Curriculum Malawi
Module 1
Curriculum Malawi
November/December 2011
Day 1
MONDAY
Time / Topic / Method / Leader8.00-8.30 / Clinical officers as advanced leaders introduction / Discussion / Paul O’Hare
8.30-9.30 / MCQ
9.30-9.45 / Break
9.45
10-45 / 1. Epidemiology
Traditional birth attendants, rationale for change, current data on place of delivery, major causes of maternal death and neonatal death / Epidemiology seminar / Chisale Mhango
10.45-11.00 / Break
11.00-12.00 / OSCE demonstration / Siobhan Quenby
Doug Simkiss
Paul O’Hare
12.00-1.00 / Lunch
1.00-2.30 / Safer vaginal delivery;
Simulations of ECV, breech, twins, vacuum extraction, shoulder dystocia. / Practical session / Siobhan Quenby
2.30-2.45 / Break
2.45-4.00 / Safer vaginal delivery teaching others
Teaching other breech, forceps, vacuum extraction,twins shoulder dystocia. Managing and leading teams, drills based on local settings / Practical session / Siobhan Quenby
Day 2
TUESDAY
Time / Topic / Method / Leader8.00-9.00 / Neonatal resuscitation
What about the baby? What are the major causes of neonatal death and disability in Malawi? / Group discussion / Doug Simkiss
9.00-10.00 / 1. Why neonatal resuscitation is important; principles of good neonatal care
Wider team-working; adoption of evidence-based practice; hypothermia, kangaroo mother care, breastfeeding
2. Serious maternal and neonatal infections in the local context
Appropriate antibiotics on local inventory? What to do when these not available / Seminar
Group discussion / Doug Simkiss
Francis Kamwendo
Doug Simkiss
10.00-10.15 / Break
10.15-11.00 / 1. Collecting the data on HIV infection and acting on it
Checking HIV status of pregnant women, offering counselling and contact tracing
2. The implications of being HIV positive for preventing puerperal sepsis / Seminar
Seminar / Francis Kamwendo
Chisale Mhango
11.00-12.00 / 4. Management of sick neonates
Signs and symptoms; appropriate interventions, local settings / Seminar / Doug Simkiss
12.00-1.00 / Lunch
1.00- 2.30 / Neonatal resuscitation scenarios
Learning techniques, training others. Bag-and-mask, Helping Babies Breathe, intubation (trial session) / Practical session / Doug Simkiss
2.30-2.45 / Break
2.45-4.00 / Neonatal resuscitation scenarios
Learning techniques, training others. Bag-and-mask, Helping Babies Breathe, intubation (trial session) / Practical session / Doug Simkiss
Day 3
WEDNESDAY
Time / Topic / Method / Leader8.00-8.30 / Managing bleeding and blood loss in PPH
1. Are we giving women a good start
Detecting, preventing and correcting anaemia, steps to enhance current practice / Seminar / Francis Kamwendo
8.30-9.00 / 2. Life support in haemorrhage and fluid loss
Optimal support for the haemorrhaging patient at clinics, during transfer and on reception at district hospitals; fluid balance considerations / Seminar / Paul O’Hare
9.00-9.30 / 3. Blood transfusion: have we got enough? If not, why not?
Evidence from the most recent inventory, current guidelines for storage and administration of blood, experience of supporting women with PPH, current guidelines on blood donation / Seminar
Discussion / Francis Kamwendo
9.30-9.45 / Break
9.45-12.00 / Abortion
1. The local scene
Legal situation, epidemiological evidence, Malawi National Health Service Guidelines ch. 6
2. Effective intervention post-abortion
Life support and general measures, the manual vacuum aspirator / Seminar
Seminar / Chisale Mhango
Chisale Mhango
12.00-1.00 / Lunch
1.00-2.30 / Other active interventions in APH/ PPH: what is available?
Placenta previa, abruption, Repair of lacerations, manual removal of placenta, repositioning inverted uterus, management of uterine atony, placenta accreta (uterotonics, bimanual uterine compression, intra uterine balloon tamponade using condoms, hysterectomy), / Practical session / Siobhan Quenby
2.30-2.45 / Break
2.45-4.00 / Other active interventions in PPH: what is available?
Teaching others, auditing, preventing recurrence / Practical session / Siobhan Quenby
Day 4
THURSDAY
Time / Topic / Method / Leader8.00-8.45 / Blood pressure
1. Managing hypertension in pregnancy and antenatal care
BP checks of pregnant women, availability of sphygmomanometers, health education for reporting signs of pre-eclampsia, time of transfer for raised BP / Seminar / Francis Kamwendo
8.45-9.15 / 2. The eclamptic patient and management: local and international practices / Seminar / Chisale Mhango
9.15-10.00 / 3. Magnesium sulphate
Evidence of effectiveness, is it administered early enough – if not, why not? Local guidelines on use of magnesium sulphate / Seminar / Chisale Mhango
10.00-10.15 / Break
10.15-12.00 / Active monitoring and active intervention prevents ruptured uterus
1. Active monitoring: is the partogram being used?
What is the evidence that it helps? If it works, why is it not happening? Evidence from significant event reviews in Malawi
Review of evidence, discussion of benefit of change
2. Place of delivery: where do women deliver and why? Relevance of place of delivery to incidence of infection and to PPH
Right place, right time? Pathway of care: transfer between healthcare localities
Low birthweight and perinatal loss: what is the evidence? Should there be more guidance on place of care?Transfers in utero, time intervals for decision-making, transport, reception, operative intervention / Seminar
Discussion / Siobhan Quenby
Siobhan Quenby
12.00-1.00 / Lunch
1.00-2.30 / Simulation training for team leadership:
Eclamptic fit and resuscitation of sick infant
Managing and leading teams, drills based on local settings, prioritising / Seminar
Practical session / Siobhan Quenby
Doug Simkiss
2.30-2.45 / Break
2.45-4.00 / Simulation training to teach others:
Eclamptic fit and resuscitation of sick infant
Managing and leading teams, drills based on local settings, prioritising / Seminar
Practical session / Siobhan Quenby
Doug Simkiss
Day 5
FRIDAY
Time / Topic / Method / Leader8.00-
10.am / Agenda setting for service improvement
What changes in current patterns of delivery of care would help to reduce morbidity and mortality. Audit as professional tool to improve clinical service and display leadership, criterion-based audit in Malawi, confidential enquiries into maternal mortality, the right culture and attitude / Seminar / Paul O’Hare
10.00-10.15 / Break
10.15-11.15 / MCQ
11.15-1130 / Break
11.30-12.30 / OSCE first half / Lunch second half / Faculty
12.30-1.30 / Lunch first half / OSCE second half
1.30-2.30 / How to do an audit / Seminar / Siobhan Quenby
Paul O’Hare
2.30-2.45 / Break
2.45-4.00 / Meet your Audit tutor: and plan audit details, time table, email address / Faculty