Gastrointestinal endoscopy capacity in Eastern Africa.

Area of Science:

• Gastroenterology
• Public Health
• Healthcare Resource Management

Background:

• Sub-Saharan Africa faces a high burden of gastrointestinal diseases.
• Existing evidence indicates insufficient endoscopy capacity in the region.
• Gastrointestinal disease management is significantly impacted by limited endoscopic services.

Purpose of the Study:

• To quantify human and material resources for endoscopy services in eastern African countries.
• To identify barriers hindering the expansion of endoscopy capacity.
• To inform strategies for improving gastrointestinal healthcare in the region.

Main Methods:

• Online survey distributed to digestive healthcare professionals in Ethiopia, Kenya, Malawi, and Zambia (August 2018 - August 2020).
• Partnership with national professional societies to enhance survey participation.
• Data collected on available endoscopy equipment, personnel, and therapeutic modalities.

Main Results:

• 87 professionals (25.3%) completed the survey, reporting on 91 facilities.
• Median resources: 2 gastroscopes and 1 colonoscope per facility.
• Endoscopy capacity is 0.12 endoscopists, 0.12 gastroscopes, and 0.09 colonoscopes per 100,000 population.
• Capacity is 1-10% of that in resource-rich countries.
• Key barriers include lack of equipment, trained personnel, and high costs.

Conclusions:

• Endoscopy capacity in eastern sub-Saharan Africa is critically low, despite a high prevalence of gastrointestinal diseases.
• Significant investment in human and material resources is essential for expansion.
• Technological innovations are needed to improve cost-effectiveness and sustainability of endoscopic services.