Global Safe Anaesthesia and Surgery Initiatives: Implications for Anaesthesia in the Pacific Region

Cooper, Michael G; Wake, Pauline B; Morriss, Wayne W.; Cargill, P D; McDougall, Robert J

doi:10.1177/0310057x1604400318

Cited by 14 publications

(15 citation statements)

References 9 publications

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“…The SAO density in our region shows marked disparity between countries but generally reflects the true specialist physician workforce and is consistent with other reports from the region. 12 For most LMICs, there is a considerable shortfall, well below the desired 20–40/100 000. As such, future health workforce planning will need to include SAO providers based on predicted medical specialist graduates and alternative providers.…”

Section: Indicator 2: Surgical Anaesthesia and Obstetric Workforce Dmentioning

confidence: 99%

Collecting data for global surgical indicators: a collaborative approach in the Pacific Region

et al. 2017

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In 2015, the Lancet Commission on Global Surgery (LCoGS) recommended six surgical metrics to enable countries to measure their surgical and anaesthesia care delivery. These indicators have subsequently been accepted by the World Bank for inclusion in the World Development Indicators. With support from the Royal Australasian College of Surgeons and the Pacific Islands Surgical Association, 14 South Pacific countries collaborated to collect the first four of six LCoGS indicators. Thirteen countries collected all four indicators over a 6-month period from October 2015 to April 2016. Australia and New Zealand exceeded the recommended LCoGS target for all four indicators. Only 5 of 13 countries (38%) achieved 2-hour access for at least 80% of their population, with a range of 20% (Papua New Guinea and Solomon Islands) to over 65% (Fiji and Samoa). Five of 13 (38%) countries met the target surgical volume of 5000 procedures per 100 000 population, with six performing less than 1600. Four of 14 (29%) countries had at least 20 surgical, anaesthesia and obstetric providers in their workforce per 100 000 population, with a range of 0.9 (Timor Leste) to 18.5 (Tuvalu). Perioperative mortality rate was reported by 13 of 14 countries, and ranged from 0.11% to 1.0%. We believe it is feasible to collect global surgery indicators across the South Pacific, a diverse geographical region encompassing high-income and low-income countries. Such metrics will allow direct comparison between similar nations, but more importantly provide baseline data that providers and politicians can use in advocacy national health planning.

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Section: Indicator 2: Surgical Anaesthesia and Obstetric Workforce Dmentioning

confidence: 99%

Collecting data for global surgical indicators: a collaborative approach in the Pacific Region

et al. 2017

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“…Anesthesia safety varies from country to country depending mainly on economic background. It is extremely safe in developed countries, whereas, it lags far behind in other parts of the world [4][5][6][7]. A study conducted by Bashford in Ethiopia [8] indicates a large proportion of respondents were not able to deliver safe general (39%), spinal (50%), pediatric (63%), and obstetric (89%) anesthesia.…”

Section: Introductionmentioning

confidence: 99%

The current state of anesthesia safety in a third world country: a cross-sectional survey among anesthesia providers in Ethiopia

Mihretu

2021

Patient Saf Surg

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Background Improving patient safety during anesthesia and surgery becomes a major global public health issue due to the increasing in surgical burden. Anesthesia is delivered safely in developed countries, but its safety is hampered by complex problems in third world countries. This survey assesses the unmet anesthesia needs of one of a third world country, Ethiopia. Methods A cross-sectional survey was conducted in Amhara region of Ethiopia from 15/12/2019 to 30/1/2020. All 81 hospitals of the region were stratified by their level as district, general, and referral hospital. The study was conducted in 66 hospitals. The number of hospitals from each strata were calculated by proportional sampling technique resulting; five referral, three general, and fifty eight primary hospitals. Each hospital from each strata was selected by convenience. Each anesthesia provider for the survey was selected randomly from each hospital and questionnaires were distributed. The minimum expected safe anesthesia requirements were taken from World Health Organization-World Federation of Societies of Anesthesiologists International Standard and Ethiopian Hospitals Standard. Anesthesia practice was expected safe if the minimum requirements were practiced always (100%) in each hospital. P < 0.05 with 95% confidence interval were used to compare the safety of anesthesia between higher and lower level hospitals. Results Seventy eight (88.6%) anesthesia providers working in 62 hospitals responded to the survey. On aggregate, 36 (58%) hospitals from the total 62 hospitals have met the minimum expected safe anesthesia requirements. Among the different variables assessed; professional aspects 32 (52.45%), medication and intravenous fluid 33 (53.36%), equipment and facilities 33 (52.56%), patient monitoring 43(68.88%), and anesthesia conduct 38 (62.1%) of surveyed hospitals have met the minimum requirements. Anesthesia safety is relatively higher in higher level hospitals (general and referral) 6 (75%) when compared to district hospitals 30 (55.5%), P < 0.001. Conclusion Anesthesia safety in Ethiopia appears challenged by substandard continuous medical education and continuous professional development practice, and limited availability of some essential equipment and medications. Patient monitoring and anesthesia conduct are relatively good, but World Health Organization surgical safety checklist application and postoperative pain management are very low, affecting the delivery of safe anesthesia conduct.

