Daniele Martinelli (Pavia/ IT), Cristina Tassorelli (Pavia/ IT), Rigmor Højland Jensen (Copenhagen/ DK), Manjit Matharu (London/ GB), Victor Tolno (Blantyre/ MW), Darlington Thole (Balaka/ MW), Giovanni Guidotti (Rome/ IT), Maria Cristina Marazzi (Rome/ IT), Massimo Leone (Milan/ IT; Rome/ IT)
Abstract text (incl. figure legends and references)
Background
Neurology is one of the least represented medical specialties in the African continent. In Sub-Saharan Africa (SSA) neurologic care is mostly delivered by non-physician healthcare professionals (np-HCPs). Here we report the results of a survey conducted to evaluate training, needs, and knowledge about headache of a representative group of np-HCPs in Malawi.
Methods
The Regional Outreach Programme of the International Headache Society (ROPE-IHS) promotes headache education worldwide. In SSA ROPE-IHS is developing an education program in collaboration ith the Disease Relief through Excellent and Advanced Means (DREAM) program, a recognized primary care health programme that has activated healthcare facilities in 10 SSA countries. In order to customize the training program on the specific needs of local HCPs, we performed a survey among np-HCPs working in the different DREAM centres in MW. For this purpose, we created a specific questionnaire to test the level of preparation and interest on headache.
Results
Fifty-one healthcare workers (23 women) participated (median age 37 years; median duration of education 3 years): 26 were clinical officers, 6 nurses, 5 clinicians, and 14 had other roles. All respondents agreed on the importance to receive education and training on headache; 84% never attended a full headache course. Past headache courses were mainly delivered by np-HCPs.
Only 2% of headache patients are referred to doctors while the vast majority (84%) are seen by clinical officers or local healers (57 and 27%, respectively).
Conclusions
Insufficient education among healthcare providers is the main barrier to care for headache patients in SSA. A partnership between international societies and recognized local providers is a valid tool to provide bottom-up tailored education on headache at primary care level in difficult contexts as in SSA. The partnership also accomplishes the WHO Intersectoral Global Action Plan.