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

Dohlman, Lena E.; Thakkar, Niharika; Jivanelli, Bridget; Pakala, Swetha; Brouillette, Mark

doi:10.1097/aco.0000000000001178

Cited by 3 publications

(9 citation statements)

References 59 publications

(71 reference statements)

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Section: Discussionsupporting

confidence: 90%

“…This is similar with findings from multiple studies conducted in low resources settings (LRS) especially in Sub Saharan Africa (SSA) [ 3 , 5 , 6 , 8 , 11 , 13 , 16 , 22 ]. There is lack of enough anesthesiologists in LRS which is further exacerbated with insufficient funding and recognition of anesthesia as a sub-specialty during training [ 3 , 5 , 6 , 8 , 11 , 13 , 16 , 22 ]. Few available anesthesiologists lack the resources to provide training to a critical mass of residents necessary to improve the practice of anesthesiology at the highest level including regional anesthesia as a sub-specialty [ 3 , 5 , 6 , 8 , 11 , 13 , 16 , 22 ].…”

Section: Discussionsupporting

confidence: 90%

“…There is lack of enough anesthesiologists in LRS which is further exacerbated with insufficient funding and recognition of anesthesia as a sub-specialty during training [ 3 , 5 , 6 , 8 , 11 , 13 , 16 , 22 ]. Few available anesthesiologists lack the resources to provide training to a critical mass of residents necessary to improve the practice of anesthesiology at the highest level including regional anesthesia as a sub-specialty [ 3 , 5 , 6 , 8 , 11 , 13 , 16 , 22 ]. A well-functioning regional anesthesia program has multiple advantages for LRS because it may improve the pain management capacity, become an alternative anesthesia option for patients who can’t tolerate general anesthesia, decrease the patient’s cost, and provide new services like labor analgesia for pregnant women [ 3 – 5 ].…”

Section: Discussionmentioning

confidence: 99%

“…In addition, protocols, and guidelines applicable to the local context should be put in place. Furthermore, the required resources (i.e., equipment like ultrasound, supplies like nerve blocks, local anesthesia drugs, and sedative medications) should be put in place with the support from the hospital administration to minimize stock outs and to ensure the sustainability of the program [ 3 – 6 ].…”

Section: Discussionmentioning

confidence: 99%

“…There is disparity in access to safe surgery and anesthesia between high and low-income countries with an estimate of approximately 5 billion people without access coming mainly from low resources settings (LRS) [ 1 , 2 ]. Regional anesthesia offers multiple advantages especially for LRS such as being low cost, safe, and offering opportunity of expansion of anesthesia practice with labour analgesia and acute pain services [ 3 – 6 ].…”

Section: Introductionmentioning

confidence: 99%

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Regional anaesthesia practice in public hospitals in Botswana: A cross-sectional study

Kassa,

Madzimbamuto,

Kediegite

et al. 2023

PLoS ONE

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Introduction Little is known about the regional anesthesia practice in low resources settings (LRS). The aim of this study was to describe the regional anesthesia capacity, characteristics of regional anesthesia practice, and challenges and solutions of practicing safe regional anesthesia in public hospitals in Botswana. Methods This was a cross-sectional survey of anesthesia providers working in public hospitals in Botswana. A purposive sampling method of public hospitals was used to achieve representation of different hospital levels across Botswana. Paper-based questionnaires were sent to anesthesia providers from selected hospitals. Descriptive statistics were used for analysis. Results Questionnaires were distributed to 47 selected anesthesia providers from selected hospitals; 38 (80.9%) were returned. Most participants were nurse anesthetists and medical officers (57.8%). All hospitals perform spinal anesthesia; however, other regional techniques were performed by a small number of participants in one referral hospital. Most hospitals had adequate regional anesthesia drugs and sedation medications, however, most hospitals (except one referral hospital) lacked ultrasound machine and the regional anesthesia kit. The common challenges reported were lack of knowledge and skills, lack of equipment and supplies, and lack of hospital engagement and support. Some solutions were proposed such as regional anesthesia training and engaging the hospital management to get resources. Conclusions The results of this study suggest that spinal anesthesia is the most common regional anesthesia technique performed by anesthesia providers working in public hospitals in Botswana followed by few upper limb blocks. However, most public hospitals lack enough training capacity, equipment, and supplies for regional anesthesia. More engagement of the hospital management, investment in regional anesthesia resources, and training are needed in order to improve the regional anesthesia capacity and provide safe surgery and anesthesia in Botswana.

