Twelve students, representing each of the University of Maryland's six professional schools in Baltimore, spent July and August in Malawi, conducting a six-week study of maternal/child health services. The project was to determine if gaps in care exist, and if so why-from a local, national, and international perspective.
The students worked together to administer the World Health Organization's (WHO) Safe Motherhood Survey in the rural district of Chikhwawa, in the southern region of Malawi. Chikhwawa is one of the largest and most populated districts in Malawi, and also one of the poorest. The government health facilities include two hospitals and 12 health centers.
The project is funded by the University of Maryland Office of the President and the Global Health Interprofessional Council, which was created to promote interdisciplinary projects among its initiatives.
At the end of the six weeks, the students presented the results of their survey at Chikhwawa District Hospital where nurse-midwives and medical assistants from the hospitals and other rural health centers in the area were given individual results for their health center and a certificate of thanks. The same presentation was made the next day at Ngabu Rural Hospital to share the same information with health care providers in more remote areas.
The students and faculty prepared a report on their findings, which included analysis description of the survey results, an assessment of maternal/child health in the Chikhwawa district using the WHO "pillars " framework for strengthening health systems, a human rights perspective of maternal/child health, and an interprofessional analysis of the project. The value of an interprofessional approach to maternal health was noted in most of the student comments.
A dental student explained, "While on this program I have learned that pharmacy encompasses more than just drugs-but supply chains and distribution. Law encompasses human rights and right to health care. Social work looks beyond the immediate issue at hand and takes into account circumstances that exist beyond the focal problem. Nurses think about patients first and are the closest to interacting with them. Medicine treats the issue and focuses on the pathology. Everyone has a different background-professionally and personally-and so collaboration creates an amalgam of ideologies that comes closer to understanding the macro issue."
A law student said, "Forming bonds between professions is helpful, as it expands everyone's views, understandings, and allows for more future work between disciplines. Perhaps the most important factor of this project is that with problems as big as maternal health, there is never one simple answer; this interdisciplinary approach is what allows us to really get at the heart of such problems."
A medical student commented, "The differences in our backgrounds complement each other, and by embracing them, they allow us to combine all of our strengths to collaborate and design more effective solutions to health care problems, issues that no one discipline can solve alone."
Many students commented that the project highlighted the need for each profession to provide services to patients and providers and, at the same time, advocate for policy change in a multi-pronged, sophisticated approach:
"We were comparing supplies from each center and realized that none of the health centers had the proper strips to test patients' protein levels in their urine," said another student. "I knew this from conducting the surveys and hearing all of the mothers say (they had not taken) the urine dip test. I did not realize the importance of this test until the SOM faculty member connected the dots. She pointed out, in order for maternity staff to diagnose a mother with pre-eclampsia, he/she needs to know two things: blood pressure and protein level. From a social work perspective, this information helps me understand the importance of the protein test and can use this to help educate patients on an individual level and influence the Ministry of Health to supply health centers with this test on a policy and macro-level."
The students included Katie Januario and Dasha Smith from the School of Social Work, Vera Kuffour-Manu and Dorothy Njathi from the School of Nursing, Kristin Lohr and Sarah Britz from the School of Medicine, Maria Maunz and Monet Stanford from the School of Pharmacy, Jonathan Nagel and Ashley LaRiccia from the Francis King Carey School of Law, and Norman Wang and Zachary Schonfield from the School of Dentistry.
Faculty included Miriam Laufer, MD, and Emilie Calvello, MD, MPH, from the School of Medicine; Jody Olsen, PhD, MSW, from the School of Social Work; Peter Danchin, JSD, LLM, LLB, and Virginia Rowthorn, JD, from the Carey School of Law; and Mary Regan, PhD, RN, MS, and Barbara Smith, PhD, RN, FAAN, from the School of Nursing.
To follow the progress of the project, visit the Malawi Project Facebook page here.