Malawian collaboration results in NIH proposal

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MSU College of Osteopathic Medicine Department of Family and Community Medicine Assistant Professor Rebecca Malouin and Professor and Chair Amy Keenum’s long-time collaboration with partners at the University of Malawi might go to the next level, thanks to a National Institutes of Health proposal to improve primary care treatment of non-communicable disease in Malawi.

The effort began when Malouin and Keenum noticed that care delivery for non-communicable disease in Malawi is based on vertical, siloed health programs. They wanted to develop and implement new, more efficient models of care, increase collaboration with the University of Malawi Department of Family Medicine and build capacity within the University of Malawi and MSU through bi‐directional peer mentorship.

“The Malawi health care model is presently fragmented in many places,” said Keenum. “At a district hospital in Mangochi, Malawi, the hypertension clinic is on Tuesday and the diabetes clinic is on Friday. Many patients have both diseases and the same workers care for both. There are no specialists outside of the few teaching hospitals. We want to study what is being done and explore what the health care workers want to do.”

Malouin wrote a proposal in collaboration with Martha Makwero, chairperson of the University of Malawi College of Medicine’s Department of Family Medicine, and was successful in receiving a $50,000 planning grant from the MSU Alliance for African Partnership to explore the topic. They wanted to work with stakeholders in Malawi to understand the current state of non-communicable disease care, jointly identify research questions, conduct a continuing medical education course on the topic and host writing retreats for manuscript and proposal development. 
 
The project is laying the groundwork to another promising grant opportunity available through the NIH.   

Using an MSU African Studies Center travel grant and support from the MSUCOM Department of Family and Community Medicine, Malouin and Keenum traveled to the University of Malawi to work with the University of Malawi Department of Family Medicine and others to develop the NIH proposal. They visited district and community hospitals to identify potential research sites.

The grant-planning meeting was convened by faculty members in the University of Malawi family medicine department and included representatives from partner nongovernmental organizations including Dignitas International and Partners in Health.  

The NIH proposal was designed to catalogue current non-communicable disease care models relevant to primary care in Malawi and to pilot the most promising model in two government clinics. Malouin expects to find out if it will be funded in summer 2017.

The research might have global implications.  “Non-communicable diseases are a growing epidemic worldwide,” said Malouin. “Developing successful integrated primary care models will have relevance to other areas within Africa and other low resource settings.”

Malouin, a primary care researcher, has visited Malawi a number of times to study health services there. Keenum served as a Fulbright scholar in the 2012-13 academic year in the University of Malawi Department of Family Medicine.