It seems very little time since my initial visit to Malawi in September 2017 for the first curriculum conference to assess the feasibility of establishing a Bachelor of Dental Surgery degree programme at the University of Malawi College of Medicine (now Kamuzu University of Health Sciences [KUHeS]). The success of that meeting culminated in a second curriculum conference in 2018 and, ultimately, approval of the new BDS curriculum on 21st March 2018, with the first cohort of students enrolled in August 2018.
That first group of BDS students has now completed the course, signalling the requirement for a full curriculum review. The process to be followed is laid down by KUHeS procedures and begins with a stakeholder meeting. For the BDS curriculum, that meeting took place on 10th and 11th March 2025 at Chikho Hotel, Mponela.
Day 1: Chair – Dr Thandie Mwalukomo, Coordinator for Curriculum Activities & Strategic Direction, School of Medicine & Oral Health, KUHeS
Following an opening prayer and introductions of all present, Professor Wakisa Mulwafu, Executive Dean of Medicine at KUHeS, provided an overview of the programmes offered by the School of Medicine & Oral Health at KUHeS. He finished his presentation with some of the challenges presented by the BDS degree programme which the curriculum review should address.
One of the main stakeholders for the BDS degree programme is the National Council for Higher Education (NCHE). Dr Ishmael Nyirenda represented the NCHE and delivered an extensive presentation covering the basis of accreditation, the relevant standards, tools, guidelines and templates used, together with the implications and effects of accreditation. In summary, the basis of accreditation (Section 28, NCHE Act) requires acceptable standards surrounding:
- Physical, human, financial, teaching and learning resources
- Management and operational procedures
- Acceptable standards of academic life focusing on teaching, research, community service and expert service
Professional programmes, such as the BDS course, are accredited by NCHE after being approved by another of our main stakeholders, the Medical Council of Malawi (MCM). Dr David Zolowere, the Chief Executive and Registrar, of the MCM attended the stakeholder meeting and spoke next.
Dr Zolowere described the creation of the MCM through the Medical Practitioners and Dentists Act No. 17 of 1987, then spoke of the vision, mission and core values of the MCM and its functions:
The MCM is a critical stakeholder for the BDS programme because it is a legal requirement that the course is approved by the Council. Subsequently, the MCM will only register practitioners who have trained under courses it has approved. The existing BDS curriculum received MCM approval in 2018, but it will now be necessary to share a copy of that original curriculum with the planned revisions shown in track changes, so that the Council can consider the next version.
The next speaker was Dr Nitta Chinyama, Deputy Director of Clinical & Rehabilitative Services at the Ministry of Health. There were some technical issues with the projection when Dr Chinyama began to speak and George Kafera, one of the BDS 5 students who had just passed Finals, leapt to the rescue – a role he would repeat on several occasions over the course of the two days!
Dr Chinyama spoke about the relevance of the BDS degree programme to two key pillars of the Malawi Government Health Sector Strategic Plan III:
- Health service delivery pillar: Increase equitable access to, and improve quality of, health care services.
- Human resources pillar: Improve the availability of competent and motivated human resources for health, for quality health service delivery that is effective, efficient and equitable.
Dr Chinyama then moved on to speak about the high level of activity at a global level to improve access to oral health care for all, aiming for universal health coverage (UHC) for oral health for all individuals and communities by 2030. The six principles of this global oral health strategy are:
- Public health approach to oral health
- Integration of oral health into primary health care
- Innovative workforce models to respond to population needs
- People-centred oral health
- Digital technologies for oral health
- Oral health interventions across the life span
The role of the young dentists who will be graduating from KUHeS over the coming years will be key to achieving these local and global goals for oral health in Malawi.
The final speaker before the coffee break was Dr Peter Chimimba, who has been such a central figure, not only in establishing the BDS degree programme, but also in creation of Malawi’s National Oral Health Policy, delivery of the National Child Oral Health Survey and currently as a member of the Task Force that has been established to develop a National Child Oral Health Improvement Plan. Nobody could be better placed than Peter to talk about the history of the BDS degree, which was first conceived 27 years ago, but finally left the blocks in 2017 and has now reached the stage in 2025 of graduating its first cohort of students.
Before the coffee break, an official photo was taken of those attending the stakeholder meeting:
The first speaker after coffee was Dr James Mchenga, Acting Head of the Department of Oral Health Sciences, who provided an overview of the first five years of the BDS curriculum. As with any new course that starts from scratch, there are challenges in the early years. These have included staffing and physical infrastructure, both of which have been mitigated and for which long-term sustainable improvement plans exist.
