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Survey is result of faculty & WHO GIEESC project in collaboration with local health authorities, & provides first-time cross-sectional measure of capacity gap to provide essential surgical, emergency and anesthesia services in Papua New Guinea.

Survey of the capacity for essential surgery and anaesthesia services in Papua New Guinea

BMJ Open 2015;5:e009841 doi:10.1136/bmjopen-2015-009841. Global health 

Janet Martin, Goa Tau, Meena Nathan Cherian, Jennifer Vergel de Dios, David Mills, Jane Fitzpatrick, William Adu-Krow, Davy Cheng

Objective

To assess capacity to provide essential surgical services including emergency, obstetric and anaesthesia care in Papua New Guinea (PNG) in order to support planning for relevant post-2015 sustainable development goals for PNG.

Design

Cross-sectional survey.

Setting

Hospitals and health facilities in PNG.

Participants

21 facilities including 3 national/provincial hospitals, 11 district/rural hospitals, and 7 health centres.

Outcome measures

The WHO Situational Analysis Tool to Assess Emergency and Essential Surgical Care (WHO-SAT) was used to measure each participating facility's capacity to deliver essential surgery and anaesthesia services, including 108 items related to relevant infrastructure, human resources, interventions and equipment.

Results

While major surgical procedures were provided at each hospital, fewer than 30% had uninterrupted access to oxygen, and 57% had uninterrupted access to resuscitation bag and mask. Most hospitals reported capacity to provide general anaesthesia, though few hospitals reported having at least one certified surgeon, obstetrician and anaesthesiologist. Access to anaesthetic machines, pulse oximetry and blood bank was severely limited. Many non-hospital health centres providing basic surgical procedures, but almost none had uninterrupted access to electricity, running water, oxygen and basic supplies for resuscitation, airway management and obstetric services.

Conclusions

Capacity for essential surgery and anaesthesia services is severely limited in PNG due to shortfalls in physical infrastructure, human resources, and basic equipment and supplies. Achieving post-2015 sustainable development goals, including universal healthcare, will require significant investment in surgery and anaesthesia capacity in PNG. 

Read the full article in BMJ Open Access


Western University faculty, Dr. Davy Cheng (MEDICI Medical Director) and Dr. Janet Martin (MEDICI Director) were invited to attend and contribute to the development of the roadmap. Dr. Cheng represented the Department of Anesthesia and Perioperative Medicine, as well as the Scientific Affairs Committee of the World Federation of Societies of Anesthesiologists (WFSA), and Dr. Martin chaired a working group on Data Metrics and Quality Indicators in Emergency and Essential Surgery and Anesthesia Care.

The MEDICI Group has been collaborating with WHO GIEESC on:

  • Developing evidence-informed guidelines
  • Advocating for development of capacity for essential surgery, anesthesia, emergency and critical care in resource-poor settings as a component of Universal Health Care
  • Providing workshops on evidence-informed decision-making in essential surgery and anesthesia contextualized to resource-poor settings

Janet Martin, Davy Cheng, and Jennifer Vergel de Dios are co-authors on a newly published paper, “Survey of the capacity for essential surgery and anaesthesia services in Papua New Guinea”. This paper is the result of a WHO GIEESC project in collaboration with local health authorities, and provides a first-time cross-sectional measure of capacity gap to provide essential surgical, emergency and anesthesia services in Papua New Guinea.