Conducting global health research: experiences from a neonatal sepsis study in Malawi

Introduction: Low-and-middle-income countries (LMIC) have the highest burden of disease and the lowest amount of resources. There are many challenges to improving health care: lack of surveillance and data collection, lack of human resources, and lack of infrastructure. Solutions to health care challenges do not simply transcend countries. Devising collaborative and innovative solutions is crucial. Considering the experiences of global health research teams is essential to conducting research in LMIC’s and subsequently reducing morbidity and mortality.

Methods: Prospective cohort study of infants <3 months evaluated for sepsis at the Kamuzu Central Hospital in Lilongwe, Malawi. Within this study, we performed phenomenological exploration of the experiences of the clinical care teams from Lilongwe, Malawi and Vancouver, Canada. Semi-structured, open-ended interview questions were derived and disseminated to 7 team members by email. Responses were collected and themed accordingly.

Results: Six participants responded. Based on preliminary analysis of the data, seven distinctive themes emerged: the learning curve, challenges encountered, team dynamics, benefits of research, moving forward, and expert advice. Benefits of research are further broken down into three subthemes: neonatal health, neonatal unit operations, and professional growth. The themes represent a powerful intersection of neonatal care, multidisciplinary care and global perspectives.

Conclusion: Observational research in LMIC’s can improve health care. Benefits extend past the target population of interest into hospital units, practice policies, staff development and sustainability. Regardless of geographical location, maintaining the team dynamic is necessary. Lastly, sustainability of relationships and benefits of the research project is a critical portion of any proposal.