MALAWI-FIFE LINK

Overall goals

Project concluded.

Screening for diabetic retinopathy prevents blindness. There is no systematic screening programme for diabetic eye disease in Malawi and people are presenting when they have lost vision and it is too late for treatment.

Our aim has been to develop capacity for screening and treatment for diabetic retinopathy. Most recent figures put the population of Malawi at just over 18 million. The number of consultant ophthalmologists working in Malawi is very gradually growing following the development of a training centre in Blantyre, but this number has only risen to 8. This is in contrast to NHS Fife, which has the same number of consultant ophthalmologists for a population of less than 400,000 people.

We, therefore, identified the need for training of other staff within Malawi to manage the workload. To achieve this we arranged and delivered a teaching programme for health care professionals working across all regions of Malawi. This teaching programme began in 2015 and to date we have taught around 206 ophthalmic clinical officers (OCOs), ophthalmic technicians (OT), nurses and optometrists. This year we had 64 participants that attended the course and provided feedback. There were 18 OCOs, 26 OTs, 15 optometrists, 4 nurses and 1 OCO/Cataract surgeon. 1 OCO who has previously attended the course was also present. Participants were from all regions of Malawi as usual including the far northern border with Tanzania.

Key UK Colleagues and Partners

NHS Fife
Malawi Ophthalmology Colleagues
Vision 2020
London School of Hygiene & Tropical Medicine

Sustainable development goals

• SDG 3 - Good health and well-being

Funding source

Vision 2020 Links Programme

Evidence of need

Our aim has been to develop capacity for screening and treatment for diabetic retinopathy. Most recent figures put the population of Malawi at just over 18 million. The number of consultant ophthalmologists working in Malawi is very gradually growing following the development of a training centre in Blantyre, but this number has only risen to 8. This is in contrast to NHS Fife, which has the same number of consultant ophthalmologists for a population of less than 400,000 people. We therefore identified the need for training of other staff within Malawi to manage the workload.

Project areas

Provision of education to staff working in the field of diabetic retinopathy screening in Malawi.

Project activities

This teaching programme began in 2015 and to date we have taught around 206 ophthalmic clinical officers (OCOs), ophthalmic technicians (OT), nurses and optometrists.

Changes

• Understand why screening is important
• Know how to screen
• Recognise features of diabetic retinopathy
• Discuss the result and outcome of screening with a patient and provide appropriate advice
• Give advice to patients on healthy lifestyle in diabetes and on other possible complications
• To understand the management options for sight-threatening diabetic retinopathy
• Update of grading skills and referral protocols for diabetic retinopathy using fundus photography (for graders only)
• Plan how can you prevent one person per week going blind from diabetes in Malawi

Next steps

To continue to provide good quality education to staff in Malawi around the importance of screening and treating diabetic retinopathy.

Challenges

Challenges in the future will be around continuing to be able to access funding to arrange these training programmes.

Partnership principles

• strategic
• harmonised
• effective
• respectful

Project gains

• leadership
• teamwork
• resilience