Module 1
Curriculum Malawi
November/December 2011
Day 1
MONDAY
Time
8.008.30
8.309.30
9.309.45
9.45
10-45
10.4511.00
11.0012.00
12.001.00
1.002.30
2.302.45
2.454.00
Topic
Clinical officers as advanced leaders introduction
Method
Discussion
Leader
Paul O’Hare
Epidemiology
seminar
Chisale Mhango
MCQ
Break
1. Epidemiology
Traditional birth attendants, rationale for change,
current data on place of delivery, major causes of
maternal death and neonatal death
Break
OSCE demonstration
Siobhan Quenby
Doug Simkiss
Paul O’Hare
Lunch
Safer vaginal delivery;
Simulations of ECV, breech, twins, vacuum extraction,
shoulder dystocia.
Break
Practical
session
Siobhan Quenby
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
8.009.00
9.0010.00
10.0010.15
10.1511.00
11.0012.00
12.001.00
1.002.30
2.302.45
2.454.00
Topic
Neonatal resuscitation
What about the baby? What are the major causes of
neonatal death and disability in Malawi?
1. Why neonatal resuscitation is important; principles
of good neonatal care
Wider team-working; adoption of evidence-based
practice; hypothermia, kangaroo mother care,
breastfeeding
Method
Group
discussion
Leader
Doug Simkiss
Seminar
Doug Simkiss
2. Serious maternal and neonatal infections in the
local context
Appropriate antibiotics on local inventory? What to do
when these not available
Break
Group
discussion
Francis Kamwendo
Doug Simkiss
1. Collecting the data on HIV infection and acting on it
Checking HIV status of pregnant women, offering
counselling and contact tracing
Seminar
Francis Kamwendo
2. The implications of being HIV positive for
preventing puerperal sepsis
4. Management of sick neonates
Signs and symptoms; appropriate interventions, local
settings
Lunch
Seminar
Chisale Mhango
Seminar
Doug Simkiss
Neonatal resuscitation scenarios
Learning techniques, training others. Bag-and-mask,
Helping Babies Breathe, intubation (trial session)
Break
Practical
session
Doug Simkiss
Neonatal resuscitation scenarios
Learning techniques, training others. Bag-and-mask,
Helping Babies Breathe, intubation (trial session)
Practical
session
Doug Simkiss
Day 3
WEDNESDAY
Time
8.008.30
8.309.00
9.009.30
9.309.45
9.4512.00
Topic
Managing bleeding and blood loss in PPH
Method
Seminar
Leader
Francis Kamwendo
Seminar
Paul O’Hare
Seminar
Discussion
Francis Kamwendo
Seminar
Chisale Mhango
2. Effective intervention post-abortion
Life support and general measures, the manual
vacuum aspirator
Lunch
Seminar
Chisale Mhango
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),
Break
Practical
session
Siobhan Quenby
Other active interventions in PPH: what is available?
Teaching others, auditing, preventing recurrence
Practical
session
Siobhan Quenby
1. Are we giving women a good start
Detecting, preventing and correcting anaemia, steps
to enhance current practice
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
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
Break
Abortion
1. The local scene
Legal situation, epidemiological evidence, Malawi
National Health Service Guidelines ch. 6
12.001.00
1.002.30
2.302.45
2.454.00
Day 4
THURSDAY
Time
8.008.45
8.459.15
9.1510.00
10.0010.15
10.1512.00
Topic
Blood pressure
Method
Seminar
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
2. The eclamptic patient and management: local and
Seminar
international practices
3. Magnesium sulphate
Seminar
Evidence of effectiveness, is it administered early
enough – if not, why not? Local guidelines on use of
magnesium sulphate
Break
Active monitoring and active intervention prevents
ruptured uterus
Leader
Francis Kamwendo
Chisale Mhango
Chisale Mhango
Seminar
Siobhan Quenby
Discussion
Siobhan Quenby
Simulation training for team leadership:
Eclamptic fit and resuscitation of sick infant
Managing and leading teams, drills based on local
settings, prioritising
Break
Seminar
Siobhan Quenby
Practical
session
Doug Simkiss
Simulation training to teach others:
Eclamptic fit and resuscitation of sick infant
Managing and leading teams, drills based on local
settings, prioritising
Seminar
Siobhan Quenby
Practical
session
Doug Simkiss
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
12.001.00
1.002.30
2.302.45
2.454.00
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 decisionmaking, transport, reception, operative intervention
Lunch
Day 5
FRIDAY
Time
8.0010.am
10.0010.15
10.1511.15
11.151130
11.3012.30
12.301.30
1.302.30
2.302.45
2.454.00
Topic
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
Break
Method
Seminar
Leader
Paul O’Hare
MCQ
Break
OSCE first half / Lunch second half
Faculty
Lunch first half / OSCE second half
How to do an audit
Seminar
Siobhan Quenby
Paul O’Hare
Break
Meet your Audit tutor: and plan audit details, time
table, email address
Faculty