Adeloye A
Department of Surgery, College of Medicine, University of Malawi.
J Trop Med Hyg. 1993 Aug;96(4):215-21.
Malawi has a pyramidal health care structure, featuring at its broad base health centres and outreach stations in villages and rural areas; at the middle the district hospitals which receive cases from the villages and outreach health stations, and at its narrow apex the few central hospitals one of which is located in each of the three regions as a referral centre. Primary health care is practised at the health centres mostly by paramedical workers. The district hospitals are manned by general duty doctors and the central hospitals by specialists. Medical auxiliaries (clinical officers and medical assistants) play a vital role in the surgical and anaesthetic services of Malawi. Surgical education is community based and aims at providing staff for the various tiers of the health care pyramid, the surgical training being now jointly supervised by both government and non-government organizations and the new College of Medicine of Malawi. The internship programme is designed to prepare doctors for service in the districts where the bulk of their clinical hospital duties is of a surgical nature.
马拉维拥有金字塔式的医疗保健结构，其底部宽广，设有村庄和农村地区的保健中心及外展站；中间是地区医院，接收来自村庄和外展保健站的病例；顶端狭窄，有少数几家中心医院，其中三家地区各有一家作为转诊中心。初级卫生保健主要由辅助医务人员在保健中心提供。地区医院由全科医生驻守，中心医院则由专科医生驻守。医疗辅助人员（临床干事和医疗助理）在马拉维的外科手术和麻醉服务中发挥着至关重要的作用。外科教育以社区为基础，旨在为医疗保健金字塔的各个层级培养工作人员，目前外科培训由政府和非政府组织以及马拉维新成立的医学院联合监督。实习计划旨在让医生为在地区服务做好准备，在这些地区，他们在临床医院的大部分职责都具有外科性质。
