Training Non-Neurologist Healthcare Professionals in the Recognition and Management of Movement Disorders in Malawi.

Background: Many patients with neurological disorders in Malawi are seen by non-neurologist healthcare professionals due to the low number of neurologists available in the country. Movement disorders are a growing concern at neurology clinics and patients often present late, having spent years before getting a neurology referral. In line with the WHO's global action plan on improving neurological care, we organized a workshop for non-neurologist healthcare professionals on the clinical overview of common movement disorders. Methods: The 2-day in-person workshop was held in Blantyre city and included pre- and post-workshop knowledge assessments, lectures, and neurologist-guided patient sessions. Sessions covered the pathophysiology, presentation, and management of common movement disorders (e.g Parkinson's disease, essential tremor, dystonia and chorea). At the end, participants provided feedback on the workshop through an anonymous post-workshop evaluation form with point Likert scale and open-ended questions. Results: Forty-five participants from all tiers of Malawi's healthcare system, including general practitioners, internists, physiotherapists, and residents in non-neurology disciplines, attended the workshop. On reflection, many planned to improve their clinical practice with the knowledge and skills gained during the workshop. Participants expressed high satisfaction with the workshop content and the majority rated patient sessions as the most preferred type of learning format. Some sessions, including dystonia, functional movement disorders, and movement disorders in psychiatry, were rated as difficult and warranted further training. Participants felt the workshop could be improved by holding regular trainings for longer and including more primary healthcare professionals. Discussion: This first workshop on movement disorders in Malawi was an effective continuing professional development program which facilitated interprofessional learning and intended changes in clinical practice. It provided lessons on improving neurological care through training of non-neurologist healthcare workers which can be adopted for other high-burden neurological disorders in Malawi.