THATTA: A comprehensive survey has revealed a serious shortage of qualified anaesthesiologists in district and tehsil (taluka) hospitals across Sindh, Dawn learnt here on Sunday.

Prof Dr Amin Khwaja, head of the anaesthesiology department of the National Institute of Cardiovascular Diseases (NICVD), and a number of others compilers of the survey report told this scribe during their visit of Makli, Thatta, that the survey was jointly compiled by Rafia Tabassum, Ahmed Soomro, Raja Diloo, Kelash Kumar, Jamil Ahmed and Fauzia Khan.

The report was prepared under title “Assessment of Anesthesia Workforce Capacity in District and Tehsil (Taluka) Hospitals of Sindh”.

Conducted by a team of anesthesiologists, the study aimed at assessing the current availability of human resources for anaesthesia services at secondary care hospitals and identifying gaps that compromise the delivery of safe anaesthesia care.

According to the report, only 54 out of 72 hospitals surveyed (75pc) had a full-time anaesthesia physician, with 32 hospitals having only one such specialist. The survey encompassed 90 taluka and district hospitals, which collectively house 201 operating rooms, 18 of which do not have any operation theatres.

Prof Fauzia Khan, one of the lead authors, stated: “Our findings underscore a significant deficit in anaesthesia workforce across secondary care hospitals in Sindh. The situation is alarming as these facilities are crucial for providing accessible surgical care to the majority of the population, especially those in smaller towns and rural areas.”

The data collected highlighted that 23 hospitals were relying on non-specialist physician anesthesiologists who had not completed their certification exams. Furthermore, there were instances where anaesthesia services were provided by medical professionals with no formal training in anesthesiology.

Prof Amin Khuwaja elaborated on the methodology: “We conducted a cross-sectional survey using a structured questionnaire tailored for secondary care hospitals. The survey tool was based on the World Federation of Societies of Anesthesiologists’ guidelines but adapted to local needs by our committee.”

The study revealed that the overall anaesthesia physician workforce density in Sindh to be only 0.26 per 100,000 population, which is far below the recommended standards. Profess Rafia Tabassum pointed out: “The ratio of qualified full-time anesthesiologists to surgeons is 1:1.8, and to obstetricians, it’s 1:1.4. Such disparity leads to work overload and potential burnout among the few available anesthesiologists.”

Given the critical shortage, the survey suggests several measures to address the gap. These include task-sharing models where family practitioners or nurses could be trained in basic anaesthesia practices, economic incentives to attract anesthesiologists to rural areas, and the establishment of continuous professional development programmes.

Prof Ahmed Soomro stressed the need for long-term planning, “To meet the goal of universal access to safe surgery by 2030, we must enhance access to safe anesthesia care. This requires a concerted effort in workforce planning, training, and infrastructure development.”

The team members told Dawnthat Sindh was the second largest province of Pakistan. According to the last census conducted in 2017, they disclosed the population of Sindh was 47.9 million with an urban population of 52pc. It has seven divisions and 29 districts, and at present the state of readiness of these hospitals to respond to anaesthesia care needs of the population was diminished.

The survey’s strength lies in its pioneering nature, being the first of its kind in Pakistan to systematically document the anaesthesia workforce in secondary care hospitals. However, the authors note limitations.

Published in Dawn, June 3rd, 2024