Mkandawire Nyengo, Ngulube Christopher, Lavy Christopher
Department of Surgery, College of Medicine, University of Malawi, P/Bag 360, Chichiri, Blantyre, Malawi.
Clin Orthop Relat Res. 2008 Oct;466(10):2385-91. doi: 10.1007/s11999-008-0366-5. Epub 2008 Jul 15.
Malawi has a population of about 13 million people, 85% of whom live in rural areas. The gross national income per capita is US$620, with 42% of the people living on less than US$1 per day. The government per capita expenditure on health is US$5. Malawi has 266 doctors, of whom only nine are orthopaedic surgeons. To address the severe shortage of doctors, Malawi relies heavily on paramedical officers to provide the bulk of healthcare. Specialized orthopaedic clinical officers have been trained since 1985 and are deployed primarily in rural district hospitals to manage 80% to 90% of the orthopaedic workload in Malawi. They are trained in conservative management of most common traumatic and nontraumatic musculoskeletal conditions. Since the program began, 117 orthopaedic clinical officers have been trained, of whom 82 are in clinical practice. In 2002, Malawi began a local orthopaedic postgraduate program with an intake of one to two candidates per year. However, orthopaedic clinical officers will continue to be needed for the foreseeable future. Orthopaedic clinical officer training is a cost-effective way of providing trained healthcare workers to meet the orthopaedic needs of a country with very few doctors and even fewer orthopaedic surgeons.
马拉维约有1300万人口，其中85%生活在农村地区。人均国民收入为620美元，42%的人每天生活费不足1美元。政府人均卫生支出为5美元。马拉维有266名医生，其中只有9名是骨科外科医生。为解决医生严重短缺的问题，马拉维严重依赖医护辅助人员来提供大部分医疗服务。自1985年以来，专门的骨科临床人员接受了培训，并主要部署在农村地区医院，负责处理马拉维80%至90%的骨科工作量。他们接受了最常见创伤性和非创伤性肌肉骨骼疾病保守治疗的培训。自该项目启动以来，已培训了117名骨科临床人员，其中82人已在临床工作。2002年，马拉维启动了一个本地骨科研究生项目，每年招收一至两名学员。然而，在可预见的未来，仍将需要骨科临床人员。培训骨科临床人员是一种经济有效的方式，可以提供经过培训的医护人员，以满足一个医生极少、骨科外科医生更少的国家的骨科需求。
