Anesthesia Workforce Map shows huge shortages


The World Federation of Societies of Anesthesiologists (WFSA) officially launched a landmark online resource tool mapping the total number of anesthesia providers worldwide. A high number of countries reported a total anesthesia provider number of less than 5 per 100,000 population, highlighting the current crisis in the surgical and anesthesia workforce.

Image: Female patient is getting anesthesia in the OR; Copyright:

Many countries and regions face anesthesia and surgical workforce shortages as the new Anesthesia Workforce Map shows; © chanawit

This has left 5 billion people without access to safe and affordable anesthesia and surgical care.

The WFSA conducted a global workforce survey during 2015-2016, sending member societies a list of information required and a link to an online survey, as well as collecting information from anesthesiologists during international conferences and contacting anesthesia providers working in non-WFSA-member countries.

Recent seminal papers have highlighted major discrepancies in the provision of safe anesthesia and surgery worldwide. The Lancet Commission on Global Surgery estimated that 5 billion of the world's 7 billion people do not have access to safe, affordable anesthesia and surgical care when needed. As the essential role of anesthesia in the provision of surgical care is not always understood by decision makers, the development of anesthesia has often been given a lower priority than the development of surgery per se in the global health agenda.

However, on 22nd May 2015 the World Health Assembly passed the ground-breaking Resolution 68.15 entitled "Strengthening emergency and essential surgical care and anesthesia as a component of universal health coverage"; a potential game-changer for the 5 billion people without access.

The online resource tool, which shows data for countries representing more than 7 billion people, highlights the huge shortage in anesthesia workforce worldwide and also highlights the gap between the rich and poor. There is a large difference between the average anesthesia provider workforce densities in high income countries compared with low income countries.

For example, there is a 35-fold difference between the anesthesia provider workforce density in Germany compared with the Democratic Republic of Congo, and a 50-fold difference between the workforce density in the United States compared with Indonesia, despite comparable population sizes. While the United States has more than 100,000 anesthesia providers, Indonesia has only 1,950 to serve the whole population of 323.9 million and 258.3 million respectively.

Of the countries reporting a total anesthesia provider number of less than 6 per 100,000 population, none are in the North American or European regions. Instead, most are located in Sub-Saharan Africa, the West Pacific, the Caribbean, Central America and South America, South East Asia, North Africa, the Middle East and West Asia, where many countries and regions face anesthesia and surgical workforce shortages.

"The crisis in anesthesia is perhaps most apparent in terms of workforce. Safe anesthesia requires a trained provider and yet across large parts of Sub-Saharan Africa, South-East Asia, and beyond, ratios of far less than 1 trained provider per 100,000 population are commonplace. In high income countries, we are used to ratios of 20 per 100,000 or higher, and we experience very low mortality from anesthesia, yet in low income countries we actually have examples of there being 1,000 times fewer trained providers and 1,000 times higher mortality rates. It is wrong." Julian Gore-Booth, WFSA Chief Executive, explained.

Dr Wayne Morriss, Director of Programs at the WFSA, shared the significance of the findings: "We know that there is a problem, and we know that there is a solution. Anesthesia provision is affordable with research from the World Bank highlighting a return on investment as high as ten to one. The map shows that substantial investment in educating anesthesia providers is required as soon as possible, and the WFSA is well placed to work with the WHO, its own member societies, other specialist medical organizations, governments, NGOs and country level health systems to correct the workforce gap and achieve safe anesthesia for all by 2030."; Source: World Federation of Societies of Anesthesiologists

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