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Section: Discussionsupporting

confidence: 90%

Section: Discussionsupporting

confidence: 90%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Regional anaesthesia practice in public hospitals in Botswana: A cross-sectional study

Kassa,

Madzimbamuto,

Kediegite

et al. 2023

PLoS ONE

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Clinical spine care partnerships between low- and high-resource countries: A scoping review

Lin¹,

Halvorsen²,

Win³

et al. 2023

Preprint

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Background Clinical collaboration between spine professionals in high-resource (HR) and low-resource (LR) countries may provide improvements in the accessibility, efficacy, and safety of global spine care. Currently, the scope and effectiveness of these collaborations remain unclear. In this review, we describe the literature on the current state of these partnerships to provide a framework for exploring future best practices. Methods PubMed, Embase, and Cochrane Library were queried for articles on spine-based clinical partnerships between HR and LR countries published between 2000 and March 10, 2023. This search yielded 1528 total publications. After systematic screening, nineteen articles were included in the final review. Results All published partnerships involved direct clinical care and 13/19 included clinical training of local providers. Most of the published collaborations reviewed involved one of four major global outreach organizations with the majority of sites in Africa. Participants were primarily physicians and physicians-in-training. Only 5/19 studies reported needs assessments prior to starting their partnerships. Articles were split on evaluative focus, with some only evaluating clinical outcomes and some evaluating the nature of the partnership itself. Conclusions Published studies on spine-focused clinical partnerships between HR and LR countries remain scarce. Those that are published often do not report needs assessments and formal metrics to evaluate the efficacy of such partnerships. Toward improving the quality of spine care globally, we recommend an increase in the quality and quantity of published studies involving clinical collaborations between HR and LR countries, with careful attention to reporting early needs assessments and evaluation strategies.

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Clinical spine care partnerships between high-income countries and low-and-middle-income countries: A scoping review

Lin,

Halvorsen,

Win

et al. 2023

PLoS ONE

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Background Clinical collaboration between spine professionals in high-income countries (HICs) and low-and-middle-income countries (LMICs) may provide improvements in the accessibility, efficacy, and safety of global spine care. Currently, the scope and effectiveness of these collaborations remain unclear. In this review, we describe the literature on the current state of these partnerships to provide a framework for exploring future best practices. Methods PubMed, Embase, and Cochrane Library were queried for articles on spine-based clinical partnerships between HICs and LMICs published between 2000 and March 10, 2023. This search yielded 1528 total publications. After systematic screening, nineteen articles were included in the final review. Results All published partnerships involved direct clinical care and 13/19 included clinical training of local providers. Most of the published collaborations reviewed involved one of four major global outreach organizations with the majority of sites in Africa. Participants were primarily physicians and physicians-in-training. Only 5/19 studies reported needs assessments prior to starting their partnerships. Articles were split on evaluative focus, with some only evaluating clinical outcomes and some evaluating the nature of the partnership itself. Conclusions Published studies on spine-focused clinical partnerships between HICs and LMICs remain scarce. Those that are published often do not report needs assessments and formal metrics to evaluate the efficacy of such partnerships. Toward improving the quality of spine care globally, we recommend an increase in the quality and quantity of published studies involving clinical collaborations between HICs and LICs, with careful attention to reporting early needs assessments and evaluation strategies.

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

Cited by 3 publications

References 59 publications

Regional anaesthesia practice in public hospitals in Botswana: A cross-sectional study

Regional anaesthesia practice in public hospitals in Botswana: A cross-sectional study

Clinical spine care partnerships between low- and high-resource countries: A scoping review

Clinical spine care partnerships between high-income countries and low-and-middle-income countries: A scoping review

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