Access and barriers to safe anesthesia in primary health care settings in India

The availability of safe anesthesia services is an essential part of necessary surgical care, but it is a pressing issue that has been poorly considered in the primary health care environment in low and middle-income countries. Therefore, it is of interest to assess the availability of safe anesthesia services, their accessibility, and obstacles of these services in primary health care in three Indian states. Between January 2022 and August 2022, 156 primary health centres (PHCs) and 312 anesthesia providers were surveyed by using structured questionnaires and facility assessment tools. Findings showed that not all PHCs had operational anesthesia processes (38.5 percent), and not all PHCs had trained anesthesia staff (62.8 percent). The major obstacles were identified as the lack of proper infrastructure (71.2%), lack of skilled labour (68.6%), unavailability of necessary drugs (54.5%), and lack of standard procedures (47.4%). Rural amenities had much worse access than urban centres (p<0.001).