ETATMBA Teleconference – 24th August 2011 8:30hrs BST
Notes
Present: Paul O’Hare (Chair), Doug Simkiss, Siobhan Quenby, David Davies, Ed Peile, David
Ellard, Francis Kamwendo, Marshal Lemerani, Godfrey Mbaruku, Alan Davies, Anne-Marie
Brennan. Staffan Bergstrom joined towards the end of the meeting due to communication
difficulties.
1. Apologies
Neil Johnson, Frances Griffiths, Chisale Mhango, Fannie Kachale
2. Minutes of last teleconference held on 21st July 2011
Approved.
3. Update from Tanzania
a) Course delivery. The current students have just graduated and the second course in
Kigoma starts this week. It will include leadership training. A report has been circulated. POH
asked if Sidney Ndeki would be available for the teaching session in November; GM said this would
be possible.
b) Leadership training. The second Kigoma course will include leadership training.
c) Clinical guidelines. An electronic copy has been sent by SB to all members of the
Guidelines group. The Tanzanian guidelines are quite specific; the Malawian ones are more
general. PO’H suggested the two might be synthesised.
d) Research capacity training. PhDs are being discussed with potential candidates and there
is a local paediatrician who is interested.
Note: GM has had problems with email; advises he be contacted only on his Ifakara account
Action: AMB to follow up and distribute the address.
4. Update from Malawi
a) Audits in pilot sites. No communication received by Warwick from the May pilot trainees but
ML reported that they have started cascading their teaching to midwives, clinical officers and
medical assistants in the two hospitals Nkhotakota and St Anne’s. They will shortly be rolling out
the teaching to health centres and audit will follow thereafter. ML asked about randomisation. This
needs to await Warwick ethics approval. DE commented that a system for NPC applications needs
to be in place.
Action: ML to send a brief report on progress so far
DE to contact ML about the application process
b) E-supervision. DE will be allocated to work on the project for 1 day per week and will
devote time to supervising the PhD students.
c) Progress in accreditation of course with University of Malawi CoM. A draft has been
prepared; EP feels this document forms a good working basis for the course, and further details can
be added. However, a preliminary response from the Dean of the CoM is needed to confirm this.
Action: FK to submit paperwork for accreditation for agreement in principle to the Dean of the CoM
and to obtain his reassurance that retrospective accreditation could be granted for the trainees
recruited in November, while full details of the curriculum in modules 2 and 3 evolve.
d) Research ethics application. The CoM have classified the project as training rather than
research and have deemed ethical approval at this stage to be unnecessary, and that baseline data
can be collected as training commences. On the basis of this, it was agreed that randomisation of
the districts can commence, but that FK should clarify the status of the project with the CoM ethics
committee. The application to the National Ethics Committee application should proceed after
discussion with the Chair of the CoM ethics committee.
Action: FK has arranged a meeting with chair of CoM Ethics Committee (who is also Vice-Chair of
the National Ethics Committee), Professor Mfutso-Bengo, on 30th August.
e) PhD applications. ML has applied for formal inclusion.
Action: DE to work with FK to encourage formal enrolment and the start of supervision for the
second candidate Wanangwa Chimwaza.
5. Action points
5a) Progress in WP1 “Assessment” (DD)
Senga Pemba has send the Tanzanian assessment framework. This needs to be discussed, and a
framework for Malawi developed.
Action: Warwick members of the Assessment group to meet on 21st September.
5b) Progress in WP2 “Guidelines (SB)
Guidelines for Malawi and Tanzania now received. The WHO 2007 “Managing Complications in
Pregnancy and Childbirth”, on which the Malawi guidelines are based (CM to confirm) also
circulated. DS has been researching the evidence base for the paediatric guidelines.
Action: SQ to review obstetric guidelines from both countries in light of WHO guidelines.
DS to continue with review of paediatric guidelines.
Note: Since the teleconference, CM has confirmed that the WHO guidelines used were the 2003
version entitled “Integrated Management of Pregnancy and Childbirth. Pregnancy, Childbirth,
Postpartum and Newborn Care: A guide for essential practice”.
5c) Progress in WP3 “Professional support network” (DD)
DD has been in contact with Jaques Devos of Vodacom to see if it is possible to replicate the
scheme of SMS and toll-free numbers used successfully in Ifakara.
FK is beginning to set up a professional support association in Malawi. The trainees are a natural
starting-point for this. The aim will be to involve the Malawi NPCs during module 1 in November.
Similar initial moves have been made in Tanzania and need to be developed. There are resources
within the budget to support secretarial assistance.
Action: FK and GM to contact individuals who may be able to support the development of a
network.
5d) Action points from June conference
(i) PO’H commented that we have guidelines from Malawi, Tanzania and the WHO. A review of
these should aim to produce something adapted to both countries. SQ said that we should focus on
ensuring the guidelines are evidence-based, in accordance with the WHO. PO’H suggested
producing a user-friendly version of the lengthy WHO guidelines might be helpful for the NPCs. SB
was less certain, and questioned whether the WHO guidelines could be viewed as the gold
standard.
PO’H reminded the group that the deadline for this work is the end of the year and progress needs
to be made urgently.
Action: SQ and SB will make a plan for going through the obstetric guidelines, covering one topic
per month; DS will continue with the neonatal guidelines. Should aim for mid-November so that
materials can be used on the next training course.
(ii) Responses awaited from Sam Lubago and Tom Lissauer regarding membership of the External
Advisory Board.
Action: EP will follow up his initial contact with Sam Lubago and Tom Lissauer.
(iii) All other action points from the June conference have been completed or are in progress.
6. Update on establishing committees and EC
AMB reported that all committees, with the exception of the External Advisory Board (see point 5d
(ii) above) are now formed. The Ethics Advisory Committee will be meeting in September; the
External Advisory Board, Quality Assurance Committee will meet in October.
Progress for the accession of the College of Medicine is continuing. Documentation has been sent
to the EC for final approval.
7. Any other business
ML reported that Dr Chithope Mwale, the Head of Clinical Department, has agreed in principle to
take an active role in the ETATMBA Project. ML and the Deputy Director of Reproductive Health
Services, Mrs Fannie Kachale, report to him directly.
Action: ML to provide Dr Mwale’s contact details once his participation in the project has been
confirmed.
12. Date of next teleconference
The next meeting will be Wednesday 21st September at 08.30am (UK), 09.30am (Malawi) and
10.30am (Tanzania).