Challenges of Providing Safe Obstetric Anesthesia in Black Lion Specialized Hospital: Cross-Sectional Survey.

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Addis Ababa University


Background:, Despite recent advances in surgery and anaesthesia which significantly improve safety, many health facilities in low-and middle-income countries (LMICs) remain chronically under-resourced with inability to cope effectively with serious obstetric complications (Knight et al., PLoS One 8:e63846, 2013) The United Nations 2015 Millennium Development Goals targeted a 75% reduction in maternal mortality. However Ethiopia has one of the highest rates of mortality in Africa. Because many of these deaths could likely be averted with access to safe surgery and anesthesia, this research is set out to assess the capacity to provide safe anesthetic care for mothers in the main referral hospital of the country. Objectives: The main aim of this research is to explore the gaps which need to be addressed to provide safe obstetric anaesthesia in the TASH. Methods: A hospital based cross sectional, simple descriptive study was conducted among physician and non-physician anesthesia providers in TASH, in the months June and July 2019, to assess availability of trained personnel, equipment and medication necessary to provide safe obstetric anesthesia according to WFSA and WHO guidelines. Anesthesia providing personnel were interviewed using a questionnaire based on the World Federation of the Societies of Anesthesiologists (WFSA) international standard guidelines for safe anesthesia. Findings: Using the WFSA checklist as a guide, the hospital did not have all the necessary requirements needed to provide safe obstetric anesthesia. Availability of monitors and life-saving equipments was limited. For estimated population of 7.8 million in 2019 only in Addis Ababa, there were only 10 anesthesiologists in TASH, even though it’s the biggest tertiary referral teaching hospital in the country. Conclusion: Significant shortages of continuous education, equipments and medications needed to provide safe anesthetic care for obstetric surgical cases was identified in TASH. These shortages have significantly affected anesthesia safety and compliance with international standard guidelines for safe anesthesia care. More funding is required to improve resources and trainings of the anesthesia service providers, if the hospital is to improve the quality of health care and patient safety regarding safe practice in anesthesia for obstetric patients.



Obstetric Anesthesia