Browsing by Author "Phiri, Ajib"

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    Graduates of Bachelors of Science in Paediatrics and Child Health in their workplace; evaluation of a national training program of non-physician clinicians in Malawi
    (Kamuzu University of Health Sciences, 2021-12-01) Phiri, Ajib
    Type of study: mixed-method, sequential explanatory design study (quantitative followed by qualitative). Problem statement: The BSc PCH training program for clinical officers has been implemented, but the cadre’s performance in the field and role in Malawi’s health system is not known. Objective: To explore the contributions of the BSC PCH COs that they make to the care of children at their workplaces and the health care system in Malawi. Methodology: The study will include all 34 graduates (2012-2020). Tools are survey questionnaires and in-depth interviews of graduates, and key informant interviews of key stakeholders from the hospitals, the Ministry of Health and Population, and the Kamuzu University of Health Sciences. Data collection is planned for Quarter 1, 2022. Expected findings: Views and perceptions from graduates and stakeholders will highlight the strengths and weaknesses of the current programme and inform its future design. Dissemination: A dissemination workshop is planned in Malawi to share the results to discuss policy implications and planning. Results will be presented at the dissemination workshop in Malawi and conferences in Malawi and Germany. A manuscript will be submitted to a peer-reviewed journal.
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    Graduates of bachelors of science in pediatrics and child health in their workplace; evaluation of a national training program of non-physician clinicians in Malawi
    (Kamuzu University of Health Sciences, 2021-12-10) Phiri, Ajib
    Type of study: mixed-method, sequential explanatory design study (quantitative followed by qualitative). Problem statement: The BSc PCH training program for clinical officers has been implemented, but the cadre’s performance in the field and role in Malawi’s health system is not known. Objective: To explore the contributions of the BSC PCH COs that they make to the care of children at their workplaces and the health care system in Malawi. Methodology: The study will include all 34 graduates (2012-2020). Tools are survey questionnaires and in-depth interviews of graduates, and key informant interviews of key stakeholders from the hospitals, the Ministry of Health and Population, and the Kamuzu University of Health Sciences. Data collection is planned for Quarter 1, 2022. Expected findings: Views and perceptions from graduates and stakeholders will highlight the strengths and weaknesses of the current programme and inform its future design. Dissemination: A dissemination workshop is planned in Malawi to share the results to discuss policy implications and planning. Results will be presented at the dissemination workshop in Malawi and conferences in Malawi and Germany. A manuscript will be submitted to a peer-reviewed journal. Background Achieving the Sustainable Development Goal (SDG) 3 is key to the global health agenda. Universal health coverage (UHC), so that all individuals receive the essential quality health services they need without suffering financial hardship, is its main element. However, the achievements of the last years did not reach all. The distribution of health and well-being is very uneven. The future of children in many countries is still under threat. Therefore, a recent WHO-UNICEF-Lancet Commission suggested placing the children at the center of the SDG policies [1]. The commission outlines how to overcome the barriers to achieving SDG targets for child health and well-being. The critical shortage of skilled human resources for health (HRH) is one of the most important limitations in many low-and-middleincome countries (LMICs) in Africa and Asia to achieve UHC [2]. In sub-Saharan Africa (SSA) alone, there is an estimated shortage of one million healthcare workers [3]. The causes are manifold and include limited training opportunities, loss of highly skilled workers to private or high-income country settings as well as inadequate working conditions, low morale, and limited career pathways [3, 4]. Creating a new cadre, the non-physician clinician (NPC), is an approach to address some of these causes and was followed by many SSA countries. According to that model, selected tasks of physicians are shifted to NPCs to make more efficient use of the available workforce [2, 3]. In Malawi, the critical shortage of skilled HRH is also a major drawback for the health system [5]. Physician and nurse/midwife ratios in Malawi are among the lowest in the world, affecting particularly the rural people [6]. Between 2006 and 2012, 80% of recent medical graduates were retained in the public sector; however, less than one-third of them were working in rural areas [7]. Although 80% of the population lives in rural areas, only 26% of the health facilities are located there [8]. No paediatric specialists are available in district hospitals [7]. Limited opportunities to network, to refer, and a feeling of professional isolation may contribute to the situation [3]. NPCs called clinical officers (COs) practice in Malawi’s health system successfully for decades, but without opportunities for professional advancement and specialization [9]. In response, in 2012, the College of Medicine (now KUHeS) and the Ministry of Health (now MoHP) of Malawi introduced a 3-year specialist Bachelor of Science (BSc) training program in Paediatric and Child Health (PCH) for the COs, following successful blueprints from other specialties. The KUHeS planned to train 34 BSc PCH COs by 2020, which were expected to be sufficient to staff each district hospital [7]. This cadre is assumed to remain in the public health system and to successfully perform selected specialist tasks. This may allow people especially those are living in rural areas to access a certain degree of specialized services resulting in improved health outcomes [3]. Broad Objective This study aims to examine the contribution of the trained BSc PCH COs at their workplace (health facilities) to the care of children in Malawi. Specific Objectives are: a. To examine the perception of the BSc PCH COs about their contribution to child health care at their workplace, b. to explore the view of the stakeholders about the contributions of the COs to the child health care at their workplace, and c. to identify enabling and limiting factors BSc PCH COs face when providing services for the children at their health facilities.