Larsson Emma, Mawkin Mala, Taylor-Robinson Simon D, Harrington Peter, Gondwe Hastings, Watson Chris, Gallagher Joseph, Ledwidge Mark, Chirambo Griphin Baxter, O'Donoghue John
Imperial College London, South Kensington, London SW7 2BX, UK.
gHealth Research Group, University College Dublin, Dublin, Ireland.
Int J Gen Med. 2020 Dec 31;13:1723-1730. doi: 10.2147/IJGM.S285130. eCollection 2020.
Safe, reliable, and effective healthcare systems are essential for all nations to ensure the health and wellbeing of their citizens. However, this is not always achievable with clinical therapies constantly evolving, resulting in a domino effect of structural, policy and training changes. For low- and middle-income countries (LMICs), implementing change is restricted. It is essential that innovative and realistic solutions are developed, so that effective change can be realised in LMICs.
In this report of a global health conference held in July 2019, six perspectives are presented which aim to generate long-term positive change in Malaŵi. Perspective 1: Pneumonia - the BIOTOPE study (BIOmarkers TO diagnose PnEumonia) sought to determine the aetiology of pneumonia in children presenting in primary care. It assessed blood-based markers of bacterial infection as part of a rapid diagnostic approach to better utilise existing resources in Malaŵi. Perspective 2: Cardiovascular - the CARDIA project (CARdiac Dysfunction in Africa) was established to assess clinical and biochemical phenotypes of diabetic patients in Malaŵi. Perspective 3: Asthma - an observational study was conducted to implement a health system strengthening initiative for asthma. The use of locally adapted formularies and protocols with ongoing online mentoring through expert partnerships provided an opportunity to sustainably build capacity. Perspective 4: Sustainable Partnerships - establishing the Malaŵi electronic Health (eHealth) Research Centre, an international hub to develop education, research and innovation for long-term collaboration. Perspective 5: Part-Time PhD Studies - undertaking a part-time PhD within a LMIC provides logistic challenges, but also a number of opportunities for observational research. Perspective 6: Medical electives - an undergraduate elective allows real exposure to global health and facilitates life-long collaborations at an early stage in a medical career.
Malaŵi is an under-doctored and resource-poor country. North-South partnerships in Malaŵi should be strengthened with particular emphasis on healthcare innovations, such as eHealth, which allow healthcare problems to be highlighted early while preventative measures are still possible.
安全、可靠且有效的医疗保健系统对于所有国家确保其公民的健康和福祉至关重要。然而，随着临床治疗不断发展，这一目标并非总能实现，进而引发了结构、政策和培训变革的多米诺效应。对于低收入和中等收入国家（LMICs）而言，实施变革受到限制。因此，必须制定创新且切实可行的解决方案，以便在低收入和中等收入国家实现有效的变革。
在这份关于2019年7月举行的全球健康会议的报告中，提出了六个旨在为马拉维带来长期积极变革的观点。观点1：肺炎——BIOTOPE研究（用于诊断肺炎的生物标志物）旨在确定在初级保健机构就诊的儿童肺炎的病因。该研究评估了基于血液的细菌感染标志物，作为一种快速诊断方法的一部分，以便更好地利用马拉维现有的资源。观点2：心血管疾病——CARDIA项目（非洲心脏功能障碍）旨在评估马拉维糖尿病患者的临床和生化表型。观点3：哮喘——开展了一项观察性研究，以实施一项针对哮喘的卫生系统强化倡议。使用当地适配的处方集和方案，并通过专家伙伴关系进行持续的在线指导，提供了一个可持续建设能力的机会。观点4：可持续伙伴关系——建立马拉维电子健康（eHealth）研究中心，这是一个国际中心，旨在开展教育、研究和创新，以实现长期合作。观点5：兼职博士研究——在低收入和中等收入国家攻读兼职博士学位存在后勤方面的挑战，但也提供了一些观察性研究的机会。观点6：医学选修课——本科选修课能让学生真正接触全球健康，并在医学职业生涯早期促进终身合作。
马拉维是一个医生数量不足且资源匮乏的国家。应加强马拉维的南北伙伴关系，尤其要注重医疗保健创新，如电子健康，它能在仍有可能采取预防措施时尽早凸显医疗保健问题。
