A Systematic Review of Comparative Medicine Studies in the Malawian Context,

Comparative medicine studies analyse differences in disease presentation, treatment efficacy, and health outcomes across populations or settings. In Malawi, which faces a high burden of obstetric and gynaecological conditions, synthesising such evidence is necessary to inform context-specific clinical practice and policy. This systematic review aimed to identify, appraise, and synthesise existing comparative medicine research conducted within Malawi, with a focus on obstetrics and gynaecology. A systematic search was performed across several electronic databases for peer-reviewed literature. Pre-defined inclusion and exclusion criteria were applied. The quality of included studies was assessed using appropriate critical appraisal tools, and data were extracted and synthesised narratively. The search identified a limited number of comparative studies meeting the inclusion criteria. A prominent theme was the comparative analysis of treatment outcomes for obstetric fistula, with studies frequently contrasting surgical repair techniques. A consistent finding was that simpler repair methods in low-resource settings demonstrated comparable success rates to more complex techniques for certain fistula types. While sparse, the existing comparative studies within Malawi provide valuable insights, particularly for surgical management. The review underscores a significant gap in comparative research addressing broader gynaecological conditions and preventative care in this context. Future research should prioritise comparative studies on common gynaecological conditions, preventative interventions, and service delivery models. Strengthening local research capacity and encouraging publication in accessible journals is also advised. comparative medicine, systematic review, Malawi, obstetrics, gynaecology, sub-Saharan Africa This review consolidates the current state of comparative medical research in Malawian obstetrics and gynaecology, identifying available evidence and critical knowledge gaps to guide future research and clinical practice.