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About Sickkids
About SickKids

June 3, 2013

Learning Institute members help to train faculty in Malawi

By Hillete Warner

Dr. Faizal Haji, Research Fellow, The Hospital for Sick Children, Ritta Banda (centre), nurse in Malawi and facilitator of the ETAT course, and Elaine Sigalet, simulation consultant from the Sidra Medical Centre in Doha, Qatar, are introducing simulation-augmented education to help lower Malawi’s infant mortality rate.
Dr. Faizal Haji, Research Fellow, The Hospital for Sick Children, Ritta Banda (centre), nurse in Malawi and facilitator of the ETAT course, and Elaine Sigalet, simulation consultant from the Sidra Medical Centre in Doha, Qatar, are introducing simulation-augmented education to help lower Malawi’s infant mortality rate.

Dr. Adam Dubrowski, Education Researcher in SickKids Learning Institute, and his doctoral student, Dr. Faizal Haji, have returned from their trip to Malawi with six other international educators from the International Pediatric Simulation Society.

The exploratory trip marked the beginning of an exciting project that aims to use simulation-augmented education to help lower the mortality rate of children in Malawi. Currently, Malawi has one of the highest infant mortality rates in the world. One in every eight children in Malawi dies before the age of five.

In a response to Malawi’s severe infant mortality rate, the World Health Organization developed the Emergency Triage Assessment and Treatment (ETAT) course in 2005. The ETAT guidelines provided medical and non-medical staff with the knowledge needed to identify very sick children and start treatment immediately upon admittance into a hospital or health care centre. Since its implementation, the mortality rate has decreased significantly and over the past 10 years the rate has been cut in half.

Despite the effectiveness of the ETAT, Malawi’s neonatal, infant and child mortality rates are still one of the highest in the world. In 2012, the child death rate in Malawi was 92 per 1,000 births. In comparison, the rate in Canada was five deaths per 1,000 births. Seven out of 10 child deaths in Malawi are due to preventable causes such as malaria, diarrhea, pneumonia, anemia, malnutrition and neonatal causes. Malaria and pneumonia alone account for nearly half of those deaths.  

In 2012, Dubrowski and other leaders from the IPSS and Malawi Secretariat of Health started the Malawi Project to try to combat these high numbers. Dubrowski’s previous experience in adult simulation-augmented education in Ethiopia and Haji’s expertise in educational program development and evaluation were the main contributions from the SickKids team.   

During their first visit, the group collected data on the education tools used in hospitals, health-care centres and universities across the country. They met with senior officials from the Malawi Secretariat of Health and the public health care system, as well as the leaders from the College of Nursing and educators from the university and public health-care system.

The team found that although there is some use of simulation in the ETAT course, there is a large gap in pedagogy related to simulation and hardly any simulation-based education in faculty development across universities and hospitals in Malawi.

The team is in the process of reporting their findings to the Malawi Secretariat of Health. They are collaborating with Malawii educators to develop a faculty training program and will be writing a series of papers describing their work that will be disseminated locally and internationally at conferences linked to the International Pediatric Simulation Society and the Society for Simulation in Healthcare. The team will return to Malawi in September 2013 to deliver their faculty development program.

To learn more about the SickKids Simulation Program.

To learn more about SickKids on the international stage, please visit SickKids International and SickKids Global Child Health.