Wakisa Mulwafu1, Thomas Elliot Nyirenda2, Johannes J Fagan3, Chris Bem4, Kumvana Mlumbe5, Jean Chitule6. 1. ENT Surgeon and Head of Unit, College of Medicine, University of Malawi, Malawi. 2. South-South Networking and Capacity Development Manager, European and Developing Countries Clinical Trials Partnership, Medical Research Council, Cape Town, South Africa nyirenda@edctp.org. 3. Professor and Chairman, Division of Otolaryngology, University of Cape Town, Cape Town, South Africa. 4. Consultant ENT and Neck Surgeon, Bradford Hospital, United Kingdom. 5. CBM/BMZ Project Coordinator, College of Medicine, University of Malawi, Malawi. 6. Company Manager, Clinical Research Education and Management Services Limited, Malawi.
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.
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.
Authors: Luke Hunt; Wakisa Mulwafu; Victoria Knott; Chifundo B Ndamala; Andrew W Naunje; Sam Dewhurst; Andrew Hall; Kevin Mortimer Journal: PLoS One Date: 2017-12-21 Impact factor: 3.240
Authors: Wakisa Mulwafu; Myroslava Tataryn; Sarah Polack; Asgaut Viste; Frederik Kragerud Goplen; Hannah Kuper Journal: Bull World Health Organ Date: 2019-05-28 Impact factor: 9.408
Authors: Mahmood F Bhutta; Xingkuan Bu; Patricia Castellanos de Muñoz; Suneela Garg; Kelvin Kong Journal: Bull World Health Organ Date: 2019-08-20 Impact factor: 9.408