History of non-physician anaesthesia providers in Papua New Guinea: from heil tultuls to Anaesthetic Scientific Officers

Loughnan, Terence E; Cooper, Michael G; Wake, Pauline B; Aigeeleng, Harry

doi:10.1177/0310057x211027872

Cited by 4 publications

(3 citation statements)

References 14 publications

(25 reference statements)

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“…In most LMICs, non-physician anaesthetists were not routinely trained to help support the system. However, Papua New Guinea, which has only 0.25 physician-anaesthetists per 100,000 populations, trained non-physician anaesthetists to meet 90% of total anaesthesia demand [ 23 ]. Meara and others thus recommend task sharing with non-physician anaesthetists, who are cheaper and quicker to train to fill the gaps in LMICs until minimum essential standards have been attained [ 2 , 24 , 25 ].…”

Section: Resultsmentioning

confidence: 99%

Anaesthesia delivery systems in low and lower-middle-income Asian countries: A scoping review of capacity and effectiveness

Shahbaz,

Howard

2024

PLOS Glob Public Health

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Literature on anaesthesia systems in low and lower middle-income countries is limited, focused on the Africa region, and provides minimal data on anaesthesia or associated disciplines within intensive care, pain management and emergency medicine. We thus conducted a scoping review of primary and secondary research literature on capacity and effectiveness of anaesthesia delivery in low and lower middle-income countries in the Asia region from 2000–2021, to clarify existing knowledge, important gaps, and possible subsequent steps. We applied Arksey and O’Malley’s scoping literature review method to search five databases (i.e. EMBASE, CINAHL, Medline, Scopus, Web of Science), screen, extract, and synthesise data under three themes: (i) availability and type of anaesthesia workforce; (ii) anaesthesia system infrastructure, equipment, and supplies; and (iii) effectiveness of anaesthesia provision. We included 25 eligible sources of 603 identified. Only ten (40%) were published in the last 5 years and Asian lower-income countries were primarily represented in 15 multi-country sources. Fifteen (60%) sources used quantitative methods and provided limited information on data collection, e.g. sampling criteria or geographic areas included. No sources included countrywide data, despite anaesthesia delivery and resources differing significantly sub-nationally (e.g. central versus rural/remote, or insecure areas). Data on anaesthesiology delivery were limited, with findings including insufficiencies in workforce, supplies, training, and skills-building of anaesthesia personnel, along with the lack of consistent strategies for overcoming maldistribution of resources and improving anaesthesia delivery systems in the region. This review, a first attempt to synthesise existing data on anaesthesia delivery systems in low and lower-middle-income Asian countries, shows the anaesthesia literature is still limited. Findings highlight the urgent need for additional research and collaboration nationally and regionally to strengthen anaesthesia delivery and surgical facilities in resource-constrained settings.

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Section: Resultsmentioning

confidence: 99%

Anaesthesia delivery systems in low and lower-middle-income Asian countries: A scoping review of capacity and effectiveness

Shahbaz,

Howard

2024

PLOS Glob Public Health

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“…which has only 0.25 physician-anaesthetists per 100,000 populations, trained non-physician anaesthetists to meet 90% of total anaesthesia demand [23]. Meara and others thus recommend task sharing with non-physician anaesthetists, who are cheaper and quicker to train to fill the gaps in LMICs until minimum essential standards have been attained [2,24,25].…”

Section: Plos Global Public Healthmentioning

confidence: 99%

Anaesthesia delivery systems in low and lower-middle-income Asian countries: a scoping review of capacity and effectiveness

Shahbaz

Howard

2023

Preprint

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Background Literature on anaesthesia systems in low and lower middle-income countries is limited, focused on the Africa region, and provides minimal data on anaesthesia or associated disciplines within intensive care, pain management and emergency medicine. We thus conducted a review of primary and secondary research literature on low and lower middle-income countries in the Asia region from 2000-2021, to clarify existing knowledge, important gaps, and possible subsequent steps. Methods We applied Arksey and O’Malley’s scoping literature review method to search, screen, extract, and synthesise data under three themes: (i) availability and type of anaesthesia workforce; (ii) anaesthesia system infrastructure, equipment, and supplies; and (iii) effectiveness of anaesthesia provision. Results We included 25 eligible sources of 603 identified. Only ten (40%) were published in the last 5 years and Asian lower-income countries were primarily represented in 15 multi-country sources. Fifteen (60%) sources used quantitative methods and provided limited information on data collection, e.g. sampling criteria or geographic areas included. No sources included countrywide data, despite anaesthesia delivery and resources differing significantly sub-nationally (e.g., central versus rural/remote, or insecure areas). Data on anaesthesiology delivery were limited, with findings including insufficiencies in workforce, supplies, training and skills-building of anaesthesia personnel, along with the lack of consistent strategies for overcoming maldistribution of resources and improving anaesthesia delivery systems in the region. Conclusions This review, a first attempt to synthesise existing data on anaesthesia delivery systems in low and lower-middle-income Asian countries, shows the anaesthesia literature is still limited. Findings highlight the urgent need for additional research and collaboration nationally and regionally to strengthen anaesthesia delivery and surgical facilities in resource-constrained settings.

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“…In PNG, 80–90% of anaesthesia is provided by NPAPs, known as anaesthetic scientific officers (ASOs), who undertake a one-year diploma of anaesthetic sciences course at the University of Papua New Guinea. 7,13 This task-sharing or task-shifting is essential for normal surgical services in remote provincial hospitals in PNG while a pool of physician anaesthetists is developed which may take decades or could never be achieved. 14,15…”

Section: Non-physician Anaesthesia Providersmentioning

confidence: 99%

The origins and development of physician anaesthesiology training in Papua New Guinea: From colonial days to the current era

Loughnan

Wake

Aigeeleng

et al. 2022

Anaesth Intensive Care

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Papua New Guinea is a Pacific country that remains an enigma to the world at large. Despite massive geographical challenges due to mountainous terrain, remote islands, poverty, and with 80% of the population of over eight million living in rural villages, Papua New Guinea has managed to develop national medical and postgraduate specialty training. The first recorded anaesthetic was administered in Papua New Guinea in 1880 and the first anaesthetist trained in 1968. The University of Papua New Guinea graduated its first diploma in anaesthesia candidate in 1986 and its first master of medicine candidate in anaesthesiology in 1991. As of December 2021, there have been 82 diplomas and 40 masters of medicine awarded. We review the factors and influences bearing on the development of physician anaesthesia training in Papua New Guinea over this period. Many of the people involved have contributed information used in this article.

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History of non-physician anaesthesia providers in Papua New Guinea: from heil tultuls to Anaesthetic Scientific Officers

Cited by 4 publications

References 14 publications

Anaesthesia delivery systems in low and lower-middle-income Asian countries: A scoping review of capacity and effectiveness

Anaesthesia delivery systems in low and lower-middle-income Asian countries: A scoping review of capacity and effectiveness

Anaesthesia delivery systems in low and lower-middle-income Asian countries: a scoping review of capacity and effectiveness

The origins and development of physician anaesthesiology training in Papua New Guinea: From colonial days to the current era

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