Initiating and developing clinical services, training and research in a low resource setting: the Malawi ENT experience

Trop Doct. 2014 Jul;44(3):135-9. doi: 10.1177/0049475514524393. Epub 2014 Feb 25.

Abstract

Background: Sub-Saharan Africa countries like Malawi have a paucity of ear, nose and throat (ENT) data, services and training opportunities.

Objective: To reflect on new Malawian ENT experience and to propose guidelines to poorly resourced countries.

Design: Analysis of data predating and following establishment of ENT services in Malawi.

Results: In 2008 the first and only Malawian ENT specialist established ENT services with external funding. Fifteen clinical officers have been trained and a nurse placed at each outreach hospital. In 2012, 15,284 consultations were recorded: 543 (3.6%) from outreach clinics. Forty-nine percent needed medical treatment, while 45% needed medical advice. Surgery was performed on 2.7% of patients; 21% for foreign bodies in the nose and throat and 18% for foreign bodies and biopsies of ears.

Conclusions: To establish accessible and sustainable specialist ENT services in a poor country requires building on an established local health delivery system, careful planning and investment in personnel, infrastructure, training and data collection.

Keywords: ENT; Malawi; clinical officer; developing country; otorhinolaryngology; training.

MeSH terms

  • Ambulatory Care Facilities / organization & administration
  • Delivery of Health Care / organization & administration*
  • Developing Countries
  • Education, Medical / organization & administration
  • Female
  • Financial Support
  • Humans
  • Malawi
  • Male
  • Otolaryngology / economics
  • Otolaryngology / organization & administration*
  • Otorhinolaryngologic Diseases / economics
  • Otorhinolaryngologic Diseases / therapy*
  • Resource Allocation