gms | German Medical Science

The College of Medicine (COM) was established in 1991, in order to improve the training of medical doctors. Before then, the government was sending people to other countries to train as doctors. Most of these trained doctors never returned to Malawi. When COM was established, would-be paediatricians were sent to the United Kingdom. Only 2 paediatricians out of the 18 that were sent returned to Malawi. Therefore, in 2004, the department of paediatrics and child health introduced the 4-year Master of Medicine in Paediatrics and Child Health to train paediatricians in-country. The programme started with two students who spent 2 years in Malawi and another 2 years in South Africa at a recognized university. The department developed partnerships with University of Kwazulu-Natal, University of Witwatersrand and University of Pretoria and the University of Cape Town’s Red Cross War Memorial Children’s Hospital through the African Paediatric Fellowship Programme (APFP). This was done to expose the trainees to other aspects of paediatric care that they would not have experienced in Malawi. To date, 27 paediatricians have been trained. Almost three quarters (74.1%) of those trained are still working in Malawi in various sectors; public sector, the private sector, research institutions and academia. Currently, there are 15 students at various levels of their training. Students spend the first three years of their training in Malawi and 1 year at an institution in South Africa. The main challenge for the training programme is funding for scholarships. Paediatricians that have been trained or are in training have been supported or are being supported by various institutions. These funders include NORHED, National AIDS Commission of Malawi, the ELMA Foundation, Else Kroner Fresenius Stiftung, Baylor College of Medicine/Texas Children’s Hospital, Malawi Child Initiative and Raising Malawi. Occasionally, individuals have assisted students in their personal capacity. The impact of the paediatric specialty training at Queen Elizabeth Central Hospital has been remarkable. There has been an improvement in teaching of undergraduate students, implementation of relevant research and provision of quality clinical care. In the last 20 years, in-hospital mortality has decreased from about 15% to 5% in the paediatric wards, and from 25% to around 11% in the neonatal wards. There is still need to increase the number of paediatricians. The government wishes to have a paediatrician at each of the 26 districts hospitals and to increase the number of paediatricians at the four referral hospitals. Paediatricians also need to be trained to cater for the other sectors in the country. The training has now been extended to Kamuzu Central hospital and in future to other central hospitals as more paediatricians are trained.