Fact-finding mission to Malawi: Opportunities for met4a in continuing medical education

In mid-November, Edeltraut Hertel and Björn Beurer, in their capacity as members of met4a e.V., had the opportunity to fly to Lilongwe, Malawi, as part of a fact-finding mission.

Initial exchange and identification of the need for continuous professional development (CPD)

The previous year, initial contact was established, and a joint project with Bwaila Maternity Hospital, a District Hospital, was agreed upon. Edeltraut and Björn were supposed to conduct training courses in “Basic Ultrasound” for midwives there, in addition to establishing further contacts. This agreement had already been made the previous year between the respective project partners. Unfortunately, however, the lead physician, who was designated as our project partner, had been replaced in the interim without the met4a board being informed.

By fortunate circumstances, we were connected with various stakeholders in the Malawian healthcare system by our host on the very first day. Thus, we were able to organize a meeting at the state-run Kamuzu University Hospital for the very next day. There, a highly insightful exchange took place between the university’s faculty, ourselves, and the former Deputy Minister of Health. A key outcome of this discussion was the realization that there is a significant need for “Continuous Professional Development” (CPD) in Malawi. This program stipulates that healthcare employees must accumulate continuing education points over time to renew their licenses. From the perspective of local partners, our work in this area would be of great benefit.

Visits to the embassy and relevant health authorities: recommendations for CPD registration and opportunities for cooperation

In the following days, we visited the Embassy, the Medical Department (responsible for the education and training of doctors), and the Department of Nursing and Midwifery. All institutions advocated for met4a to register as a “Provider of CPD” to offer continuing education. On-site, a corresponding program was developed, which also included the concept of a “Training of Trainers” to ensure that the program could be continued in our absence.

In discussions with the German Embassy and later with GIZ, we were informed about several hospital projects by KfW, which has built clinics in Malawi. However, the exact operational management of these clinics has not yet been definitively clarified. This may present an opportunity for met4a to actively contribute to improving healthcare policy in Malawi.

The Embassy also suggested that entering medical development cooperation might be easier through a denominational hospital that operates regular clinics and is subordinate to the Ministry of Health (MOH). Collaboration with an organization already registered in Malawi could help avoid high costs that would otherwise be incurred by an association wishing to operate in Malawi.

Problems with implementation at Bwaila District Hospital: lack of communication, staff shortages, and unused resources

Unfortunately, collaboration at Bwaila District Hospital could not be initiated because the contact established through GIZ the previous year was no longer on-site, and the current hospital management was not informed about either the planned project or the training of midwives in “Basic Ultrasound”. In a detailed on-site discussion, it became clear that due to staff shortages, there is hardly any capacity for additional training. Nevertheless, the option of offering the training as a CPD program was considered – in which case, a suitable skill lab could be made available to us. To our surprise, we also found ample materials that had been provided by GIZ in the past but were never used, and which would enable an immediate start of the program.

Needs and opportunities in Salima: potential for cooperation and focus on preventive and operational training

Overall, the Lilongwe region appears well-served, so from our perspective, no acute need is apparent. In contrast, during the visit to Salima on Lake Malawi, a significantly greater willingness to cooperate was observed: The local District Hospital, where neither international organizations nor a specialist doctor are present, showed great interest in collaboration. The hospital there is managed by a Medical Officer and a dedicated nurse, which, combined with the well-maintained, well-organized environment and the open atmosphere, left a positive overall impression.

In summary, there is a fundamental need for met4a’s involvement in Malawi, with potential seen particularly in the area of continuing education and training for nurses, midwives, and doctors – extending beyond the focus on women’s health. Furthermore, the topic of prevention is increasingly coming to the forefront. Particularly in Salima, there could also be a significant need for surgical training for operating room nurses and medical staff. In contrast, cooperation with Bwaila Hospital appears less effective, and engagement should not exclusively focus on the capital region, as it seems to be already well-covered by international organizations.

Overall, it is clear that met4a, with expanded engagement in continuing education and training – particularly in regions less present internationally like Salima – can make a sustainable contribution to improving the healthcare system in Malawi.