Anesthesia Provider Training and Practice Models: A Survey of Africa

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dc.contributor.authorLaw, Tyler J.
dc.contributor.authorBulamba, Fred
dc.contributor.authorOchieng, John Paul
dc.contributor.authorEdgcombe, Hilary
dc.contributor.authorThwaites, Victoria
dc.contributor.authorHewitt-Smith, Adam
dc.contributor.authorZoumenou, Eugene
dc.contributor.authorLilaonitkul, Maytinee
dc.contributor.authorGelb, Adrian W.
dc.contributor.authorWorkneh, Rediet S.
dc.contributor.authorBanguti, Paulin M.
dc.contributor.authorBould, Dylan
dc.contributor.authorRod, Pascal
dc.contributor.authorRowles, Jackie
dc.contributor.authorLobo, Francisco
dc.contributor.authorLipnick, Michael S.
dc.date.accessioned2023-01-23T14:09:29Z
dc.date.available2023-01-23T14:09:29Z
dc.date.issued2019
dc.description.abstractIn Africa, most countries have fewer than 1 physician anesthesiologist (PA) per 100,000 population. Nonphysician anesthesia providers (NPAPs) play a large role in the workforce of many low- and middle-income countries (LMICs), but little information has been systematically collected to describe existing human resources for anesthesia care models. An understanding of existing PA and NPAP training pathways and roles is needed to inform anesthesia workforce planning, especially for critically underresourced countries. METHODS: Between 2016 and 2018, we conducted electronic, phone, and in-person surveys of anesthesia providers in Africa. The surveys focused on the presence of anesthesia training programs, training program characteristics, and clinical scope of practice after graduation. RESULTS: One hundred thirty-one respondents completed surveys representing data for 51 of 55 countries in Africa. Most countries had both PA and NPAP training programs (57%; mean, 1.6 pathways per country). Thirty distinct training pathways to become an anesthesia provider could be discriminated on the basis of entry qualification, duration, and qualification gained. Of these 30 distinct pathways, 22 (73%) were for NPAPs. Physician and NPAP program durations were a median of 48 and 24 months (ranges: 36–72, 9–48), respectively. Sixty percent of NPAP pathways required a nursing background for entry, and 60% conferred a technical (eg, diploma/license) qualification after training. Physicians and NPAPs were trained to perform most anesthesia tasks independently, though few had subspecialty training (such as regional or cardiac anesthesia). CONCLUSIONS: Despite profound anesthesia provider shortages throughout Africa, most countries have both NPAP and PA training programs. NPAP training pathways, in particular, show significant heterogeneity despite relatively similar scopes of clinical practice for NPAPs after graduation. Such heterogeneity may reflect the varied needs and resources for different settings, though may also suggest lack of consensus on how to train the anesthesia workforce. Lack of consistent terminology to describe the anesthesia workforce is a significant challenge that must be addressed to accelerate workforce research and planning efforts.en_US
dc.identifier.citationLaw, Tyler J., et al. "Anesthesia provider training and practice models: a survey of Africa." Anesthesia & Analgesia 129.3 (2019): 839-846. DOI: 10.1213/ANE.0000000000004302en_US
dc.identifier.other10.1213/ANE.0000000000004302
dc.identifier.urihttps://nru.uncst.go.ug/handle/123456789/7125
dc.language.isoenen_US
dc.publisherAnesthesia & Analgesiaen_US
dc.subjectAnesthesia Provider Trainingen_US
dc.subjectPractice Modelsen_US
dc.subjectAfricaen_US
dc.titleAnesthesia Provider Training and Practice Models: A Survey of Africaen_US
dc.typeArticleen_US
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