Clearly, some of the most important feedback on the existing curriculum comes from the first group of students to successfully complete the BDS course. In the run-up to the stakeholder meeting, that group of students had completed a detailed questionnaire and the data were analysed for presentation to the delegates. Chifundo Banda, who had been the President of the Dental Student Society and George Kafera, who was the BDS 5 Class President, gave a joint presentation of the class feedback. The general consensus was that the curriculum was extremely engaging and that the staff were very approachable, but that elements of the administration and organisation of the course required attention. George finished his presentation by saying that despite challenges along the way, he and his classmates were nevertheless ‘globally competent and locally relevant’, the mantra adopted from the beginning of The MalDent Project when it was first used by Dr Mwapatsa Mipando!
I was due to speak next on progress with construction of the new clinical dental teaching facility and student hub for the Blantyre Campus of KUHeS. Unfortunately, repeated power cuts interfered with my presentation and I was unable to share the computer generated illustrations of the planned new facility. I have included one picture in this blog post to provide an impression for readers of the new building that is due to commence construction very soon:
The final presentation of the morning was delivered by Dr Wellington Chikuni on behalf of the Ministry of Health. Wellington is a dental surgeon who works at the Queen Elizabeth Hospital Dental Department in Blantyre and is engaged in clinical teaching of BDS undergraduates. Wellington spoke about the interface of the BDS programme with Malawi’s National Oral Health Policy and touched again on some of the points raised by Dr Nitta Chinyama earlier in the morning. It is critical that the BDS curriculum includes a substantial component that relates directly to the national policy, a key consideration for the forthcoming review.
After lunch, there were two sessions of small group work. The first was a SWOT analysis of the BDS programme and the second was a session addressing the challenges of the BDS programme. Once again, both George Kafera and Chifundo Banda played leading roles.
The day concluded with a general discussion led by Professor Wakisa Mulwafu.
Day 2: Chair – Dr James Mchenga, Acting Head, Department of Oral Health Sciences, KUHeS
The second day began with an excellent recap on the discussions during Day 1, delivered by Dr Peter Chimimba.
Peter’s recap session was followed by a presentation from Mr Emmanuel Chiphiko, who is based in the KUHeS Teaching & Learning Development Centre, on the KUHeS Curriculum Development Framework. This very technical presentation defined clearly the steps we will need to take as we complete the forthcoming BDS curriculum review.
Next up was an excellent presentation on the interface between the MB BS and the BDS curricula, delivered by Dr Lerato Mambulu, who is the MB BS Year 3 coordinator. The BDS and MB BS students are taught together in Years 1 and 2, but begin to diverge significantly in Year 3. Since the recent review of the MB BS Year 3 curriculum, there will be significant work to do when we review Year 3 of the BDS course.
The final session before the coffee break featured the return of Mr Emmanuel Chiphiko, who covered Intended Learning Outcomes and Bloom’s Taxonomy.
Immediately after coffee, we divided again into small groups to discuss ‘Assessing clinical competence and professionalism on the BDS degree programme’. Once again, George Kafera and Chifundo Banda, our two new alumni, showed great initiative in facilitating the group work and reporting back in the plenary session.
One of the elements of the BDS course that has proved particularly challenging is the research methodology component, which requires identification of a research question, writing a protocol, making a submission to the KUHeS Research Ethics Committee, collecting data and delivering a research report. This work is spread over Years 3 and 4. Dr Loti Nyirenda, from the School of Global and Public Health, oversees this module and gave some very clear, practical suggestions on modifications to its delivery that would facilitate its completion by the BDS students in a timely fashion.
The final session of the meeting on the last afternoon included one presentation on opportunities for outreach and community engagement for BDS students …
… and a heated discussion about multiple entry and exit targets for the BDS degree programme. The formal proceedings closed with a prayer.
The meeting concluded with a photograph of George Kafera and Chifundo Banda, our two alumni, with the BDS teaching staff who were present at the meeting. It was a very happy ending to a positive and fruitful BDS curriculum stakeholder meeting.
The hard work now begins. Once the notes from the stakeholder meeting are made available, an extended departmental meeting, held over several days, will be required to draft the suggested changes to the BDS curriculum for presentation to the School of Medicine & Oral Health. This will be followed by scrutiny from two further committees before final presentation to KUHeS Senate for approval.
There’s a lot to do, but the review process offers a great opportunity for further evolution and enhancement of what all present at the stakeholder meeting agreed is fundamentally a very sound curriculum.
Acknowledgements
The support of Ms Walusungu Nkhwazi, Ms Annie Mwapasa and Ms Madalitso Kaphamtengo with organisation and running of the meeting is gratefully acknowledged.
Thank you for the update đź‘Ź
Great to see the work being done here, Prof!
Nice
It was quite good
The planned dentistry building looks impressive, we can’t wait!