Co-Creating a Socially Responsive Palliative Care Curriculum: Lessons from Stakeholder Engagement in Malawi
Keywords:
social accountability, Partnership pentagram plus, Appreciative inquiry, Bachelor of Science, Palliative care, MalawiAbstract
Despite growing demand, access to palliative care in Africa remains critically limited, with fewer than 5% of those in need receiving appropriate services. In Malawi, this gap is driven by a complex mix of systemic, individual, and relational barriers. In response, the Kamuzu University of Health Sciences (KUHeS) launched the Bachelor of Science in Palliative Care (BPAC) program in 2018 to train specialist providers locally.
This paper explores how stakeholder engagement informed a curriculum review aimed at strengthening the social accountability of the program. In 2024, a participatory curriculum review was conducted using the Partnership Pentagram Plus (PPP) framework, guided by appreciative inquiry and deliberative dialogue. Key stakeholders—including students, faculty, policymakers, service providers, and community representatives—provided feedback through structured group discussions and plenary sessions. Their insights were organized using the 4D cycle of appreciative inquiry (Discover, Dream, Design, Destiny) and integrated into curriculum redesign and implementation.
Stakeholders recommended greater emphasis on community-based learning, reduced classroom hours, and stronger clinical supervision. As a result, the BPAC modules were consolidated from 24 to 14, a clinical lecturer was appointed, and clinical placement sites were expanded. Portfolio-based learning and reflective presentations were introduced to enhance experiential learning. Additionally, the district placement period was extended to include immersive, ethnographic engagement in home-based palliative care, strengthening students’ capacity to deliver culturally safe care.
The PPP framework, together with appreciative inquiry and deliberative dialogue, enabled meaningful, community-informed changes in curriculum delivery. The BPAC program now serves as a model for socially accountable health professions education. This approach holds promise for adaptation in other programs at KUHeS, highlighting the importance of stakeholder relationships, inclusive dialogue, and context-driven curriculum transformation.
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Copyright (c) 2025 Duncan Kwaitana, Alex Chitani, Mwandida Nkhoma, Modai Mnenula, Martha Makwero, Jessie Mbamba, Prosper Lutala (Author)
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