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“…Nonetheless, Global Surgical Research from Australia, NZ, Timor, PNG and the Pacific published papers on POMR, 20,[29][30][31][32][33] Bellwether access, 36 the global burden of surgical disease [37][38][39] and the graduation and retention of surgical, obstetric and anaesthesia specialists. 7,40 Lessons learned from the introduction of emergency medicine specialists and their training in PNG, 41,42 informed a successful and rapid implementation in Myanmar. 43 The growing burden of cancer, and challenges facing detection, treatment and palliation in small island states merited two papers in Lancet Global Health that presenting a Pacific perspective.…”

Section: Surgical Metrics and Pomrmentioning

confidence: 99%

“…Academic surgery and research capability in the Pacific and PNG require further development as this will strengthen local leadership and provide evidence on which to base NSOAPs and other capacity building initiatives. Nonetheless, Global Surgical Research from Australia, NZ, Timor, PNG and the Pacific published papers on POMR, 20,29–33 Bellwether access, 36 the global burden of surgical disease 37–39 and the graduation and retention of surgical, obstetric and anaesthesia specialists 7,40 . Lessons learned from the introduction of emergency medicine specialists and their training in PNG, 41,42 informed a successful and rapid implementation in Myanmar 43 .…”

Section: Surgical Metrics and Pomrmentioning

confidence: 99%

Advocacy for global surgery: a Pacific perspective

Watters

Tangi

Guest

et al. 2020

ANZ Journal of Surgery

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Background The geographic region of the South Pacific covers a third of the globe, much of which is ocean, the world's largest geographic feature, spanning 155 km 2. The ocean expanse is scattered with numerous Pacific Island countries and territories (which fall into three main political groups, whose connections are historical, political and/or economic; Table 1). They represent nations generally with small populations but with the least access to safe, affordable and timely surgery in the world, partly as a result of their geography as well as their stage of economic development. This paper describes how the Royal Australasian College of Surgeons (RACS) and the Pacific region have been involved with global surgery and anaesthesia advocacy since 2012. This has included engagement with the World Health Organization (WHO) in Geneva, their Global Initiative for Emergency and Essential Surgery (GIEESC) and WHO's Western Pacific Region Organization (WPRO). The paper focuses on the Pacific Island countries with which RACS, and the Australian and New Zealand College of Anaesthetists (ANZCA), have established relationships and a history of engagement in supporting local agendas for capacity building. The Colleges engage not only in partnership with universities and health departments, but also collaborates with other Australian and New Zealand specialist medical colleges, and their Pacific or Papua New Guinea (PNG) surgical and anaesthesia counterpart associations (Table 2). Although Timor Leste falls outside of the WPRO, the clinical networks and partnerships established through RACS and the other colleges justify including their role in this account of regional advocacy.

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Global Safe Anaesthesia and Surgery Initiatives: Implications for Anaesthesia in the Pacific Region

Cited by 14 publications

References 9 publications

Collecting data for global surgical indicators: a collaborative approach in the Pacific Region

Collecting data for global surgical indicators: a collaborative approach in the Pacific Region

The current state of anesthesia safety in a third world country: a cross-sectional survey among anesthesia providers in Ethiopia

Advocacy for global surgery: a Pacific perspective

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