Management of feeding and swallowing disorders in Malawi

ABSTRACT

Malawi, as a low and middle income country (LMIC), with one of the lowest per capita gross domestic products, faces challenges in the provision of healthcare to its citizens. According to the Centers for Disease Control (CDC), leading causes of death include but are not limited to, lower respiratory disease, stroke, cancer, neonatal disorders, and nutritional deficiencies. Feeding and swallowing disorders can present as a symptom to any of these medical diagnoses. Currently, there are no known studies focusing on the service provision for feeding and swallowing disorders in Malawi.

This pilot study was designed to provide a baseline on how feeding and swallowing disorders are currently being provided for in an emerging country like Malawi. Malawian healthcare professionals who see patients with feeding and swallowing disorders completed a survey and interview pertaining to their personal demographics, caseload, opinions, experiences, and treatment recommendations regarding the management of swallowing disorders (dysphagia).

Results indicate a wide range of occupations (Otolaryngoloists, Rehabilitation Technicians, Audiology Technicians, and Nurses) are involved in feeding and swallowing care. Participants expressed a high obligation to provide services for feeding and swallowing disorders, as well as a high concern for their patients. Generally, participants expressed high confidence in their treatment abilities, which did not correspond to knowledge of treatment recommendations that meet U.S. standards of care. Specifically, there was no variation in treatment recommendations across severities and a general lack of resources and tools for assessing and treating dysphagia. Treatment recommendations tended to align with resources currently available in Malawi.

Implications for the utilization of NGOs (non-governmental organizations) and the education of healthcare providers on feeding and swallowing disorders in the social and cultural contexts of this country are discussed.