Background: Knowing how anesthesia is practiced is a necessary starting point for improving how it is delivered. Our objective is to provide an overview of how anesthesiology is performed and has developed in Ghana based on data from multiple surveys collected over the past 10 years. This information will outline the current state of anesthesia care in Ghana and help to identify directions in which to pursue improved anesthesia care in Ghana and other low resource countries.
Methods: Surveys were administered every three years from 2006 to 2016 to participants of the annual anesthesia refresher course in Kumasi, Ghana. The assessments were completed by nurse anesthetists and anesthesiologists in attendance from various regions in Ghana. They were surveyed about available medications, equipment, personnel, and infrastructure at their facility.
Results: Overall there was a reported increase in resource availability from 2006 to 2016. The majority of respondents described improved, yet still limited access to essential anesthesiology supplies such as anesthesia machines,airway equipment, and medications. Over the last 10 years, access to medications has improved, with a 10-26% increase in availability reported for ketamine, thiopental, succinylcholine, pethidine and bupivicaine, which are now available at 90% of institutions. The largest increases in availability occurred with propofol, midazolam, and isoflurane, which increased by over 50%. Many respondents noted shortages during the post-operative period with limited or lack of recovery rooms and monitors. In 2015 compared to 2006, the highest reported needs were for anesthesia machines (40%), monitors (36%), ventilators (26%), recovery rooms (25%), personnel (13%), and trained anesthetists (11%).
Conclusion: The results of our questionnaire show that anesthetic care in Ghana is still vastly under equipped, although access to vital equipment and medications appears to be improving. With increased access to resources intra-operatively,the focus is now more on the perioperative period with shortages reported for monitors, recovery rooms, and adequately trained personnel. Exploring the stimuli for such changes in availability of equipment, medications and personnel could inform future healthcare policies in Ghana, and current policies in less developed healthcare systems.
