Technical Priorities for Orthopaedic Trauma Care Development in Malawi

Area of Science:

• Public Health
• Orthopaedic Surgery
• Health Systems Strengthening

Background:

• Malawi faces a high and increasing burden of musculoskeletal injuries.
• Existing orthopaedic trauma care capacity is insufficient to meet the demand.

Purpose of the Study:

• To identify essential goals and challenges in musculoskeletal trauma care delivery across Malawi.
• To prioritize these challenges through expert consensus.

Main Methods:

• A scoping literature review was conducted.
• Essential goals and challenges were defined across five domains: injury prevention, pre-hospital care, rural health centres, district hospitals, and central hospitals.
• A panel of experts on Malawian orthopaedic trauma care ratified goals and prioritized challenges.

Main Results:

• Top priorities include injury prevention, definitive treatment at central hospitals, and initial fracture management at district hospitals.
• Specific recommendations address road injury prevention, pre-hospital transportation, basic injury management training for rural health workers, improving diagnostic imaging at district hospitals, and enhancing surgical capacity at central hospitals.

Conclusions:

• Addressing prioritized challenges requires developing targeted strategies and working groups.
• The study provides a practical guide for stakeholders and a replicable framework for other clinical areas and low- and middle-income countries.