The Situation of Safe Surgery and Anaesthesia in Tanzania: A Systematic Review

Abstract

Background Improvement in the surgical system requires intersectoral coordination. To achieve this, the development of National Surgical, Obstetric, and Anaesthesia Plans (NSOAPS) has been recommended. One of the first steps of NSOAP development is situational analysis. On the ground situational analyses can be resource intensive and often duplicative. In 2016, the Ministry of Health of Tanzania issued a directive for the creation of an NSOAP. This systematic review aimed to assess if a comprehensive situational analysis could be achieved with existing data. These data would be used for evidence-based priority setting for NSOAP development and streamline any additional data collection needed. Methods A systematic literature review of scientific literature, grey literature, and policy documents was performed as per PRISMA. Extraction was performed for all articles relating to the five NSOAPS domains: infrastructure, service delivery, workforce, information management, and financing. Results 1819 unique articles were generated. Full-text screening produced 135 eligible articles; 46 were relevant to surgical infrastructure, 53 to workforce, 81 to service delivery, 11 to finance, and 15 to information management. Rich qualitative and quantitative data were available for each domain. Conclusions Despite little systematic data collection around SOA, a thorough literature review provides significant evidence which often have a broader scope, longer timeline and better coverage than can be achieved through snapshot-stratified samples of directed on the ground assessments. Evidence from the review was used during stakeholder discussion to directly inform the NSOAP priorities in Tanzania.

Development and upgrading of public primary healthcare facilities with essential surgical services infrastructure: a strategy towards achieving universal health coverage in Tanzania

“…This finding is similar to finding obtained in the study done by Nyberger et al [44] on the situation of safe surgery and anesthesia in Tanzania. There is a need to have adequate investment in the urban infrastructure at the same time having strong Public-Private Partnership framework that will help the people who are residing in urban areas to have subsidized cost of health care.…”

“…This will be needed for the Tanzanian setting as well to have a better outcome for surgeries conducted to the well-constructed health facilities. Surgery has become a global health priority with the adoption of the World Health Assembly Resolution 68.15 that called for the strengthening of emergency as well as essential surgical and anesthesia care as an integral component of Universal Health Coverage (UHC) [27,44].…”

Development and upgrading of public primary healthcare facilities with essential surgical services infrastructure: a strategy towards achieving Universal Health Coverage in Tanzania

“…This finding is similar to finding obtained in the study done by Nyberger et al (2018) on the situation of safe surgery and anesthesia in Tanzania [45]. There is a need to have adequate investment in the urban infrastructure at the same time having strong Public-Private Partnership framework that will help the people who are residing in urban areas to have subsidized cost of health care.…”

“…This will be needed for the Tanzanian setting as well to have a better outcome for surgeries conducted to the well-constructed health facilities. Surgery has become a global health priority with the adoption of the World Health Assembly Resolution 68.15 that called for the strengthening of emergency as well as essential surgical and anesthesia care as an integral component of Universal Health Coverage (UHC) [27,45].…”

The challenge of safe anesthesia in developing countries: defining the problems in a medical center in Cambodia

“…Many developing countries, especially countries with longstanding conflicts such as Cambodia, have a critical shortage of healthcare workers and medical resources [1]. As an important part of medical services, anesthesia services are particularly susceptible to the level of socioeconomic development [2]. In low-income countries, anesthesia services are often provided by unqualified personnel, who are considered a low priority and lack the voice to request access to resources [3].…”