On-the-job training of clinical officers in Malawi

Although Malawi started a Medical College in 1991 to train medical doctors, it continues to face a chronic shortage of medical staff. A number of qualified doctors and nurses continue to leave the country for better conditions abroad and there are very few specialist services available in District- and Mission-hospitals. Currently there are 2 doctors and 6 nurses per 100,000 population. The minimum numbers for developed countries are respectively 27 doctors and 100 nurses. Meanwhile Malawi has a huge disease burden (greatly augmented by HIV/Aids) and an unacceptably high mortality rate among both children and young adults. The maternal death rate in Malawi has been reported at 1800/100,000 in 2004 and although this figure is disputed, Malawi's rate is almost certainly among the highest in the world. The average life expectancy has come down to 37 years for males, from 65 some 25 years ago.