Anesthetic Care in Mozambique

Area of Science:

• Global Health
• Anesthesiology
• Health Workforce Development

Background:

• Global shift towards noncommunicable diseases necessitates safe surgical and anesthesia care in low-income countries (LICs).
• A significant barrier to safe surgery in LICs is the limited number of anesthesia providers.
• This study assesses the anesthesia capacity in Mozambique, a representative LIC in Africa.

Purpose of the Study:

• To qualitatively evaluate the anesthesia capacity in Mozambique.
• To identify barriers and assets within the Mozambican anesthesia system.
• To suggest country-based solutions for expanding anesthesia services in LICs and lower-middle income countries (LMICs).

Main Methods:

• A comprehensive review of Mozambique's anesthesia system.
• Interviews with key stakeholders in the Ministry of Health, educational institutions, and healthcare facilities.
• Analysis of personnel databases from the Ministry of Health and Maputo Central Hospital.

Main Results:

• Mozambique has minimal anesthesia capacity with only 290 providers for over 25 million people.
• Anesthesiologists are concentrated in urban areas and the private sector, with limited growth potential due to resource constraints in the sole anesthesia residency program.
• Key barriers include a lack of teachers, limited student exposure to anesthesia, insufficient training institutions, and low public sector compensation.

Conclusions:

• Mozambique possesses a robust health system design but faces severe resource limitations for surgical and anesthesia care.
• Human resources, access to essential medicines, and safety monitoring are critical constraints for safe anesthesia in Mozambique, mirroring challenges in other LICs.