Establishing a sustainable anaesthetic education programme at Jimma University Medical Centre, Ethiopia

Abstract

Lack of continuing education and physician anaesthetist support are commonly cited problems amongst Ethiopian anaesthetic providers. Whilst operating at Jimma University Medical Centre (JUMC), Operation Smile volunteers identified a clear need for improvement in anaesthetic care delivery at JUMC. JUMC is a 450-bed university teaching hospital 350 km southwest of Addis Ababa. At the start of this programme it had two physician anaesthetists, with the majority of anaesthesia historically having been provided by non-physician anaesthesia providers. A visiting lecturer programme was established at JUMC in 2012 following collaboration between two consultant anaesthetists, working for Operation Smile and JUMC respectively. UK trainee anaesthetists in their final years of anaesthetic training volunteered at JUMC for periods of two to six months, providing sustainable education and consistent physician anaesthetist presence to support service provision and training. Over its six-year history, nine visiting lecturers have volunteered at JUMC. They have helped establish a postgraduate training programme in anaesthesia, assisting in the provision of a future physician anaesthetist workforce. Four different training courses designed for low- and middle-income countries (LMICs) have been delivered and visiting lecturers have trained local anaesthetists in subsequent course delivery. Patient safety and quality improvement projects have included introducing the World Health Organization Surgical Safety Checklist, Lifebox pulse oximeters, obstetric spinal anaesthesia packs, improving critical care delivery and establishing two post-anaesthetic care units. Development of partnerships on local, national and global platforms were key to the effective delivery of relevant sustainable education and support. Instilling local ownership proved fundamental to implementing change in the local safety culture at JUMC. Sound mentorship from anaesthetic consultant supervisors both in the UK and in Jimma was crucial to support the UK trainee anaesthetists working in a challenging global setting. This model of sustainable capacity building in an LMIC with a significant deficit in its physician workforce could be replicated in a similar LMIC setting.

The impact of the Safer Anaesthesia from Education (SAFE) Obstetric Anaesthesia training course in Ethiopia: A mixed methods longitudinal cohort study

“…report that instilling local ownership was fundamental to implementing change in the local safety culture, when describing their programme of utilising visiting UK volunteers to help establish a postgraduate training programme at Jimma University Medical College in Ethiopia. 25 The SAFE-OB courses described in our study were run in collaboration with the Federal Ministry of Health of Ethiopia, the Ethiopian Society of Anaesthesiologists (ESA) and the Ethiopian Association of Anaesthetists (EAA) as part of the National Safe Surgery 2020 initiative. Courses have since been run independently by these organisations in Ethiopia, with local ownership driven by these national bodies.…”

Regional anesthesia global health collaborations- a scoping review of current intervention methods

“…The following data items were extracted: study details, HRC region, LRC region, the intervention focus (e.g., RA, pain medicine), intervention type (e.g., medical education, research), intervention recipients (e.g., anesthesiologists, residents, fellows), intervention basis, needs assessment method (e.g., standardized tools, informal assessment), evaluation of intervention, it's aspects (e.g., impact, educational) and evaluative research methodology utilized (e.g., qualitative, quantitative). A total of 1314 articles identified by the search, 134 qualified for full text assessment for eligibility, with 44 studies qualifying in the final review [20 ▪▪ ,21,22 ▪ ,23,24 ▪▪ ,25 ▪▪ ,26,27,28 ▪ ,29–63]. There were few studies published in the last 18 months (probably due to COVID travel restrictions) but four studies focused on RA were published recently.…”

Pulse oximeter provision and training of non-physician anesthetists in Zambia: a qualitative study exploring perioperative care after training

“…Although developing equipped PACUs de novo is time and resource intensive, once instituted, it can have tangible patient care benefit. [ 32 ] Our study revealed that, from the perspective of a cohort of non-physician anesthetists, patient safety could be improved through continued strengthening of postoperative recovery areas that include additional resources and monitoring capabilities, even beyond pulse oximetry.…”