Non-technical skills of anaesthesia providers in Rwanda: an ethnography

Livingston, Patricia; Zolpys, Lauren; Mukwesi, Christian; Twagirumugabe, Théogène; Whynot, Sara; MacLeod, Anna

doi:10.11604/pamj.2014.19.97.5205

Cited by 13 publications

(12 citation statements)

References 15 publications

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“…This study is the first to highlight on-going challenges within the anaesthesia delivery system in Punjab province as experienced by senior practitioners. Challenges described in recruitment and retention, qualityof-care, training, and inter/intra-specialty discrepancies align with findings in several African LMICS, including Malawi, Rwanda, and Uganda (22)(23)(24).…”

Section: Discussionsupporting

confidence: 71%

Anaesthesia provision challenges in public hospitals of Pakistan’s Punjab province: a qualitative study of expert perspectives

Shahbaz

Zakar

Howard

2023

Preprint

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Background Anaesthesia delivery in Pakistan remains limited to conventional intraoperative procedures, with research showing ongoing challenges in quality and resourcing. We aimed to identify systemic challenges in the delivery of quality anaesthesia services for surgical support in Pakistan’s Punjab province. Methods This qualitative study included 22 semi-structured interviews with purposively selected anaesthesia system experts in Punjab province, including heads of teaching hospital anaesthesia departments, healthcare commission representatives, and health department officials. We analysed data thematically, using deductive and inductive coding. Results We identified three themes of anaesthetist recruitment and retention, quality-of-care and in-service training, and discrepancies between specialities, describing major challenges experienced within the speciality. Findings indicated that workforce shortages and maldistribution, insufficient in-service training and standards, inadequate equipment maintenance, and lack of anaesthesia representation in decision-making compromised anaesthesia provision quality and safety. Conclusions Improving anaesthesia provision in Punjab would require increasing physician and non-physician anaesthetist numbers and rotation to peripheral postings, strengthening training quality, and ensuring availability of minimum essential equipment and supplies. To achieve essential anaesthesia provision standards, policy interventions are needed to, for example, balance anaesthesiologist and surgeon numbers, require that anaesthesiology graduates work a few years in-country (e.g. scholarship bonds), ensure in-service training attendance for skills updates, and implement quality assurance standards for equipment and supplies.

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Section: Discussionsupporting

confidence: 71%

Anaesthesia provision challenges in public hospitals of Pakistan’s Punjab province: a qualitative study of expert perspectives

Shahbaz

Zakar

Howard

2023

Preprint

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“…30 Many studies included in our review explored health professionals' experiences, views, and practices. A number of studies explored how anesthesiologists view their professional role; 31,32 others described the non-technical skills employed by anesthesiologists 33,34 and examined how leadership style affects healthcare delivery. 35 Yet again, other studies explored the experiences of healthcare professionals when caring for specific patients or in specific settings.…”

Section: Discussionmentioning

confidence: 99%

A systematic scoping review of published qualitative research pertaining to the field of perioperative anesthesiology

Gisselbaek

Hudelson

Savoldelli

2021

Can J Anesth/J Can Anesth

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Purpose Qualitative research (QR) take advantage of a wide range of methods and theoretical frameworks to explore people's beliefs, perspectives, experiences, and behaviours and has been applied to many areas of healthcare. The aim of this review was to explore how QR has contributed to the field of perioperative anesthesiology. Source We performed a systematic scoping review of published QR studies pertaining to the field of perioperative anesthesiology in three databases (CINAHL, Pubmed, and Embase), published between January 2000 and June 2018. We extracted data regarding publication and researchers' characteristics, main study objectives, and methodological details. Descriptive statistics were generated for each data extraction category. Principal findings A total of 107 articles fulfilled our inclusion criteria. We identified 13 main research topics addressed by the included studies. Topics such as ''patient safety,'' ''barriers to evidence-base medicine,'' ''patient experiences under local/regional anesthesia,'' ''training in practice,'' ''experiences of care,'' and ''implementation of changes in clinical practice'' were commonly tackled. Others, such as ''interprofessional communication'', ''work environment,'' and ''patients'/healthcare professionals' interactions'' were less common. Qualitative research was often poorly reported and methodological details were frequently missing. Conclusion Qualitative research has been used to explore an array of issues in perioperative anesthesiology. Some areas may benefit from further primary research, such as interprofessional communication or patient-centred care, while other areas may deserve a detailed systematic knowledge synthesis. We identified suboptimal reporting of qualitative methods and their link to study findings. Increased attention to quality criteria and reporting standards in QR is called for. RésuméObjectif La recherche qualitative (RQ) tire parti d'un large e´ventail de me´thodes et de cadres the´oriques afin

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“…Given the number of years to complete the necessary training and the need to provide care right now, alternative strategies for delivery of anaesthesia care are a reality in many LMICs (and some high-income countries) 13 14. The LCoGS endorsed task sharing as a means to expand the surgical workforce.…”

Section: Discussionmentioning

confidence: 99%

What is the minimum number of specialist anaesthetists needed in low-income and middle-income countries?

et al. 2018

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IntroductionThe number of specialist anaesthetists in most low-income and middle-income countries is below what is needed to provide a safe quality anaesthesia service. There are no estimates of the optimal number; therefore, we estimated the minimum density of specialist anaesthetists to achieve a reasonable standard of healthcare as indicated by the maternal mortality ratio (MMR).MethodsUtilising existing country-level data of the number of physician anaesthesia providers (PAPs), MMR and Human Development Index (HDI), we developed best-fit curves to describe the relationship between MMR and PAPs, controlling for HDI. The aim was to use this relationship to estimate the number of PAPs associated with achieving the median MMR.ResultsWe estimated that, in order to achieve a reasonable standard of healthcare, as indicated by the global median MMR, countries should aim to have at least four PAPs per 100 000 population. Existing data show that currently 80 countries have fewer than this number.ConclusionFour PAPs per 100 000 population is a modest target, but there is a need to increase training of doctors in many countries in order to train more specialist anaesthetists. It is important that this target is considered during the development of national workforce plans, even if a stepwise approach to workforce planning is chosen.

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Non-technical skills of anaesthesia providers in Rwanda: an ethnography

Cited by 13 publications

References 15 publications

Anaesthesia provision challenges in public hospitals of Pakistan’s Punjab province: a qualitative study of expert perspectives

Anaesthesia provision challenges in public hospitals of Pakistan’s Punjab province: a qualitative study of expert perspectives

A systematic scoping review of published qualitative research pertaining to the field of perioperative anesthesiology

What is the minimum number of specialist anaesthetists needed in low-income and middle-income countries?

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