Anaesthesia workforce distribution, practices and essential resources in Sierra Leone: a nationwide, cross-sectional,...

Area of Science:

• Global Health
• Surgical Care
• Anesthesiology

Background:

• Sierra Leone's healthcare system faces significant challenges in providing safe surgical and anesthesia services.
• Limited data exists on the current state of anesthesia capacity and practice within the country.

Purpose of the Study:

• To comprehensively assess anesthesia capacity and practice in Sierra Leone.
• To enumerate the anesthesia workforce, analyze anesthesia methods, and evaluate essential resources.

Main Methods:

• A nationwide, cross-sectional, facility-based study was conducted.
• Data collection involved structured questionnaires and retrospective review of logbooks from 69 surgical facilities.

Main Results:

• The anesthesia workforce is predominantly non-physician, with only 40.4% independently trained.
• Ketamine-based and spinal anesthesia were most common; general anesthesia with a protected airway was rare (5.0%).
• Infrastructure, equipment, and medications fell below international standards, with rural areas most affected.

Conclusions:

• Shortages of certified providers, limited techniques, and inadequate resources are major barriers to safe anesthesia care.
• Targeted investments are crucial for workforce development, infrastructure, and resource allocation, especially in rural regions.
• Improving anesthesia care is essential for enhancing the safety, quality, and equity of surgical services nationwide.