whole of Malawi," said Dr Paul O'Hare, Reader in Medicine from the University of Warwick Medical School.

"Whilst it's difficult to stem the numbers of qualified doctors leaving Africa for better pay and work conditions elsewhere, what we can practically do is ensure that the existing clinical officers and midwives are provided with the a higher level of clinical training and education.

"This means, for example, not only teaching them to improve their surgical skills such as C-Sections, but to be more aware that the aftercare treatment can have a profound effect on survival rates."

Over the next three years, Warwick Medical School will research and track whether the model they have developed to educate, train and facilitate the wider cascade of that medical knowledge and skills will have an impact on the quality and level of medical treatment available to pregnant women and whether it ultimately impacts to reduce the numbers of deaths in childbirth and amongst newborns.

Paul went on to explain that one of the side issues they have to combat in Malawi is that of transport: "Often, it's not just the absence of clinical skills that's the problem; it's the fact that there are large distances involved and no way of transporting a pregnant woman to a district hospital to receive treatment. Even though they tend to use motorcycle side cars instead of ambulances because they are more available, there's an urgent need to install effective transport management processes to ensure these systems work effectively and therefore save many more mothers.

"So our research and training must also adapt to the political landscape and physical limitations of the region and which includes transport, availability of drugs and the current professional culture if we are to produce effective change."

The programme began in February and Warwick Medical School, alongside the Karolinska Institute in Sweden and industrial partner GE Healthcare, will be working out in Malawi at various times for the next three years. Their aim is to train 50 clinical officers as advanced leaders who will then be expected to teach and cascade to others what they have learnt.

At the end of the programme Warwick Medical School's research will be able to demonstrate any relation to extra training and a reduction in mortality rates for mums and babies. It's also feasible that the model being tested could be adopted in other African countries with similar problems.

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