What is the minimum number of specialist anaesthetists needed in low-income and middle-income countries?
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INTRODUCTION: The number of specialist anaesthetists in most low-income and middle-income countries is below what is needed to provide a safe quality anaesthesia service. There are no estimates of the optimal number; therefore, we estimated the minimum density of specialist anaesthetists to achieve a reasonable standard of healthcare as indicated by the maternal mortality ratio (MMR). METHODS: Utilising existing country-level data of the number of physician anaesthesia providers (PAPs), MMR and Human Development Index (HDI), we developed best-fit curves to describe the relationship between MMR and PAPs, controlling for HDI. The aim was to use this relationship to estimate the number of PAPs associated with achieving the median MMR. RESULTS: We estimated that, in order to achieve a reasonable standard of healthcare, as indicated by the global median MMR, countries should aim to have at least four PAPs per 100 000 population. Existing data show that currently 80 countries have fewer than this number. CONCLUSION: Four PAPs per 100 000 population is a modest target, but there is a need to increase training of doctors in many countries in order to train more specialist anaesthetists. It is important that this target is considered during the development of national workforce plans, even if a stepwise approach to workforce planning is chosen.
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Previous studies have shown evidence that similar variables are predictors for NCD incidence and for health workforce.
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- Authors
- Davies, J. I., Vreede, E., Onajin-Obembe, B., & Morriss, W. W.
- Affiliations
- University of the Witwatersrand (ZA)
- University of Sierra Leone (SL)
- Department of Anaesthesiology, University of Port Harcourt, Port Harcourt, Nigeria
- Christchurch Hospital (NZ)
- Corresponding author
- Davies, Justine I
- Venue
- BMJ Global Health
- Publisher
- BMJ
- Published
- 2018-01
- Volume
- 3
- Issue
- 6
- Pages
- e001005
- ISSN
- 2059-7908 (ISSN-L)
- PMC
- PMC6278919
- OpenAlex
- W2903169944
- Cited by
- 62
- References
- 11
- Citations by year
- 2026: 4 · 2025: 6 · 2024: 9 · 2023: 7 · 2022: 9 · 2021: 8 · 2020: 13 · 2019: 6
- FWCI
- 6.44
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- cc-by-nc
- Locations
- BMJ Global Health (publishedVersion, cc-by-nc)
- Europe PMC (PubMed Central) (publishedVersion, other-oa)
- PubMed Central (publishedVersion, cc-by-nc)
- PubMed (publishedVersion)
- University of Birmingham Research Portal (University of Birmingham) (submittedVersion, cc-by-nc)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Global Health and Surgery
- Health Sciences › Health Professions › Emergency Medical Services › Global Health Workforce Issues
- Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Advances in Oncology and Radiotherapy
- Keywords
- anesthesiology workforce, maternal mortality ratio, workforce planning, low- and middle-income countries, Human Development Index, anesthesiology education
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