Provision of anesthesia services for emergency obstetric care through task shifting in South Asia
Abstract
Anaesthesia is required for certain procedures in emergency obstetric care, such as
caesarean section and the repair of ruptured uterus. Task shifting for provision of anaesthesia has
been implemented in public sector rural hospitals of South Asia in recent years because of
significant shortages of anaesthetists, but there has been limited research on this issue. This paper
reviews the literature on this topic and documents existing programmes for task shifting anaesthesia
services to mid-level providers in South Asia to increase access to emergency obstetric care and
reduce maternal mortality. We found that task shifting of anaesthesia services has been effective
in expanding coverage and access to care in South Asia, but most programmes have not been
implemented systematically as part of an overall human resources strategy. A comprehensive
approach, to maximise the benefits of these programmes, calls for countries to appoint a director
at national or state level who is responsible for the availability of anaesthesia services in rural
areas; legal protections, licensing by a competent authority and registration to perform anaesthesia
services, including prescription of anaesthesia drugs; supportive managerial arrangements,
competency-based training, monitoring and evaluation; performance rewards, career structure and
job clarity; adequate equipment and supplies; support from specialist anaesthetists and quality
assurance for safety
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